Computerised Attention Functions Training Versus Computerised Executive Functions Training for Children with Attention Deficit/Hyperactivity Disorder: A Randomised Controlled Trial

Background: Attention deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by deficits in attention, hyperactivity, and impulsivity. Current treatments, such as stimulant medication and behavioural therapy, ameliorate symptoms but do not address the core cognitive dysfunctions. This study aimed to investigate the effects of two computerised neurocognitive training programs, attention functions training and executive functions training, in children with ADHD. Methods: Eighty children with ADHD (ages 8-13) were randomly assigned to one of three groups: Attention functions training (AFT), targeting sustained, selective-spatial, orienting, and executive attention; executive functions training (EFT), focusing on working memory, cognitive flexibility, and problem solving; or a passive control group. Training sessions were administered in small groups twice a week for nine weeks. Participants underwent comprehensive assessments of attention (Continuous Performance Test, Conjunctive Visual Search Task), executive functions (Corsi Block-Tapping Tasks), nonverbal reasoning (Raven's Colored Progressive Matrices), parent-rated behavioural symptoms, and arithmetic performance at baseline, post-intervention, and follow-up. Results: The AFT group demonstrated significant improvements in sustained and selective-spatial attention, nonverbal reasoning, inattentive symptoms, and arithmetic performance, and most improvements persisted at follow-up. The EFT group showed gains in nonverbal reasoning and inattentive symptoms, although no improvements were documented in working memory or in parent ratings of executive functions. Conclusions: The AFT program that addressed core attentional functions in children with ADHD produced robust cognitive and behavioural benefits, whereas the EFT program yielded behavioural benefits and a limited improvement in executive functions. Future research should explore different training protocols for broader gains in executive functions. These findings support the potential of theory-driven, structured neurocognitive training targeting basic cognitive functions as an effective small-group intervention for ADHD.