To appear in the P. McCardle, L. Freund, and J. a. Griffin (Eds.

) Executive
Function in Preschool Age Children: Integrating Measurement,
Neurodevelopment and Translational Research, APA Press.

Development of Selective Sustained Attention: The Role of Executive Functions

Anna Fisher¹ and Heidi Kloos²

¹Carnegie Mellon University; ²University of Cincinnati

Please address correspondence to: Anna Fisher, 335-I, Baker Hall, Department of Psychology,
Carnegie Mellon University, Pittsburgh PA 15232, [email protected]
Development of Selective Sustained Attention: Draft 1

Attention is a multi-faceted construct which notoriously lacks a commonly agreed upon

definition. Nonetheless, there is a widespread agreement that attention is central to human

performance. Several sub-functions of attention are commonly distinguished, including alerting

(i.e., achieving high sensitivity to incoming stimuli), orienting (i.e., selecting information from

sensory input), and executive (or endogenous) attention (i.e., monitoring/resolving cognitive

conflict and directing cognitive resources on a volitional basis) (Colombo & Cheatham, 2006;

Posner & Petersen, 1990; Posner & Rothbart, 2007). Some theories of attention also include

maintenance (i.e., sustaining attention) as a separate sub-function (Kahneman 1973), although

others consider it as a part of the alerting function (Posner & Peterson, 1990; Posner & Rothbart,

2007) or the executive function (Colombo & Cheatham, 2006).

The focus of this chapter is the type of attention that is both selective (as opposed to

divided over multiple tasks) and sustained (i.e., extended over time as opposed to extremely

brief, as in visual search which can typically be accomplished in several hundred milliseconds).

Selective sustained attention, which has also been referred to as focused attention in the infancy

literature (e.g., Colombo & Cheatham, 2006; Oakes, Kannass, & Shaddy, 2002; Ruff &

Rothbart, 2001; Tellinghuisen, Oakes, & Tjebkes, 1999), is the ability to maintain focus on a

single object, task, or sensory channel for an extended period of time. It is a crucially important

ability that has been implicated in learning across development – from the crib to the classroom

and beyond (e.g., Kupietz & Richardson, 1978; Oakes, Kannass, & Shaddy, 2002). As Oakes et

al. (2002) put it), “if attention were constantly reoriented to every new event, it would be

difficult … to learn about any single object or event” (p.1644). This chapter reviews extant

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research on the development of selective sustained attention and discusses research opportunities

in furthering our understanding of this important ability.

Theoretical Perspectives on Selective Sustained Attention

Ruff and Rothbart (2001) proposed that selective sustained attention is subserved by two

systems that are anatomically and neurally separate: the orienting system and the executive

control system. These two systems are said to have different maturation schedules, with the

orienting system maturing during infancy and the executive control system following a

protracted maturational schedule that extends into adolescence (Diamond, 2002; Luna, 2009;

Posner & Rothbart, 2007). Therefore, the orienting system is assumed to subserve selective

sustained attention early in life, whereas the executive control system becomes increasingly

important later in development.

2.1. Two-Systems Theory of Selective Sustained Attention

Orienting in infants is often characterized as stimulus-driven or automatic (i.e., driven by

exogenous factors), rather than participant-driven or voluntary (i.e., driven by endogenous

factors). That is to say, the locus of attention in newborns and young infants is determined

largely by the properties of the stimulus, such as its frequency and duration for auditory stimuli,

and intensity, degree of curvature, and brightness for visual stimuli (Bornstein, 1990; Ruff &

Rothbart, 2001). This lack of intentionally guided attention is furthermore illustrated by the

phenomenon called obligatory looking: Once a visual stimulus “grabs” attention, 1- to 2-month-

old infants often find it difficult to disengage attention, and unlimited exposure to attention-

grabbing stimuli may result in prolonged looking ending in considerable distress (Colombo,

2001; Stechler & Latz, 1966). Obligatory looking diminishes after 2 months of age suggesting

development of some degree of control over disengagement of attention. Similarly, control over

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engagement of attention also develops during the first months of life. For example, unlike 4-

month-old infants, 6-month-olds are capable of both reactionary saccades (saccades in response

to the appearing target) and anticipatory saccades (saccades to the anticipated location of a yet

invisible target) (Johnson, Amso, & Slemmer, 2003).

According to Ruff & Rothbart (2001), periods of selective sustained attention in early

infancy are “a prolongation of the orienting response, sustained as long as the object retains some

novelty” (p.114). Consequently, early in life sustained attention is at its maximum when objects

are novel; termination of sustained attention is particularly likely if there is competition from

another novel object or event (Richards, 1988).

