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Previously, I have discussed the use of circulars and telephone books in scanning exercises for brain injury survivors with left neglect and/or a field cut. Another practical option for scanning exercises can be found in restaurant menus. Almost everyone will go to a restaurant at some point in a given year, so working with menus presents as a pretty straightforward opportunity to many survivors. Most people have menus sitting around at home, making them easily available to employ as tools. If one does not have a menu handy, many can be downloaded online. Also, most any restaurant will be more than happy to give out extra copies of menus. It can be helpful to have menus of different sizes and complexities since this allows for adjustments to task difficulty over time.
Once the survivor has agreed to the task, simply place the menu in front of the survivor. Ask the survivor to point to various items on the menu (e.g. “Point to the Pastrami Sandwich” or “Point to the appetizer that costs $7.99″). Be sure to vary the location of the items the survivor is asked to find. For instance, you may first ask that he or she find an item in the upper left corner, then next request something closer to the middle, followed by an item in the lower right corner. If the survivor is having difficulty finding an item, have the survivor begin a slow and organized scanning search. As a rule, the survivor should start the search on whichever side is the most difficult for him or her. As example, if the survivor has left neglect then he or she should start on the left side of the menu. If the survivor has a right field cut, he or she should start on the right side. The survivor should start at the top of the menu with the column furthest to the chosen side, slowly bringing the search to the bottom of the page. Once he or she has reached the bottom of the page, the survivor should start back from the top moving one column over and searching slowly from the top to the bottom as before. This should continue until the survivor has found the item. This method works best if the survivor uses his or her finger as a guide. If the survivor cannot find the item, the helper working with the survivor should aid the survivor by re-starting the search as a more active participant (this time using the helper’s finger as guide instead). If the survivor continues to struggle with the task, the helper may wish to demonstrate how to use the organized search method to find the item as if the helper is the survivor.
Always make sure that the material is not too small for the survivor to see and that if the survivor uses reading glasses, he or she is wearing them. It is usually a good idea to start off with simple, one page menus with fewer items listed and to then move on to more complex menus only after the survivor has first mastered the simpler ones. Remember that colors and pictures can be very distracting to many survivors. Patience is key, as it may take a significant amount of time for the survivor to find an item even with help. Although these items may seem easy to find to the helper, the survivor is having to learn an entirely new way to engage with visual material. A little teamwork will go a long way to ensure success in this vitally important endeavor. As in all new learning, mastering a scanning technique can be a slow and laborious process requiring much support, goodwill and encouragement!
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Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.