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Attention is a foundational skill that lays the groundwork for much of our cognitive functioning. For instance, absent sufficient attention paid to your supervisor’s directions, it is impossible for you to remember and then follow those directions. Similarly, without proper attention given to driving one cannot solve critical problems that may come up (such as avoiding a potential accident). These examples of how attention affects other cognitive domains such as memory and problem-solving are just the tip of the iceberg when it comes to understanding the importance of attention. One research-demonstrated method of improving attention after a brain injury is through Attention Process Training.
Attention Process Training (APT) is a multi-session exercise designed to help improve the brain injury survivor’s ability to focus on relevant material while ignoring irrelevant distractions. Further, it helps improve the speed of processing information. Speed of processing is a very important factor to success in areas such as driving, as the driver must pay attention to a myriad of information (even more so at high speeds). The APT version used by the Moody Neurorehabilitation Institute consists primarily of the patient listening to audio tracks presenting a variety of information and then being asked to press a buzzer when information previously identified as relevant is given. For instance, the audio track may consist of a long list of numbers and the patient must press the buzzer every time he or she hears the number 5. These tracks are always first read slowly, and then repeated at an increased speed. The therapist listens for errors of omission (missing the relevant information) as well as errors of commission (pressing the buzzer as an indication of having heard distractor information). The APT tracks become steadily more difficult as the tasks progress. After completing the tracks without any background noise, the tracks are repeated but this time including a different voice reading newspaper articles in the background. Again, the patient must press the buzzer for the relevant information and ignore the distracting information (now including that background voice). This skill is important since most life tasks involve some form of background distraction. As example, a parent may cook a meal while his or her children are watching television. If the parent is not able to sufficiently ignore the background noise of the children and the television, there may be a large kitchen disaster. When a patient demonstrates good skill on these first tasks, he or she will be moved to a more difficult version of APT in which he or she must not only listen for relevant information but also alternate between sets of information to which he or she must pay attention. For instance, a patient may have to alternate between listening for names of sports and names of animals. This alternating attention is also important in our daily lives. One common example of an alternating attention task would be found at a cookout, when a cook has to alternate between watching the meat grilling on the barbecue and cutting vegetables for condiments. A failure to alternate attention adequately could lead to a charred dinner or a lost finger.
By working with Attention Process Training, patients can strengthen these vital attentional skills and thereby be more successful in their daily lives. TLC has seen many patients improve in their overall functioning through this training program.
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