Ch. 5 Flashcards
Clinical Model of Attention: Focused Attention
Refers ability to respond discretely to specific visual, auditory, or tactile stimuli. This type of attention is often affected in early stages of emergence from a coma. A patient may initially be responsive only to internal stimuli (e.g., hurst, thirst, wake/sleep cycles).
Clinical Model of Attention: Sustained Attention
It is the ability to maintain a consistent behavioral response during continuos and repetitive activity.
o Vigilance: Focus on a task for a considerable amount of time.
o Mental control/ working memory: Tasks that involve manipulation and storage of information.
Clinical Model of Attention: Selective Attention
Refers to the level of attention needed to maintain a behavior in the presence of distracting a competing stimuli. It also involves concentration on one stimulus.
Clinical Model of Attention: Alternating Attention
The capacity to shift attentional focus and move between tasks with different cognitive requirements.
Clinical Model of Attention: Divided Attention
The ability to respond simultaneously to multiple tasks.
Factors affecting attention
Arousal level is important for attention and performance. Arousal and attention are linked, as well as to performance.
Arousal level:
• ↑d arousal = ↑d performance
• ↓d arousal = ↓d performance
Assessment Tools: Standardized Tests
o Standardized Testing any kind of test that involves a set of questions. You get a score and find the problem.
• Advantage it is affective in assessing the level of impairment and information relative to nature of problem.
• Limitation difficulty in predicting how well an individual is going to function in real world activities (it is going to give you a score, but doesn’t tell you what to do with it).
Assessment Tools
o Rating Scales/ Questionnaires (Page 131):
o Goal of Rating Scales Rating scales provide an indication of an individual’s perception of functioning.
• Examples: Attention Questionnaire, Dysexecutive Questionnaire, Brock Adaptive Functioning Questionnaire
Management Approaches: Attention Process Training
Clients engage in a series of repetitive drills or exercises aimed to improve their attention. Several commercially available programs are used. One example is Attention Process Training (APT) which consists of a group of hierarchically organized tasks that include different components of attention commonly affected after brain injury. Examples of APT are listed on Appendices 5.2 (Page 157) and 5.4 (Page 159).
o Treatment efficacy: APT evaluations provide following information (Page 137):
• Gives you information about performance on the training task itself.
• The psychometric tests related to task.
• Everyday functioning levels.
o Majority of published studies have reported positive outcomes following APT
Use of cognitive exercises to remediate and improve attentional systems.
Management Approaches: Self-Management Strategies
Orienting
Could be useful for clients with deficits in sustained attention. The goal here is to encourage clients to monitor their activities consciously, and thereby avoid attentional lapses. These activities can be designed for specific tasks or environments.
Management Approaches: Self-Management Strategies
Pacing
Goal is to first develop realistic expectations for productivity and second facilitate clients to keep going for a longer period of time. Sometime the time of day can be a helpful aspect of pacing.
Management Approaches: Self-Management Strategies
Notes
Clients can benefit by maintaining a written logs with key questions or ideas that come to mind, but can be addressed late. This allow them to continue with a particular task, rather than abruptly discontinuing a task.
Management Approaches: Environmental Supports
The client’s environment should be carefully assessed. Environmental supports can be grouped into two types:
- Task Management Strategies (Page 145): This includes generation of strategies for effective task performance. The client can be reminded that they may choose the more helpful environment whenever possible.
- Environmental modifications: The modifications in a clients’ physical space to reduce the load on their attention, memory, and organizational abilities.
