Attention is a complex yet fundamental thinking skill. Attention is necessary for the function of many other cognitive skills, such as memory and problem solving. It also is one of the most commonly affected cognitive skills after stroke, brain injury, or in other neurological diseases. When someone has difficulties with attention, it can make completing necessary daily tasks feel almost impossible.
While many may think of attention simply as their ability to focus or concentrate within a task, there are actually several types of attention skills we use each day.
Sustained attention- this is our ability to focus on a task, person, conversation, or activity for a certain amount of time. Can you hold your attention on one activity until that activity is done? After a stroke or brain injury, it can be difficult to sustain attention for more than a few minutes.
Selective attention- this is our ability to maintain our focus to that task (or person, conversation, activity) while ignoring distractions or competing stimulation. These distractions can be external, such as noises, lights, people, or internal, such as our own thoughts or feelings. Can you read in a coffee shop and ignore the other conversations or the music playing? Can you complete a task at work without getting distracted by a loose button on your shirt or thoughts of what you need to cook for dinner?
Alternating attention- this is our ability to shift our attention back and forth between two or more tasks or stimuli. Perhaps you are writing a grocery list and then get a phone call. Can you complete the phone call and then return to writing your grocery list without difficulty?
Divided attention- many people think of divided attention as “multitasking.” Can you split your attention between two or more tasks at the same time. Can you cook a meal while having a conversation with someone in the room? Can you complete household chores while listening to a podcast or radio program?
There are some basic and universal strategies that can help anyone having difficulties with attention:
Eliminate distractions- get rid of all competing stimulation in your environment. This could include turning off music or a television, closing blinds or shutting doors, or moving to a quiet space to work individually without others around. You could even wear earplugs or noise-canceling headphones to help ignore potential distractions. Make sure your working environment is organized and not cluttered, as this can be a distraction.
Work at your best time of day- many of us have an easier time focusing at a certain time of the day. If you feel more alert in the morning, do your most important tasks at this time when your attention is sharper. It is also important to take breaks and pace out your daily activities so that you are not too fatigued, which can greatly reduce attention.
Complete only one task at a time- our culture seems to prize multitasking. Many of us pride ourselves on being great multitaskers or feel we must be doing multiple tasks at once. However, our brains have a much easier time only focusing on one thing at a time. This will lead to more success with tasks and reduce potential mistakes.
Talk out loud to yourself- talking aloud to yourself while you work on a task can be very helpful to maintain your focus and help decrease any potential mistakes. You could talk through what you are doing as you cook a meal or work on a home project. If you leave a room to go find something or complete another task, remind yourself out loud (or even in a whisper!) of what you are doing.
Add structure to tasks- this could look like taking notes, writing a task into a list of multiple small steps, crossing out parts of a list, circling or highlighting, or using signs or prompts in your environment. The more structure you can add to what you are doing, the easier it can be to maintain your attention to the activity.
While these strategies can be helpful, if you or someone you know is struggling with any of these types of attention after stroke, brain injury, or another neurological diagnosis (e.g., Parkinson’s), getting skilled and personalized treatment from a speech-language pathologist is often the most beneficial. As attention difficulties can be so different for each individual, strategies tailored to each person are often the most effective.
