attention difficulty will require rehabilitation, just like any other injury to the body. During cognitive rehabilitation, a therapist will identify the severity ofthe impairments and use strategies and treatments to improve attention. The therapist will also teach family members and friends how to use these attention strategies with the person Attention in their daily life and how to encourage and support their loved one as they recover. It is important to be patient with yourselfor After brain injury your loved one, as frustration and judgment will only increase internal distractions. With support and persistence, attention can improve after brain injury. References This tip card helps survivors, Papa, J (2013). Patient & family education flashbook. therapists, clinicians and families ... Newington: Bright Side Therapy, LLC. Mateer, M. M, Kerns, K.A., & Eso, K. L. (1996).Management ./ understand types of attention ofAttention and Memory Disorders Following Traumatic Brain ./ improve attention skills Injury. Journal of LearningDisabilities, 29: 618-632. Sohlberg, M. M., & Mateer, C. A. (2001). Improving Attention and Managing Attentional Problems. Annals of the New York Academy of Sciences, 931: 359-375. Alaska Brain Injury Network Sohlberg, M. M., & Mateer, C. A. (Eds.). (2001). Cognitive 121 W. Fireweed Lane #175 Rehabilitation: An integrative neuropsychological approach. Anchorage, AK 99503 Guilford Press. Sohlberg, M. M., & Mateer, C. A. (1987). Effectiveness of an attention-training program. Journal of Clinical Experimental Neuropsychology, 9(2): 117-130.
This tip card is not a substitute for medical advice. Written by Always consult a doctor for advice and treatment. Jennifer Papa Llado, MS, CCC-SLP Erica Blomberg, MS, CCC-SLP, CBIS ltem:ATIN Copyright© 2014 by Lash & Associates Publishingffraining Inc. This material is copyrighted by Lash & Associate s and can not be reproduced in any form without permission. This tip card is part of a series on brain injury among children, adults and veterans. For an order form with prices, contact Lash & Associates. Tel: (919) 556-0300 or visit our web site www.lapublishing.com
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II What is Attention? Types of Attention Attention is the ability to focus or concentrate. Attention Attention can be auditory or visual. Auditory attention focuses skills range from simple to complex. For instance, focusing on listening. You must have auditory attention to listen to the on one task for a short time is a simple attention task. A more radio. Visual attention focuses on what you see. You use visual complex task may require attention to two or more things at attention when you are reading a book. There are 5 types of once for longer time or shifting attention back and forth between attention listed below in order from simple to complex. different items or tasks. Attention is the most important cognitive skill. Without Focused Attention attention, you cannot remember new things, write a check, drive Responding briefly to something in the environment (30 a car or read a book. It is the foundation of all our thinking seconds or less) processes and influences so much of what we do every day. Without the ability to attend, we would have a difficult time Examples:Giving a simple response to a question, recognizing maneuvering through the many very simple and complicated the phone ringing, noticing a car drive by. aspects of our day-to-day lives. When the brain has been damaged, a person's ability to pay Sustained Attention attention can be affected. This can range from a mild to severe impairment. For instance, someone whose attention is mildly Staying focused on one activity (a few minutes to several hours) affected may have subtle difficulty multi-tasking. This may Example: Watching a movie, listening to a lecture, eating a meal. prevent the person from returning to work full time. Or a person might go back to work and now find it hard to complete tasks that were very easy before the injury. Subtle changes in attention Selective Attention can lead to fatigue, frequent headaches, and overall irritability Focusing on one thing while ignoring another or frustration, as the person finds it harder to complete tasks that once were done with little effort. Example: Having a conversation while ignoring others talking in the background, balancing your check book with a loud radio A person with a more severe impairment in attention may be or tv turned on in the room, reading a road sign while ignoring unable to hold even brief conversations or finish a simple task all other visual stimuli nearby. such as eating a meal. A person may now require supervision or help to complete even day-to-day routines and activities. Regardless of the severity, impairments in attention can create Alternating Attention a very difficult and frustrating situation for the person who has been injured, as well as loved ones and caregivers. Switching attention back and forth between two activities Example: Composing an email when you are interrupted by a phone call and then returning to the email and picking up where Attention Impairments you left off without difficulty or losing your train of thought, A physician may refer a patient with a brain injury to a speech going back and forth between reading your grocery list and language pathologist (SLP). This specialist or SLP will evaluate locating the items in the store. all areas of cognition (or thinking) and develop a treatment plan. The physician or SLP may also consult a neuropsychologist who will take an even deeper look at cognitive function and Divided Attention make additional recommendations. Completing two activities at the same time During these evaluations, professionals look at each type of Example: Talking on the phone while making dinner, listening attention to determine how it has been affected by the brain to a lecture while taking notes, driving in the car while following injury and make recommendations for treatment. written or verbal directions.
