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104 ch 8 attention

QuestionAnswer
Why is attention important? it is a prerequisite for other cognitive processes. Prereq to engage in all meaningful activities and any impairment of attention will result in observable difficulties in everyday life.
When does recovery of attention usually take place? 1-3 months after brain injury or never.
What is the relationship between attention and functional recovery? difficult for a patient to learn to function if they can’t focus to learn.
How is impaired memory usually observed? during task performance, pt is off task.
Pre-requisites to attention are alertness and arousal
Alertness is the ability to maintain a wakeful state. It refers to both the physical and mental level of arousal that is necessary to respond.
Tonic arousal One form of arousal refers to a general level of wakefulness from one time of the day to another
Phasic arousal Another type refers to a specific level of alertness due to some kind of warning signal. Immediately following the warning signal the individuals experiences a heightened readiness to respond.
Selection of Attention involves the ability to attend to certain information at the exclusion of other information. This trait also allows us to focus our mental effort on certain information in the environment and to shift our attention when needed
Attentional capacity limited pool of cog resources A difficult cognitive task will use more capacity than a simple one. Example: Driving in a rainstorm during rush hour traffic will require more capacity than driving on a deserted country road.
Orientation occurs when someone adjusts some portion of their body in relation to a stimulating source. It functions to identify those objects, events, or ideas that may deserve attention in the future. Ex: We adjust our head when we hear an unidentified sound.
How do we ask a patient to describe orientation to person? what is your name? DOB?
orientation to place, what do we ask pt? What is the name of this facility? Where is it located?
orientation to Time (temporal) – what do we ask patient? what is the date today? Day or week? Time?
Routine attention is the person’s ability to perform a simple task without exerting a great deal of mental work, (ie, when performing a learned skill or task such as dressing, eating, performing chores, etc).
Focused attention or concentration ind’ls emerging from coma. is the ability to focus on and respond discretely to one or more aspects of the environment: specific visual, auditory, or tactile stimuli. almost all patients with brain injuries recover this level of attention
Definition of Concentration fixation of the mind on one subject to the exclusion of all other thoughts.
Sustained attention or Vigilance or concentration span This refers to the ability to maintain attention over time. Ex: balance a checkbook, watch a movie or tv show. It is associated with right hemisphere specialization.
Selective attention or freedom from distractability ability to ward off distractions or w/ distracting or competing stimuli. Ind'ls with deficits at this level are easily drawn off task by irrelevant stimuli: external sights, sounds, or activities, as well as internal (worry)
Alternating attention capacity for mental flexibility that allows individuals to shift their focus of attention and move between tasks with different cognitive requirements, thus controlling which information will be selectively processed.
example of alternating attn. while typing a paper, your husband comes into the room and discusses something else. When he leaves, you resume your paper
example of Divided attention making tea and toast at the same time or taking on the phone while shopping
def of divided attn. respond to more than one task at a time or to multiple demands within a task. Two or more behavioral responses may be required
What is distractibility and what are some examples? a breakdown in selective attn. noise in the hallway takes away your attention while taking notes during class.
Discrimination? involves the progressive detection of differences in a perceptual field or set of ideas.
These 5 levels of attention can function… in either a routine or a non-routine mode, although most tasks require a combination of both.
What is seen in a pt with alternating attn. issues? difficulty changing treatment tasks, and who needs extra cuing to pick up and initiate new task requirements.;
Circadian rhythms 24 hour cycles are a type of biological rhythm linked with attn. Apparently, different circadian rhythms occur for different thinking processes and even for different aspects of attention.
conscious attention processes are typically good during what time of day? the morning, diminish after lunch, and rise again in the afternoon
automatic attention are good at what time of day? do not fluctuate during the day.
arousal and vigilance are good at what time of day? begin at a low level in the morning and gradually improve to a peak in the evening.
how does TBI impact biological rhythms? disrupts them. Thus, disruption of these rhythms may be one of the many factors contributing to attentional deficits in individuals with brain injury.
how do brain injuries impact memory? Although many people report that attentional problems subside within 3 months of the injury, a large number of people continue to report problems at 2 or more years post injury.
If attention is compromised, information is not properly processed by the brain, causing ,reduced understanding. Thus, it is important to ensure that attention and concentration are enhanced to allow the brain to perform the more complex thinking processes.
Attentional problems can affect what 4 functions: 1 Thought processes (impulsivity, memory problems) 2 Social judgment (egocentricity, social withdrawal, frustration, aggressiveness,) 3 Self awareness (lack of insight, denial, unconcern) 4 Communication (being too concrete, language comprehension)
What are common approaches for interventions addressing attentional deficits? (1) improving underlying attn. deficit (which includes computer based tasks and pen & paper training but no functional tasks and the (2) intervention focused on improving living skills & increasing participation despite the attn. deficit.
Which approach does Gillen recommend and why? "Glen" hates the pen & paper tests as he finds them to be ineffective so he would find #2 to be more beneficial as it focuses more on functional tasks
What strategies are supported by research? Acute period – no benefits. Better to tretrain complex tasks requiring attn. rather than basic: reaction time or vigilance.
strategies for clinicians and caretakers avoid overstimulating environs, face away from visual distracters during tasks, wear earplugs, use filing systems, label cupboards, reduce clutter
Review strategies to review with clients reduce distractions, avoid crowds, manage fatigue, avoid interruptions, get exercise, ask for help
Created by: andijean1