Impaired Attention & Treatment Flashcards
Who might have attention impairments?
Highlighted:
- Patients with
- TBI
- Aphasia
- Dementia
Attention is widespread in brain, any acquired brain damage = deficits
TBI & attention deficits
- Heterogeneous group
- Attention is usually impaired
- May be difficult to separate attention from overall slowed processing
- Important to focus on :
- how attention impairments manifest during ADLs or everyday tasks
- Attention can impact driving - some do not drive again
Aphasia &
Attention
- though it’s a language impairment, many with aphasia show attention impairment
- Visual attention may impact use of AAC devices
- Difficulty allocating attention to different tasks or maintaining consistent attention over time
- not yet fully understood how attention & language in this population related
Dementia &
Attention
- Attention deficits = not diagnostic criterion for most types of dementia
- except for Lewy Body dementia =
- fluctuations in attention are typical and may appear early in the progression of the disease
- any type=attention may become issue in later stages of disease
Approaches for
Treatment of Attention
- Direct training
- Training in specific skills
- Compensatory strategies
Use of decontextualized tasks to train attention in a specific context
Direct Training
Examples of Direct Training of Attention
- Computer based or app-based task that trains the patient to attend to objects on the screen
- Attention-process training
- Seven-level model of attention training
Is Direct Training in attention effective on its own?
NO!
Best to combine with other approaches
Computer/app based tasks: look for construct validity
Attention Process Training
- graded procedure that steps a patient through levels of training
- includes tasks such as
- listening for target words in presented strings
- includes tasks such as
- Attention-Process Training - effective for improving scores on:
- standardized memory tests &
- informal measures of independent living skills (Mateer & Sohlberg, 1988)
Type of Attention traning that steps a patient through levels of training
(i.e. listening for target words in presented strings)
Attention-Process Training
Seven-Level Model of Attention Training
Type of Direct Training
- Hierarchical attention training module for the following processes:
- basic arousal
- orientation
- attention with discrimination
- concentration
- distracted attention
- attention with immediate memory
- interference resistance training
- Patient must master each level before moving to the next
- Examples:
- Level 1 - basic arousal - patient maintains arousal by listening to radio or watching video, expanding greater amounts of time
- Level 2: Orientation to a visual-auditory stimulus - patient sits in a swivel chair blindfolded and instructed to turn towards clinician clapping
- Level 3 : Attention with Discrimination - patient pictures of two people and asks questions such as “Which is one is blonde? Which one is taller?”
- Examples:
Direct Attention Training that requires patients to master each level before moving to the next
Seven-Level Model of Attention Training
Skill-Based Training/
Training in Specific Skills
Training Attention in the context of everyday activities
Examples:
- providing scaffolding to help a patient attend to a morning routine, step by step
- breaking down the steps of preparing food, dressing, bathing, and having patients practice each one
Scaffolding a patients bedtime routine, step-by-step
and
breaking down the steps of preparing food, dressing, bathing, and having patients practice each one
are examples of
_______ ______ _______
Skill-based training
or Specific Skill Training
Compensatory Strategies for Attention
Can include:
- environmental modifications
- self-management strategies
- external aids to help the patient/caregiver compensate for attention impairment