There is a general agreement in the literature that between 9 and 12 months of age many

cognitive processes, including selective sustained attention, gradually come “under control of

both systems rather than one” (Ruff & Rothbart, 2001, p.117; see also Colombo & Cheatham,

2006; Diamond, 2006; Oakes et al., 2002). There is also agreement that the ability to sustain

attention in a voluntary fashion is supported by higher-order cognitive functions that are

typically characterized as executive functions, namely inhibition and working memory. It has

been argued that sustaining attention to an object or a task requires inhibition of orienting to

irrelevant objects and events (Colombo & Cheatham, 2006; Kane & Engle, 2002; Ruff &

Rothbart, 2001). Inhibition is traditionally considered one of the core executive functions (e.g.,

Miyake et al., 2000; although see MacLeod, Dodd, Sheard, Wilson, & Bibi, 2003 for divergent

arguments), and persistent correlations between level of inhibitory control and sustained

attention have been documented in children as well as adults (Barkley, 1997; Hrabok, Kerns, &

Müller, 2007; Reck & Hund, 2011).

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Development of Selective Sustained Attention: Draft 1

Working memory, another of the core of executive functions, is also considered to be a

key component in the ability to voluntarily sustain attention (Colombo & Cheatham, 2006; Kane

& Engle, 2002): one needs to maintain an active representation of a goal in order to organize

behavior to achieve this goal. However, Colombo & Cheatham (2006) also argued that the

linkages between selective sustained attention and memory are bi-directional, as memory “can

serve as a basis for the distribution of attentional resources” and “sustained allocation of

attention to a stimulus allows for the establishment of an enduring memory trace” (p. 300).

Neural Bases of the Two Systems of Attention

Functional neuroimaging data provide support to the proposal that the orienting and

executive systems of attention involve distinct anatomical regions and chemical modulators

(Colombo & Cheatham, 2006; Fan, McCandliss, Fossella, Flombaum, & Posner, 2005; Posner &

Rothbart, 2007). In humans, brain injury to posterior parietal lobe, superior colliculus, or lateral

pulvinar nucleus of the thalamus impairs the ability to shift attention covertly (i.e., in the absence

of shifting one’s eyes; Posner & Peterson, 1990). However, injury to these brain regions impairs

orienting in different ways. Specifically, damage to the posterior parietal lobe produces the

greatest impairment in the ability to disengage attention from target stimuli contralateral to the

side of the lesion. In contrast, progressive deterioration in the superior colliculus leads to a

deficit in the ability to shift attention, regardless of whether attention was first engaged elsewhere

or not. Yet a different pattern is found in patients with lesions of the thalamus, who exhibit

difficulties in engaging attention to a target stimuli contralateral to the side of the lesion (Posner

& Peterson, 1990).

The executive control system is traditionally associated with prefrontal cortex (PFC) and

anterior cingulate gyrus (e.g., Diamond, 2002; Miller & Cohen, 2001; Posner & Rothbart, 2007).

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Development of Selective Sustained Attention: Draft 1

PFC damage has long been known to produce profound deficits in goal-directed behavior.

Patients with prefrontal damage exhibit difficulties in classic tasks assessing executive

functioning, such as Stroop, Wisconsin Card Sorting Task, and Tower of London (Miller &

Cohen, 2011). With regards to its maturation, PFC is said to undergo “one of the longest periods

of development of any brain region, taking over two decades to reach full maturity” (Diamond,

2002, p. 466). Evidence for protracted maturation of the PFC comes from the postmortem studies

of myelination, examination of resting levels of glucose metabolism, and studies of

synaptogenesis and gray matter reduction (for review see Casey, Giedd, & Thomas, 2000).

Studies of chemical modulation of attention networks are often carried out on alert

animals which can perform a variety of attention tasks after being injected with various

neuromodulators. Chemical modulation in the brain regions associated with the orienting

network has been linked to the neurotransmitter acetylcholine (for review see Davidson &

Marrocco, 2000). For example, blocking cholinergic receptors with scopolamine, an

anticholinergic drug, impairs orienting and sustained attention in rhesus monkeys and rats

(Callahan, Kinsora, Harbaugh, Reeder, & Davis, 1993; Jones & Higgins, 1995). Similarly,

reduction in cholinergic neurotransmission through selective lesions in monkeys and rats leads to

impaired orienting but not learning or working memory (Chiba, Bushnell, Oshiro, & Gallagher,

1999; Voytko et al., 1994). Finally, direct injections of scopolamine into the lateral intra-parietal

area of rhesus monkeys have been shown to produce dose-dependent increases in reaction times

and decreases in accuracy during visual orienting tasks (Davidson & Marrocco, 2000).

