This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Answer transcribed from the Brightway Answers interview with clinical specialist Marlene Rivera:
Practice, practice, practice. Repetition, repetition, repetition.
I'm sure many brain injury survivors have heard this. The best way for you to build focus and increase your attention span really depends on you and what your lifestyle looks like. Setting a specific time each day to engage in activities that target your focus and attention can help you improve these skills over time.
There are many cognitive programs out there that are pretty mainstream, like Luminosity is widely accessible to the public and can help you keep track of your progress. I know some individuals receive outpatient therapy or may receive other services that help them work on these skills. But even if you're not in a therapy program, you still have access to these programs that help you track your progress.
Mindfulness activities also help with improving concentration and attention. With meditation for example, it makes you focus on the present and it takes practice. It's not something that you can just do and be well versed in. It takes repetition and practice.
Being aware of your cognitive endurance level is also very useful before engaging in any of these activities, because that'll help you set limits for yourself. Sticking to those limits is very important, because if you engage in any task for too long you are at risk for decreased cognitive performance because of cognitive fatigue and other residual effects that you may be experiencing from your brain injury.
To determine your cognitive endurance, think about physical endurance. After your workout you are probably tired. Depending on the physical demand, our body is basically telling us we're tired and need to rest. The same thing happens with cognition, even if we don't recognize it as easily. So if you're engaging in a cognitive task - and let's be clear - just managing your environment day-to-day can be cognitively overwhelming at times.
An individual with a brain injury has a more difficult time processing information, which can really impact how you engage in any cognitive task. So if you feel like you are becoming a little bit disoriented or you're having more trouble comprehending what you're reading, what someone's saying to you, that may be a sign of cognitive fatigue.
So when you think about your cognitive endurance, think about at what point that starts to occur for when you begin a task. If you're feeling fine, but then some time later you're noticing that you're just not as productive as you were when you first started, it may mean that you need to take a break because you don't have the cognitive endurance at this point to proceed.
You definitely can improve your cognitive endurance, but it's good to get a baseline of where you are now so that you can begin to set those limits before you put yourself at risk of doing some unsafe things when you're not thinking as clearly as you could if you were to take a break.
This is actually really important. We can't really expect someone to sustain focus for 30 minutes. Someone uninjured is able to be on task for seven minutes without interruption. What that means is if I'm writing a letter, I have seven minutes on that letter without picking up my head, turning to see if everything's okay in the living room, looking at my phone.
Sometimes clinicians shoot too high - 30 minutes isn't feasible. So what I do is time attention so you can see how long the patient is able to sort colors or cross out letters or fold towels, whatever the exercise is. Doing these common tasks is how we start to build focus, that actual sustaining of attention.
Auditory attention is determined by reading two-three sentences and asking “did you hear what I said?”. That goes into the working memory as well. So auditory attention would be their working memory, going into short-term memory, going into retainment. So that all goes hand in hand and are important preliminary tasks to target.