The recovery of attention following head injury

William Alan Douglas

The aim of this dissertation has been to assess the effectiveness of computer aided repetitive practice at certain attentional tasks, in pursuit of enhancing attention among head injured subjects. The last fifty years has seen a momentum gathering in the area of brain injury rehabilitation and in recent decades, greater emphasis has been placed on the assessment and retraining of attentional disturbances. Drawing on the ideas of the British Neurologist, John Hughlings Jackson, Zangwill (1947) suggested that rehabilitation could assist higher levels of executive control within the organism to develop compensating strategies to partially overcome the manifestations of lower level disruption. This thesis uses the hierarchical model of attention provided by Shiffrin and Schneider (1977) as a framework within which to explain the functioning of attention, and to understand the deficits of attention which can arise as a consequence of head injury. There is evidence to show that deficits of phasic arousal, signal detection, and speed of information processing are common among the head injured population. A number of studies have been unsuccessful in realizing improvements in attention as a result of four weeks cognitive retraining, but it is argued that this lack of success is due to an inadequate period of training. Using groups of head injured subjects, this study attempted to retrain aspects of attention in 55 hours of training conducted over three months. In addition, some subjects in the first experimental procedure took a maintenance dose of Methylphenidate, a CNS stimulant, in order to study the effect of combining such medication with attentional retraining. Results indicated that three months of computer assisted retraining produced improvements in attention, while one month of such training was not successful. The introduction of Methylphenidate had no therapuetic effect.

The recovery of attention following head injury

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