In contrast, chemical modulation in the prefrontal cortex is linked to the neurotransmitter

dopamine. For example, local injections of selective dopamine antagonists into the prefrontal

cortex in rhesus monkeys led to dose-dependent increases of error rates and reaction time on

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Development of Selective Sustained Attention: Draft 1

working memory tasks but not on control tasks (Sawaguchi & Goldman-Rakic, 1991); similar

findings have been obtained in rats (Seamans, Floresco, & Phillips, 1998). Furthermore, when

infant rhesus monkeys show improvement in performance on several tasks thought to involve

prefrontal cortex, there is also a concomitant increase in the level of dopamine and density of

dopamine receptors in their prefrontal cortex (for a review see Diamond, 2002). In human

infants, reduced dopamine level in prefrontal cortex is associated with reduced level of

performance on tasks requiring working memory and response inhibition (Diamond, Briand,

Fosella, & Gehlbach, 2004; Diamond, Prevor, Callender, & Druin, 1997).

Finally, several recent neuroimaging and genetic studies have established linkages

between specific genes, neurotransmitters, and attention networks (for review see Posner &

Rothbart, 2007). Many genes exhibit variants, or polymorphisms, which are relatively high in

frequency. These polymorphisms are thought to lead to different efficiency of cholinergic and

dopaminergic modulation, and in turn to individual differences in performance on attention tasks.

Several studies have linked specific genes and gene polymorphisms to modulation of orienting

through acetylcholine, and executive control through dopamine (Diamond et al., 2004;

Parasuraman, Greenwood, Kumar, & Fossella, 2005).

Summary

Overall, selective sustained attention is commonly thought to be subserved by two

distinct systems of attention, the orienting system and the executive system. Neuroimaging and

neurophysiological studies suggest that these systems involve distinct anatomical regions and

different maturation schedules. Specifically, the executive system (subserved by the prefrontal

cortex and anterior cingulate gyrus) is thought to follow a more protracted maturational schedule

than the orienting system (subserved by the posterior parietal lobe, superior colliculus, and

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Development of Selective Sustained Attention: Draft 1

lateral pulvinar nucleus of the thalamus). Neuroimaging and genetic studies indicate that these

two systems also involve distinct chemical modulators, with the executive system being linked to

dopamine and the orienting system to acetylcholine.

Selective Sustained Attention across the Lifespan

Characterizing selective sustained attention at different points in development often

involves drastically different research paradigms. Therefore, this part of the chapter is organized

around different types of measures that have been used to study selective sustained attention

from infancy to adulthood.

Looking-Based Measurement of Selective Sustained Attention

This section summarizes research on selective sustained attention that is based on, or

involves to a large degree, measures of looking behavior. Looking has been traditionally used to

investigate different aspects of visual attention across the lifespan (for reviews see Colombo,

2001; Henderson & Ferreira, 2004; Just & Carpenter, 1976), and there is evidence that visual

attention and saccadic eye movements rely on the same neural mechanisms (Corbetta et al.,

1998). Furthermore, looking is sometimes used as a behavioral measure of auditory attention as

well (e.g., Reisberg, 1978; Saffran, Newport, & Aslin, 1996; Spelke, 1976).

Ample evidence suggests that selective sustained attention is present in young infants,

including newborns. For example, when newborns (averaging less than 40 minutes after birth at

the moment of testing) are presented with moving schematic face-like images and scrambled

images (containing the same features as the face-like stimuli), newborns turn their head and eyes

to track both kinds of stimuli, although more so for the face-like images (Goren, Sarty, & Wu,

1975; Johnson, Dziurawiec, Ellis, & Morton, 1991). The findings resulting from this paradigm

are usually presented in terms of degree of head and eye rotation rather than duration of visual

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attention; however, based on the reported results it is possible to estimate that newborns can

sustain attention to face-like stimuli for up to 9 seconds (mean reported eye rotation was

approximately 45° and stimuli were moved at 5° per second; Johnson et al., 1991).

