Attention and memory training in children with acquired brain injuries I van’t Hooft 1 , K Andersson 1 , T Sejersen 1 , A Bartfai 2 and L von Wendt 1 Neuropediatric Unit 1 , Astrid Lindgren’s Children’s Hospital, Karolinska Hospital; University Hospital 2 , Huddinge, Stockholm, Sweden van’t Hooft I, Andersson K, Sejersen T, Bartfai A, von Wendt L. Attention and memory training in children with acquired brain injuries. Acta Pædiatr 2003; 92: 935–940. Stockholm. ISSN 0803– 5253 Aim: To test the feasibility of the Amsterdam memory and attention training for children (Amat-c) in Swedish children with acquired brain damage. Methods: Amat-c consists of structured exercises in specific attention and memory techniques. Three Swedish children aged 9–16 y with acquired brain injuries and related memory and attention deficits trained with the Amat-c method for half an hour a day in school or at home interactively with a teacher or parent for a period of 20 wk. Results: All children and their coaches completed the training without interruption. The results showed an improvement in several neuropsychological tests of sustained and selective attention as well as in memory performance. Questionnaires filled in by parents and teachers indicate that, using the Amat-c method, the children learned strategies that improved their school achievement and self-image. Conclusions: The Amat-c is a valuable treatment option for improving cognitive efficiency in children with acquired brain injuries. The results indicate improved performance in several psychometric measurements. On the basis of these results, the second step will be to modify the complexity and duration of the method, as well as to integrate a reward system before further evaluating the efficacy in a larger controlled study. Key words: Children, CNS malignancies, cognitive rehabilitation, neuropsychological assessment, trauma Ingrid van’t Hooft, Neuropsychiatric Unit, Astrid Lindgren’s Children’s Hospital, Karolinska Hospital, SE-171 76 Stockholm, Sweden (Tel. 46 8 5177 7538, fax. 46 8 5177 7544, e-mail. ingrid.vant.hooft@bup.sll.se) The concept “acquired brain injury” (ABI) is used for conditions arising postnatally owing to trauma, infections, vascular catastrophies or malignancy. Up to 50% of patients with ABI have been reported to have neuropsychological sequelae (7). Deficits in attention and memory are the most common cognitive dysfunctions in ABI and often contribute to sig- nificant disability both in adults (1, 2) and children (3–7). Brain injury in children not only disrupts established functions but also affects functions that are in the process of developing and those that have yet to emerge (8–10). Children that appear to have fully recovered from brain injury may, over time, demonstrate deterio- ration in cognitive, behavioural and/or socio-emotional functioning (11, 12). Memory and attention are crucial for learning; deficits in these functions have a major negative influence on academic and social adjustment. Another major difficulty frequently reported following ABI is decreased speed of information processing. It has been suggested that slow processing speed limits attention capacity (13). Problems with working memory have also been described following injury to frontal brain systems (14). Cognitive remediation, rehabilitation and retraining are all terms that refer to systematic therapeutic efforts designed to improve cognitive functions (15–17). There are few studies investigating the use of cognitive training in children (18–20). Moreover, currently available training methods for children are often versions of material designed for adults. Hendriks et al. (20) developed an intervention programme, the Amsterdam Memory and Attention Training for children (AMAT-c), at the Amsterdam Academic Hospital. This programme is the first method specifically designed for children and is based on a modified model from Sohlberg and Mateer (15) differentiating attention on three levels: sustained attention, selective attention and mental tracking. In the AMAT-c programme these three levels of attention as well as three levels of memory functions—the sensory register, working memory and long-term memory—are being trained. The AMAT-c combines  2003 Taylor & Francis. ISSN 0803-5253 Acta Pñdiatr 92: 935±940. 2003 DOI 10.1080/08035250310004586