A comprehensive analysis in Nature reveals that multicomponent programmes and cognitive training may enhance attention and self-control in children with ADHD, offering promising alternatives alongside medication.
A new analysis in Nature suggests that some non-drug approaches may do more than ease behaviour in children with attention-deficit/hyperactivity disorder: they may also improve performance on objective attention and executive function tasks. The study, which pooled 86 randomised reports involving 4,628 children and adolescents aged six to 18, found the clearest gains for multicomponent programmes and cognitive training, particularly on inhibitory control and sustained attention.
The authors used a Bayesian network meta-analysis to compare eight broad intervention groups, including cognitive training, neurofeedback, physical activity and motor training, and combined behavioural and educational approaches. They focused on task-based outcomes rather than symptom ratings alone, with results assessed shortly after treatment ended. Inhibitory control improved most consistently with multicomponent programmes, cognitive training and physical activity or motor training, while cognitive training also showed a smaller benefit for working memory. For sustained attention, multicomponent interventions produced the largest effect, with additional gains seen for cognitive training and neurofeedback.
The findings matter because earlier reviews of non-pharmacological ADHD treatments have often judged the evidence to be mixed or uncertain. A 2017 systematic review found no clear benefit for omega fatty acids on parent- or teacher-rated symptoms, while other reviews concluded that several psychological, dietary and complementary approaches showed at best limited or inconsistent effects. More recent work has also suggested that medication may not reliably improve executive function itself, leaving room for interventions that target these skills more directly.
Even so, the authors cautioned that the evidence was less convincing for higher-order executive skills such as planning, and for processing speed and reaction-time variability. Their exploratory analysis did not show a clear link between study-level age or the share of male participants and the stronger effects seen in some domains. That means the results should not be read as proof of age-specific or sex-specific treatment benefits for individual children. For parents and clinicians, the broader message is more restrained: non-drug interventions are not a substitute for careful assessment and, when needed, medication, but some structured programmes may help children perform better on tasks that depend on attention and self-control.
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