Measuring infants’ looking and heart rate, Richards and colleagues (e.g., Richards, 1987;

Richards & Casey, 1988) identified different attentional states in 2- to 6-month-old infants

including: pre-attention, orienting, sustained attention, and attention termination. In this

paradigm, animated stimuli (e.g., a Sesame Street recording or a series of sequentially appearing

and disappearing concentric squares) were presented to infants on a TV monitor. Results

indicated that rapid heart-rate deceleration accompanied initial orienting to a stimulus; slower

heart rate was maintained throughout the sustained attention phase and heart rate returned to

baseline level when attention was terminated (for a review see Richards, 2003). Such changes in

heart rate show that selective sustained attention to dynamic events in 2- to 6-month-old infants

can last from 2 up to 120 seconds, with duration of sustained attention influenced by the state of

an infant during testing, stimulus novelty and complexity, as well as individual differences.

With regard to static two-dimensional images, a steady age-related decrease in looking

duration was found during the first 6 months of life (Colombo & Cheatham, 2006). This decrease

is traditionally attributed to improved efficiency of processing with development: the more

efficiently an infant can encode the features of an object or event, the shorter looking duration is

required to do so. This possibility is supported by negative correlations between duration of

looking early in the first year of life and later cognitive outcomes (i.e., IQ and language

development) (for a review see Bornstein, 1990).

However, it has also been shown that between approximately six months and three years

of age duration of looking to static images steadily increases (Colombo & Cheatham, 2006).

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Development of Selective Sustained Attention: Draft 1

Furthermore, beyond age one, the correlations between looking duration and cognitive outcomes

are positive, such that longer looking predicts better learning (Dixon & Salley, 2007), problem

solving (Kannass & Colombo, 2007), and better cognitive outcomes later in development

(Lawson & Ruff, 2004).

Colombo and Cheatham (2006) suggest that nonlinear changes in looking duration during

infancy provide support for the hypothesized shift in the locus of attentional control. In

particular, they suggest that the U-shaped curve of looking duration in infancy stems from a

change in the processes underlying selective sustained attention – from reflexive/endogenous to

voluntary/exogenous. According to this proposal, while initial decrease in looking duration over

the first six months of life likely reflects improved encoding efficiency, the increase in looking

duration over the next 3 years likely reflects “the ability to voluntarily sustain or maintain

attention to an object, either in response to the object’s properties or to some short-term goal”

(Colombo & Cheatham, 2006, p. 294).

There has also been reported a developmental increase in duration of looking at a blank

screen in anticipation of a rewarding stimulus. Goldman, Shapiro, and Nelson (2004) developed

a computerized measure of sustained attention for toddlers and young children - the Early

Childhood Vigilance Task (ECVT). In this task children need to look at a computer screen in the

absence of stimuli in order to view interesting stimuli (e.g., moving cartoon characters) when

they appear: the better children are able to sustain attention to the blank screen in 5- to 15-second

intervals between cartoons, the more likely children are to view the short cartoons when they

appear on the screen. Children are videotaped during the task and their looking is later analyzed

to determine the total duration of time children spent looking toward the computer screen. With a

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Development of Selective Sustained Attention: Draft 1

sample of 12- to 46-month-old children, Goldman et al. (2004) found a significant age-related

increase in total looking towards the screen on the ECVT.

Play-Based Measurement of Selective Sustained Attention

Developmental studies of selective sustained attention often use elaborate coding

schemes to determine the attentional state of a participant, typically during free play. The coding

schemes commonly distinguish between selective sustained (or focused) attention and casual

attention. Selective sustained attention is measured by coding a child’s direction of gaze and

behavior, including facial expressions that are intent or show concentration or interest (knitted

brows, lip biting), body movement changes such as minimal extraneous movement, postural

enclosure of the object, or leaning toward while gazing at the object (Choudhury & Gorman,

2000; Oakes, at al., 2002; Ruff & Capozzoli, 2003; Ruff & Rothbart, 2001; Tellinghuisen,

Oakes, & Tjebkes, 1999). Studies that utilized coding schemes similar to the one described

above point to a steady increase in duration of selective sustained attention, from approximately

2 minutes in 21-month-old infants to 4 minutes in 2- and 3-year-old children, and to over 9

minutes in 5- and 6-year-olds (Choudhury& Gorman, 2000; Ruff & Lawson, 1990; Sarid &

Breznitz, 1997).

