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The influence of methylphenidate on sustained attention in paediatric acquired brain injury: a meta-analytical review

Lookup NU author(s): Alexander Hagan, Dr Sarah Verity


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Impairment in sustained attention is a common consequence of childhood Acquired Brain Injury (ABI). Whilst methylphenidate provides promise in enhancing “attention” as a unitary construct, little work has explored its effectiveness upon individual attentional domains. The current systematic review and meta-analysis evaluates the utility of methylphenidate on sustained attentional performance across childhood ABI groups. Five databases (PsycINFO, MEDLINE, Embase, Scopus & Cochrane Library) were searched for relevant articles from their inception to March 2022. A purpose-developed evaluation tool was used to assess each study’s research quality (QuEST:MAP). Nine of the 1600 identified articles were included within this review (n = 259). Meta-analytical findings reported an overall significant benefit of methylphenidate on sustained attention in childhood ABI (g = −0.33, 95% CI: −0.62 to −0.04). Associated summary effect sizes were relatively small, particularly when adjusting for outlier cases. Subgroup analyses identified a significantly greater benefit of methylphenidate in clinical subgroups with comorbid ADHD diagnoses (p < .01). The current evidence base is characterized by small-scale clinical trials with variable research quality and low generalizability. Further robust research is needed to quantify methylphenidate utility upon individual attentional domains in larger and more representative ABI samples.

Publication metadata

Author(s): Hagan AJ, Verity SJ

Publication type: Review

Publication status: Published

Journal: Child Neuropsychology

Year: 2023

Volume: 29

Issue: 5

Pages: 710-741

Online publication date: 24/08/2022

Acceptance date: 08/08/2022

ISSN (print): 0929-7049

ISSN (electronic): 744-4136


DOI: 10.1080/09297049.2022.2112559