II Distractions Tips for increasing self-awareness ... Everyone has distractions. Speech-language pathologists ./ What are some signs you need a break - fidgeting, mind (SLPs) divide distractions into two categories: internal and wandering, increased pain? external distractions. An internal distraction occurs when your ./ What time of day are you at your best? Schedule thoughts (worry, pain, mind wandering) distract you from demanding activities during your best times. the task at hand. An external distraction is something in the environment that makes the person lose focus, such as loud ./ Practice mindfulness! Begin to notice what you are noises or people walking by the window. thinking about when you are trying to focus .
While everyone has these distractions from time to time, Tips for using strategies ... individuals with cognitive impairments are less aware of these ./ Set your phone or a timer to signal a rest break. distractions. They often have difficulty ignoring them and ./ Keep a written cue in front of you, such as "STAY returning to a task once they are distracted. SLPs help identify FOCUSED." these distractions and provide strategies to help the individual stay focused. ./ Break large tasks into small pieces that require less attention at one time . ./ Talk yourself through steps out loud as you do them. Improving Attention Reading out loud may help too . Tips for creating a healthy body... ./ Take a break when switching from one task to another. ./ Eat a healthy and well balanced diet by limiting ./ Take a deep breath and re-center yourself into the task. sugars, processed foods and caffeine. Certain foods may help improve brain functioning and promote clear thinking such as foods high in antioxidants which Speak your Truth include a variety of berries. It is important to educate those around you about your ./ Get quality sleep. Good sleep improves attention for difficulties with attention. This may be your family, friends, everyone. Ifyou are having trouble sleeping, tell your co-workers or classmates. physician. Let them know ... ./ Take breaks or naps throughout the day when you notice fatigue setting in . • I have trouble paying attention for longer than ./ Wear your glasses or hearing aids to take in information. However, turning your hearing aids off if you are trying • I may need to take a break every _____ to focus on something visual in a noisy environment • Ifyou notice that I have lost my focus, it is helpful if may be helpful. you _____ • It does not help me when you _____ Tips for checking the environment. .. ./ Make yourself comfortable - check your seat, clothes, Practice Strategies to Use in Your Life pain level, room temperature . ./ Bring your "Stay Focused" Card to work or school and ./ Remove visual and auditory di stractions - turn off the put it on your desk. TV or radio, close the door, put on headphones/ ./ Wear headphones to cancel out background noise while earplugs, clear your desk. grocery shopping or studying in a busy area. Ill ./ Take a short walk around the office after checking email Hemispatial Neglect (Left Neglect) and before making phone calls. Hernispatial neglect is a specific type of visual attention ./ Take a nap or find some quiet time before attending a impairment that is common after damage to the right side of social function. the brain. With hernispatial neglect, a person ignores the left side of space. This is not related to the person's actual vision. Tips for families, friends and caregivers... With neglect, one simply cannot attend to the left. ./ Notice when a distraction is pulling the person's Examples: The individual. .. attention away from the conversation and try to remove • eats food only on the right side of the tray or plate. that distraction. • begins to write or read in the middle of the page . ./ When giving instructions, ask the person to repeat them back to you . • bumps into things on the left while walking. ./ Create a verbal CUE to get the person's attention, or change your intonation to demand attention. Tips for reducing neglect... ./ Create a visual CUE to get the person's attention during ./ Talk to the person from the left side of his or her body. conversation (ie. a tap on the shoulder, a wave) This helps re-train the brain to focus on the left. ./ Provide "CUES" described below when on the person's left side. Activities to Challenge Your Attention Tips for verbal cues ... Focused and Sustained Attention ./ "Look all the way to your left side." ./ Work on a jigsaw puzzle. Set a timer and increase the amount of time each day to focus on it without getting ./ "Tum your head to the left until you see ____ distracted. Tips for visual cues Selective Attention ./ Encourage the person to look left by adding stimulation to the left side of the page (for reading) or the tray or ./ Try having a conversation with your family member or plate (for meals). Try highlighting a margin in red to friend with the door open or the TV on in the catch the person's attention). background. Tips for encouragement... Alternating Attention ./ Constantly encourage the person to look left and reach for things on the left whenever possible . ./ Find one clue in a crossword puzzle and then read a paragraph of the newspaper. Keep switching back and ./ Congratulate the person on a job well done when he/ forth between these two activities without losing your she is able to look left! place. Final Thoughts on Attention Divided Attention Attention is the most important cognitive skill as it is the foundation for all our thinking. Without attention we would not ./ Try talking on the phone, while doing a word search, be able to complete any of our simple and complex day-to-day puzzle or iPad game. tasks. A change in one's ability to pay attention can significantly affect the ability to meet the demands of daily life. Therefore,
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