Being in the state of selective sustained attention has been shown to affect children’s

response to environmental distracters. For example, following an episode of distraction children

are more likely to return to the interrupted activity if they were in a state of selective sustained

attention than in the state of casual attention (Oakes & Tellinghuisen, 1994). Furthermore,

infants and children take longer to orient to environmental distracters when in the state of

selective sustained attention (Lansink & Richards, 1997; Oakes et al., 2002; Oakes &

Tellinghuisen, 1994). For example, Oakes et al. (2002) presented 6- to 9-month-old infants with

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target events that consisted of colorful multipart toys. As infants investigated the toy, distracter

events were presented in the periphery on a computer monitor. Distracters consisted of visual-

auditory compounds (i.e., colored blinking rectangles accompanied by a beeping sound) and

were presented until infants visually fixated them. Latencies to orient to a distracter were longer

when infants were in a state of selective sustained attention and target events were novel.

Similarly, Richards (1987) showed that latency to orient to a distracter is greater if the distracter

is presented during the maximum heart rate deceleration (i.e., the sustained attention phase to the

target stimulus) compared to distracter presentation during heart rate acceleration (i.e., return to

baseline which marks termination of selective sustained attention).

Performance-Based Measurement of Selective Sustained Attention

Beyond infancy and toddlerhood, one of the most widely used tests of selective sustained

attention is the Continuous Performance Test (CPT; Rosvold, Mirsky, Sarason, Bransome, &

Beck, 19561). The CPT was originally developed as a screening tool for brain damage, but is

widely used today in research on sustained attention. This includes attention in neurotypical

adults (e.g., Davies and Parasuraman, 1982; Nuechterlein, Parasuraman, & Jiang, 1983),

attention in typically developing children (e.g., Akshoomoff, 2002; Corkum, Byrne, & Ellsworth,

1995), and attention in patients with attention deficit hyperactivity disorder (ADHD) (e.g.,

Barkley, 1990; Kerns & Rondeau, 1998) and schizophrenia (e.g., Cornblatt & Keilp, 1992;

Nuechterlein & Dawson, 1984).

The core feature of the CPT is that participants are presented with a continuous stream of

stimuli (visual or auditory) consisting of infrequently appearing targets and frequently appearing

1
Several commercial versions of this task have been developed (e.g., Conners’ CPT: Conners, 2002; Gordon
Diagnostic System: Gordon, 1983; Test of Variables of Attention: Greenberg & Waldman, 1993). Note however,
that there are many versions and modifications of the CPT, with some versions being referred to by other names
(e.g., “Picture Selection Task”, Akshoomoff, 2002).

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non-targets (usually numbers or letters). The typical duration ranges from 5 to 40 minutes (with

shorter durations usually used with younger participants). Participants have to respond to targets

(usually via a button press) and withhold responses to non-target stimuli. Originally performance

on the CPT was measured in terms of commission errors (false alarms), omission errors (misses),

and reaction time; however, signal detection indices d' (sensitivity) and β (response criterion)

have become increasingly popular (Davies & Parasuraman, 1981).

A variety of factors were found to affect performance on the CPT (for extensive reviews

see Ballard, 1996; Riccio, Reynolds, & Lowe, 2001). Depending on the version of the test, they

include (1) the ratio of targets to non-targets, (2) the presentation rate, (3) the type of target event

(e.g., target event can be defined as letter “X” in the X-CPT version or as letter “X” preceded by

a different letter, for instance “A”, in the AX-CPT version); (4) the modality in which the task is

administered (i.e., visual vs. auditory); (5) demographics (primarily age, although some effects

of education level and gender have been observed; Chen, Hsiao, Hsiao, & Hwu, 1998); (6)

whether clinical symptoms are present (i.e., the diagnosis of ADHD, schizophrenia, and more

recently Specific Language Impairment; Spaulding, Plante, & Vance, 2008); (6) environmental

factors (e.g., noise and temperature); and (7) the person’s physiological state (e.g., amount of

sleep; intake of caffeine, glucose, alcohol, or medication). Summarizing these effects is beyond

the scope of this chapter, particularly given the many different versions of the CPT; instead we

will concentrate on the typical patterns of performance in neurotypical populations.

The core CPT pattern with adults is a decrease in performance over time, usually referred

to as vigilance decrement. Vigilance decrement in CPT typically occurs for relatively long task

durations; however, under certain conditions (e.g., detection of perceptually degraded stimuli),

decrements in performance can occur after less than 10 minutes of performing the task

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Development of Selective Sustained Attention: Draft 1

(Nuechterlein et al., 1983). Standard versions of the CPT have been successfully used with

children starting from approximately 5 to 6 years of age (e.g., Edley & Knopf, 1987; Gordon,

Thomason, & Copper, 1990). However, the task was deemed inappropriate for younger children,

primarily because of long task durations and possible unfamiliarity with letters and numbers.

