Attention occupies a central place within cognitive processes and allows us to carry out daily life activities optimally. It could be defined as the ability to select, direct, and maintain a level of mental activation on certain stimuli to process information. It allows us to be aware of what is happening around us and discriminate between relevant and irrelevant stimuli.
TYPES OF ATTENTION
Focused attention
Ability to respond specifically to a stimulus that enters through any of the sensory pathways.
Selective attention
Ability to maintain a cognitive or behavioral activity in the presence of distractors, whether internal or external.
Sustained attention
Ability to maintain a constant response during the execution of a continuous task.
Alternating attention
Refers to the mental flexibility that allows us to change the attentional focus between tasks with different cognitive demands.
Divided attention
Involves responding simultaneously to multiple tasks or multiple cognitive demands.
ALTERATIONS IN ATTENTION
Alterations in selective attention
Involves great distractibility with irrelevant stimuli, whether external (sounds, movements…) or internal (thoughts). Their attention and behavior will follow the stimulus. These are usually people with rigid and inflexible behavior.
Alteration in sustained attention
Difficulties appear in maintaining attention for prolonged periods of time.
These are people who fatigue quickly and need more rest periods.
Alterations in this attentional process have a great impact on people’s lives, as it affects the rest of the cognitive functions.
Alternating attention alterations
Difficulties appear in changing the attentional focus from one stimulus to another.
Divided attention alterations
They have difficulties performing several tasks simultaneously.
Alterations in the speed of information processing
Slowing down in information processing implies a slower reaction, difficulties in acquiring new information, comprehension and reasoning problems, among others.
Hemineglect.
It is an alteration of the ability to attend to information located in the hemisphere or hemicorpus contralateral to the damaged cerebral hemisphere.
REHABILITATION OF ATTENTION
After an exhaustive cognitive evaluation that allows us to know the symptoms or alterations present in the cognitive functions of each patient, we propose the rehabilitation of these altered functions.
Rehabilitation is based on three principles:
– Restoration: It is carried out through cognitive training.
– Reorganization: Strategies are provided to reduce the impact of the deficit on ADLs.
– Compensation: It is carried out by modifying the environment and using external aids.
To begin the cognitive rehabilitation process, first, we establish a hierarchy of objectives focused on daily limitations and individualized for each patient adapted to the alterations observed in the previous assessment. Secondly, a selection is made of the materials and tasks that are going to be used, taking into account the usefulness of the task, who it is aimed at, the modality by which it is going to be presented to the patient (visual and/or auditory) …
Selective Attention Rehabilitation:
We use materials or tasks to train the selection of relevant stimuli, ignoring distractors.
Example, cancellation tasks:
Sustained Attention Rehabilitation:
We use tasks for which it is necessary to maintain attention for prolonged periods of time.
Example: labyrinths.
Alternating Attention Rehabilitation:
We use tasks that force the attentional focus to be changed between different stimuli.
Example:
Divided Attention Rehabilitation:
We use dual tasks to work on alterations in this type of attention, for example, an activity presented visually while the patient has to attend to another task simultaneously presented auditorily.
Rehabilitation of Information Processing Speed:
One way to work on IPS is by progressively adding the time factor in the tasks.
Hemineglect Rehabilitation:
Depending on the type of hemineglect that the patient presents, we adapt the materials/tasks.
Example: for patients who ignore the stimuli presented on the side contralateral to the lesion, we can present tasks that involve visual tracking on the side that is ignored.
At FIVAN we establish a rehabilitation process based on an interdisciplinary, individualized perspective, with specific training of the altered functions, relying on the preserved skills, together with the work of awareness of the deficit and emotional problems.
