Implementation of an attention training program with children who have sustained traumatic brain injuries in South Africa

Master Thesis

2015

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University of Cape Town

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Traumatic brain injury (TBI) is an international public health concern, particularly in lowand middle-income countries. Children who sustain TBIs typically have attentional difficulties, which disrupt the development and functioning of other cognitive, behavioural, and social skills. The aim of this research was to evaluate the efficacy and feasibility of implementing an attention-training program for children who have sustained moderate-tosevere TBI in South Africa, and to compare the efficacy of the program in two clinical samples: children with TBI and children with Attention Deficit Hyperactivity Disorder (ADHD). Fifteen children aged 6 to 8 who sustained TBIs at least a year before were recruited to form three groups: a TBI Intervention Group (n=5), a TBI Art Group (n=5) and a TBI Control Group (n=5). Five children who had been diagnosed with ADHD formed the ADHD Intervention Group. Children in the two Intervention Groups participated in the ‘Pay Attention!’ program (originally designed to assist children with ADHD) for 45 minutes twice a week for 12 weeks. All children underwent neuropsychological testing pre- and postintervention and behavioural data was collected from parents and teachers. Between- and within-group analyses showed that children in the TBI Intervention group did not show overall significant improvements in attention. However, children in the ADHD Intervention Group showed individual attentional improvements on measures of the CPT-II, as well as secondary gains in verbal memory. Nevertheless, implementing a cognitive rehabilitation intervention in South Africa is feasible and necessary, despite limited infrastructure and access to resources. Further research is required to better tailor interventions to the needs of children with TBIs.
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