Corkum et al. (1995) created the first adaptation of the CPT that closely paralleled the

adult versions. In their version, letters and numbers were substituted for pictures of familiar

objects (e.g., ice-cream, sun, pig, lollipop), task duration was reduced to 9 minutes, rate of

presentation of stimuli was decreased to allow for longer viewing time and a longer response

window, and a training phase was included to familiarize children with the task. Despite these

changes, 50% of 3-year-olds failed to complete the task. Performance of the 3-year-old children

who completed the task was significantly below that of 4- and 5-year-olds in terms of both

misses and false alarms; additionally, younger children spent more time looking away from the

computer screen during the task than did older children. Importantly, vigilance decrement was

observed in all three age groups for omission errors, with the slope of the decrement being

steeper for younger children.

Based on the results reported by Corkum et al. (1995), successive studies using the CPT

with preschool-age children further reduced the task duration to 5 minutes (Akshoomoff, 2002;

Kerns & Rondeau, 1998). With the reduced task duration, almost all children were able to

complete the task, although Akshoomoff (2002) found that nearly half of the children below 4.5

years of age did not reach the performance criterion for inclusion in data analyses (i.e., at least

50% hits and less than 20% false alarms). Overall, developmental studies indicate a clear age-

related improvement in CPT performance from preschool age until adolescence (Akshoomoff,

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2002; Annett, Bender, & Gordon, 2007; Corkum et al., 1995; Cornblutt et al., 1988; Kerns &

Rondeau, 1998) and decreased performance with aging (e.g., Chen et al., 1998).

Summary

In infancy, development of selective sustained attention follows a U-shaped pattern,

characterized by initial decrease in looking duration at static images until approximately 6

months of age, and subsequent increase in looking over the next three years. Beyond the first

year of life, all paradigms used to investigate selective sustained attention (i.e., looking-based,

play-based, and performance-based paradigms) indicate improvement in this ability from infancy

to adulthood, with marked gains during the preschool years. Performance-based measures also

indicate a decline in selective sustained attention in the course of aging.

Opportunities for Research

Despite much progress made in the study of development of selective sustained attention,

important issues remain to be addressed, including clarifying several conceptual issues and

advancing the methodological toolbox. Addressing these two issues will ultimately allow us to

specify more precisely the coordination of the two systems supporting selective sustained

attention at different points in development.

Conceptual Issues in the Study of Selective Sustained Attention

Whenever multiple tasks are used to assess purportedly the same psychological process,

it is important to understand whether these different tasks tap into the same process. With regards

to selective sustained attention, there are at least two important differences between the

paradigms used with younger and older participants. The first critical difference is that looking-

based and play-based measures are self-paced and allow children to stay on task until they lose

interest, whereas predetermined task durations are used in the CPT. It is possible that this

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difference taps into the distinction between controlled and automatic processes: looking- and

play-based measures may be well suited to assess selective attention sustained in an automatic

stimulus-driven fashion and CPT may be well suited to assess selective attention sustained in a

controlled fashion. However, caution is needed when adopting this interpretation of task

differences. Specifically, while infants indeed sustain attention to an object or activity for as long

as it maintains some level of novelty, research reviewed earlier in this chapter indicates that

toddlers and preschoolers clearly have some degree of control over how their attention is

allocated and maintained. Therefore, as Ruff & Rothbart (2001) pointed out, the differences

uncovered by different paradigms may stem not only from the differences in the locus of control

of attention, but also from the differences in the degree to which the task is motivating to

participants of different ages. One could argue that executive control is needed precisely when

the task/activity is not intrinsically motivating but needs to be performed nonetheless. This,

however, poses a new problem, because executive control is often defined as “the ability to

orchestrate thought and action in accordance with internal goals” (Miller & Cohen, 2001, p.

167). Intrinsic motivation is by definition driven by the participants’ intentions (although it can

interact with the properties of the outside world). Clearly, further research is needed to clarify the

relationship among selective sustained attention, motivation, and executive control.

The second important difference is that in looking/play-based measures of selective

sustained attention participants actively engage in an activity when the measurement is taken,

whereas in the CPT participants spend a significant proportion of the time in preparation for

action – often referred to as vigilance. Therefore, it is not at all clear whether the two kinds of

paradigms measure the same kind of process. Both sustained attention and vigilance refer to

attentional processes unfolding over time. However, unlike vigilance, which involves

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maintaining alert state, sustained attention refers to active engagement with a particular activity

for a period of time. Traditionally, the vast majority of researchers use the term sustained

attention interchangeably with the term vigilance. This is problematic if the two processes are

distinct, and this possibility has been recently raised by Egeland and Kovalik-Gran (2010). In a

recent study, these researchers examined the factor structure of the commercial Conner’s CPT

(Conners, 2002) in a clinical sample of participants with compromised sub-functions of attention.

