Practice guidelines for direct attention training

This article is part of a series of reports from a committee charged with developing evidence-based practice (EBP) guidelines for rehabilitation of cognitive-communication deficits following traumatic brain injury (TBI). We examine the literature for evidence of the effectiveness of direct attention training to treat attention impairments following TBI. Evidence is gleaned from the outcomes of nine Class I and Class II studies that span intervention from acute to outpatient rehabilitation. Results and discussion are organized using five key questions as a mechanism to review the research to determine if the approach, outcomes, and associated recommendations warrant a change in clinical practice. The key questions are: Who are the participants who received the intervention? What comprises the attention training? What are the outcomes of the intervention? Are there methodological concerns? Are there clinically applicable trends across different attention remediation studies? The complexities and difficulties inherent in implementing clinical trials with the heterogeneous TBI population are discussed. The article concludes with treatment guidelines and options supported by the research review. Future research needs are highlighted.