Neurocognitive Assessment of Attention and Its Relationship With Academic Performance Among Schoolchildren

Background: Attention is a key cognitive factor in classroom learning, but the relationship between attentional abilities and academic performance remains understudied in South Asian countries like Nepal. This study aimed to assess attentional performance by the Stroop Color Word Test (SCWT) and Trail Making Test (TMT) and its relationship with academic performance among schoolchildren in Bhiarahawa, Nepal. Methods: In this cross-sectional study, 377 students from grades 6 to 10 were included using stratified random sampling from three schools. Neurocognitive assessment of attention was done by SCWT (Word, Color, Color-Word), with calculated Interference score (IG) and TMT-A and TMT-B. Academic performance was taken from the official school mark-sheet (overall percentage and subject scores). Sociodemographic data, anthropometrics, and screen use habits were collected. Associations among the variables were evaluated with Pearson correlations and multiple linear regression analysis. Results: The Stroop test score in 45 seconds was Word 82.3 ± 17.86, Color 56.17 ± 11.52, Color-Word 34.3 ± 8.2, with a calculated interference score (IG) of 1.1 ± 6.8, whereas the time for TMT-A was 37.1 sec (±12.6); TMT-B was 80.9 sec (±31.4). There was a significant inverse relationship between TMT A and TMT-B completion times and overall academic percentage and subject scores, signifying that faster TMT performance corresponds to better academic performance, especially in mathematics, as confirmed by regression (β = -0.30 for TMT-A and β=-0.34 for TMT-B). In contrast, the SCWT IG score had no significant association. Conclusion: In this study, TMTs were the robust correlates of the academic outcomes, particularly mathematics, whereas the Stroop test was not a significant predictor of academic achievement. These findings emphasize that school-based interventions for enhancing the attentional abilities of students can greatly support learning. In the future, longitudinal studies using culturally adapted measures are recommended.