The scores loaded onto five different factors, identified as focusing, hyperactivity–impulsivity,

sustained attention, mental control, and vigilance. Egeland and Kovalik-Gran (2010) concluded

that the CPT assesses “not only sustained attention, as we are accustomed to think, but also other

aspects of attention” (p. 343). With regard to the distinction between vigilance and sustained

attention, Egeland & Kovalik-Gran summarized it as a “differentiation between a fall in

vigilance when driving on monotonous straight roads as opposed to fatigue because of a high

activity level over time”.

Measurement Issues in the Study of Selective Sustained Attention

As stated above, the CPT is by far the most common measure of selective sustained

attention from preschoolage onward. Originally this task has been considered a relatively “pure”

measure of selective sustained attention (Ballard, 1996). However, subsequent research

highlighted that it is not clear to what degree the CPT measures selective sustained attention

versus other aspects of performance. For example, there is a consistent relationship between CPT

performance and academic readiness (Edley & Knopf, 1987), classroom inattentiveness (Kupietz

& Richardson, 1978), and academic performance (Annett et al., 2007; Riccio, Reynolds, Lowe,

& Moore, 2001). At the same time, CPT performance is correlated not only with academic

success but also with general tests of intelligence, memory, and speed of processing (Annett et

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al., 2007; Gordon et al., 1990; Riccio, et al., 2001). All of these factors are also known to

correlate with academic achievement; thus it is not clear what proportion of the variance in

academic achievement is uniquely accounted for by CPT performance. More importantly, it is

not clear to what extent general intelligence, memory, and speed of processing are reflected in

CPT performance. Shalev, Ben-Simon, Mevorach, Cohen, & Tsal (2011) recently evaluated a

new version of the CPT that is intended to minimize memory and perceptual components of the

task. The results of this evaluation are promising; however, further evaluations are clearly

needed, particularly with children and clinical populations.

Tapping multiple aspects of performance is not unique to the CPT: many cognitive

measurement tools, particularly those designed to study higher-order processes, tap more than

one aspect of performance – an issue to which Miyake et al. (2000) referred as the “task impurity

problem.” Miyake and colleagues offered the following solution to this problem in their research

on the structure of executive functions: “We … carefully select multiple tasks that tap each target

executive function, and examine the extent of unity or diversity of these three executive

functions at the level of latent variables (i.e., what is shared among the multiple exemplar tasks

for each executive function), rather than at the level of manifest variables (i.e., individual tasks)”

(p. 54). Implementation of this elegant solution to the task impurity problem indicated that set

shifting, information monitoring, and inhibition are separable but related functions.

Notice that attention maintenance was not included in Miake et al.’s (2000) study, as it

was not included in the majority of other similar analyses of the unity and diversity of executive

functions (for a review see Garon, Bryson, & Smith, 2008). One reason for this omission could

be that attention maintenance is not under the purview of executive control, although several

theoretical proposals suggest otherwise (Colombo & Cheatham, 2006; Ruff & Rothbart, 2001).

17
Development of Selective Sustained Attention: Draft 1

Another reason could be relative paucity of tools for assessing selective sustained attention,

which would make the central feature of Miake et al.’s approach (i.e., selection of multiple tasks

that putatively tap the same construct) impossible. Given the suggested task impurity problem

with regards to the CPT, an important direction for future research in this area is development of

new measurement tools, particularly tools that are not based on the CPT paradigm. In the next

section we briefly describe our research on developing a new developmentally-sensitive

paradigm – the Object Tracking task – for assessment of selective sustained attention in the

visual domain.

The Object Tracking Task and Associated Findings

In the Object Tracking task participants visually track a target moving among several

distracters. All objects move along a random trajectory on a grid and participants are asked to

report the last location visited by the target object before it disappears; in the studies briefly

described below each location was marked by a different cartoon character to facilitate reporting.

Targets and distracters are randomly selected on each trial from a pool of unique objects (e.g., a

red circle, a green diamond) At the onset of each trial the target is clearly marked by being

encircled in red (see Figure 1; the circle disappears when the objects start moving).

