Research Reports - Interventions for attention problems after pediatric traumatic brain injury

PM R. 2014 Sep;6(9):814-824

Backeljauw B(1), Kurowski BG(2)

OBJECTIVE: 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 recommendations for future research.
TYPE: Focused systematic review.
LITERATURE SURVEY: 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.
METHODOLOGY: 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 recommendations for evidence grading.
SYNTHESIS: 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.
CONCLUSIONS: There are studies that demonstrate 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 guide
management of attention problems after pediatric TBI. Larger randomized,
controlled trials and multicenter studies are needed to elucidate optimal
treatment strategies in this population.

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