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Advanced neuropsychological rehabilitation of executive functions in attention deficit hyperactivity disorder: A scoping review

(2023)

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Abstract
Background: ADHD, a prevalent, disabling and consequently costly disorder has witnessed improvements through neuropsychological cognitive training approaches. This rehabilitation method is expanding and gaining research attention, particularly due to the incorporation of technology such as virtual reality and serious games in ADHD assessment and rehabilitation, which has demonstrated positive outcomes. While other cognitive functions such as attention and memory have received more extensive study, executive function (EF), an underlying aspect of ADHD symptomatology, has not garnered the same level of investigation. Objectives: The objective of this scoping review is the exploration and synthesis of the literature concerning advanced EF rehabilitation instruments for individuals with ADHD. We hoped to extract from our study, the trends and contributions of these instruments to the field of ADHD rehabilitation in the hopes of providing a comprehensive source of information regarding advancement in a domain seemingly lacking concise evidence. Design: A scoping review methodology was chosen to investigate the gap of literature seeming to emerge. Three search strategies were applied to three electronic databases: PubMed, Scopus, and Embase, from which, 81 articles were found. The application of the rigorous PRISMA-ScR study selection process resulted in the inclusion of 13 articles in the scoping review. We extracted the obtained data and organized them in tabular format and then proceeded to discuss these results in light of the literature surrounding advanced rehabilitation of EF in ADHD populations. Results: This scoping review resulted in the extraction of 12 instruments revealing the trends in this field of literature. We found that the majority of these instruments were VR-based, child-focused and targeted EF, notably inhibition, alongside other cognitive functions. Half of these instruments report significant effects on ADHD symptomatology. Conclusion: The literature presents encouraging outcomes, marked by the observation of significant effects from advanced rehabilitation in ADHD symptoms, and an observable increase in scholarly focus on executive function (EF). However, it's important to note that these studies and tools are still in the early stages of development, often involving modest sample sizes, and some study designs lacking rigor.