Attention problems after brain injury and the specialists who can help

Attention is a cognitive process that helps us decide what we need to concentrate on and take in, allowing us to maintain concentration for as long as required.  Attention is crucial for us to learn new information, remember things, communicate effectively, socialise, work, and carry out other everyday activities.

Impairments of attention are common after brain injury and can be life-changing for the individual.  Paying attention can be one of the toughest things to do after a brain injury.  It may take a lot of effort and energy to focus when before it came naturally.  Often, survivors do not understand that it is attention problems which are causing them difficulty to engage in information processing and memory.

Read more about how attention affects the other cognitive processes in my recent blog – A focus on the wider implications of attention problems.

It is essential that those who are involved with the individual’s recovery understand attention impairments and how they alter what that individual is able to comprehend and achieve.  There are a number of specialist who are highly competent in diagnosing and treating someone who is experiencing changes in their ability to pay attention. 

Occupational therapists

Occupational therapists (OT’s) work within hospitals and in the community, helping people overcome physical and cognitive impairments following an injury.  The primary goal of occupational therapy is to enable the patient to participate in the activities of everyday life.  An OT’s job will frequently involve them treating an individual’s attention impairments, so as to help them overcome wider cognitive problems and reach the goal of participating independently in everyday tasks.

An OT will assess the individual by asking them to carry out certain everyday tasks to assess which type(s) of attention have been affected and how that affects the other cognitive skills.  From here the OT will work with the individual, putting in place activities and exercises to help them build up their attention skills as well as strategies to compensate any changes in those skills.

An OT will often advise the individual to look at their environment when they are practicing the type(s) of attention they have problems with and can provide tips depending on the individual’s needs, for example

• To face away from distractions and toward the information/person you are attending to or to wear earplugs when reading/giving your full visual attention to something
• That you should carry out the task which requires your attention at a time of the day when you have the most energy
• To do tasks in small steps to begin with and repeat this.  This would be particularly relevant when practicing a task which requires you to alternate/divide your attention.
• That saying, the steps of the tasks you are completing out loud will help focus your attention

An OT will continuously assess the individual, ensuring they are assigning specific, purposeful activities which are suitable to the level of ability reached.  Once enough progress has been made with the problematic area(s) of attention, the OT can incorporate tasks which require the use of the individuals information processing, memory and executive functioning skills until they are satisfied that all cognitive skills are functioning at a level that allow the person to carry out essential day to day tasks and live full, satisfying and independent lives.

Clinical Neuropsychologists

Clinical neuropsychologists are specially trained to understand the relationship between the brain and a person’s behavior and cognition.  Seeing a neuropsychologist and completing their assessments can provide someone who has suffered a brain injury with a deeper understanding of how problems with attention are affecting their other cognitive functions, in particular, their ability to enter into independent self-serving behavior (Executive functioning).  Like OT’s, neuropsychologists plan training programs to help the individual return to normal functioning and can recommend alternative cognitive strategies to minimize the effects of brain injury. 

Speech and language therapist

A speech and language therapist can be very beneficial as attention problems often lead to problems in communication.  This is because if one cannot pay attention and listen to what is being said to them, it results in the person not acting appropriately to the spoken information that is presented to them.  Furthermore, difficulties attending to visual or written information can again cause a breakdown in effective communication.  A speech and language therapist can, like the other specialists, provide activities and training to help the individual overcome attention problems with a view to improving communication.  They may also offer one on one therapy or group therapy/practice sessions which can be very helpful in the later stages of treatment for attention problems in building confidence for the individual in social situations.

Help and advice

If you or a loved one have suffered a brain injury and are experiencing a change in cognitive abilities, you can find support and advice by visiting Headway, the brain injury association who are passionate about improving the lives of brain injury survivors.  They work in partnership with specialists such as occupational therapists, speech and language therapists and physiotherapists to help survivors overcome cognitive and physical impairments following a brain injury.