At the end of each trial participants are asked to identify the target object. This memory

check helps to discriminate between two possible reasons why a participant may fail to correctly

report the location where the target object disappears. The first possibility is that a child may fail

to actively maintain the representation of the specific object to be tracked; this would indicate

working memory failure. The second possibility is that a child may track distracters for a part of

the trial despite remembering which object was supposed to be watched; this would indicate the

failure of selective sustained attention.

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Development of Selective Sustained Attention: Draft 1

Empirical results based on the Object Tracking paradigm are partially described in Fisher

(2010) and we will only briefly summarize them here. Three- to 5-year-old children were

presented with the task, with trial duration set at 10 seconds. There were two experimental

conditions. In the Homogeneous Distracters condition there were two distracters which were

identical to each other and different from the target; in the Heterogeneous Distracters condition,

the two distracters were different from each other and from the target (see Figure 1). The target

objects were expected to be more distinct, and thus more salient, in the Homogeneous Distracters

condition. All children were presented with these conditions in counterbalanced order.

We predicted that performance in the Heterogeneous Distracters condition should reflect

the contribution of predominantly endogenous factors, as children were engaged in a task that

was not intrinsically motivating and the task provided no contextual support that could benefit

performance (i.e., target objects were not more salient than distracters). In the Homogeneous

Distracters condition each target object was unique and likely more salient than distracters. Thus,

performance in this condition was expected to reflect the contributions of both endogenous

factors (e.g., completing a task that is not intrinsically motivating) and exogenous factors (e.g.,

higher saliency of target objects compared to distracters). The difference in performance between

these conditions was expected to reflect the unique contribution of exogenous factors to

performance on this task at different points in development.

It is important to note that manipulating saliency of the target objects within the same

paradigm allowed us to addresses the concern raised by Ruff & Rothbart (2001) regarding the

interpretation of findings as reflecting exogenous or endogenous locus of attentional control.

Specifically, any differences in performance observed between conditions could not be due to

greater motivation to perform one task vs. another, as all children performed the same task.

19
Development of Selective Sustained Attention: Draft 1

Differences in tracking performance could arise from differences in memory demands, but

memory performance was equivalent in both conditions (Figure 2): memory accuracy was lower

in 3-year-olds than in both older age groups. However there were no differences in memory

performance between the Homogeneous and Heterogeneous Distracters conditions in any age

group. Furthermore, memory performance was equivalent in 4- and 5-year-old children. Despite

equivalent memory performance, there were substantial differences in tracking accuracy in the

two experimental conditions in younger children, with greater accuracy in the Homogeneous

than Heterogeneous Distracters condition (Figure 2).

Follow-up experiments indicate that some parametric manipulations (e.g., removing

background images) decrease task difficulty and thus make it possible to extend the task to

younger children, and other parametric manipulations (e.g., increasing the number of distracters

and the grid size) increase the task difficulty, and thus make it possible to extend the task to older

children. Test-retest reliability of this task has been relatively high in our initial testing (r = .80).

Overall, our research indicates that the Object Tracking task is developmentally sensitive,

has good parametric properties, allows dissociating memory failures from attention failures, and

makes it possible to estimate the contribution of exogenous and endogenous factors to

maintaining selective attention within the same paradigm. While these initial results are

promising, clearly further research is needed to evaluate this new paradigm as well as develop

other paradigms for investigating selective sustained attention and its underlying mechanisms.

Conclusions

Selective sustained attention is an important cognitive process, implicated in both

successful learning and performance. Several theoretical accounts suggest that in early infancy

sustaining selective attention is subserved by the orienting system, and beyond infancy by the

20
Development of Selective Sustained Attention: Draft 1

executive control system. Ample empirical evidence has been accumulated to support the role of

the orienting system in selective sustained attention; however, there is less direct evidence for the

role of the executive control system and very little is known about the coordination of these two

systems in the course of development. Lastly, several conceptual issues and measurement issues

in the study of selective sustained attention remain to be addressed in future research.

21
Development of Selective Sustained Attention: Draft 1

Acknowledgements

Preparation of this chapter was supported in part by grant number 1R03HD060086-01A1

from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to

Anna Fisher and by grant number NSF DRL #723638 from the National Science Foundation to

Heidi Kloos.

22
Development of Selective Sustained Attention: Draft 1

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30
Figure 1. Example of the Object Tracking task in the Homogenous Distracters condition (Panel
A) and Heterogeneous Distracters condition (Panel B).
Figure 2. Tracking and memory accuracy on the Object Tracking task reported in Fisher (2010).