Interventions for Attention Problems After Pediatric Traumatic Brain Injury

This study attempted to gain an understanding of the current state of the evidence for management of attention problems after traumatic brain injury (TBI) in children, determine gaps in the literature, and make suggestions for future research. PubMed/Medline and PsychINFO databases were searched for relevant articles published in English during the last 20 years. Keywords included “attention” “attention deficit and disruptive behavior disorders,” and “brain injuries.” Studies were limited to children. Titles were examined first and eliminated based on lack of relevancy to attention problems after brain injury in children. This was followed by an abstract and full text review. Article quality was determined based on the US Preventative Services Task Force suggestions for evidence grading. Four pharmacologic and 10 cognitive therapy intervention studies were identified. These studies varied in level of evidence quality but were primarily nonrandomized or cohort studies.

There are studies that exhibit benefits of varying pharmacologic and cognitive therapies for the management of attention problems after TBI. However, there is a paucity of evidence available to definitively direct management of attention problems after pediatric TBI. Larger randomized, controlled trials and multicenter studies are required to elucidate optimal treatment strategies in this population.