ATTENTION TRAINING EXERCISES USING BRAINWAVE-R Aim To understand why attention training is needed by some service users. To be able to safely and effectively carry out prescribed attention training exercises with a service user. What is attention? Attention is the ability to focus on certain aspects of the environment that the service user considers important. Attention skills underlie all other cognitive processes and are commonly affected even after mild brain injury, stroke and other neurological conditions. Attention can be divided into 5 clinical models:- - Focussed attention the ability to be flexible in attending to something - Sustained attention the ability to maintain attention - concentration - Selective attention the ability to avoid distractions from stimuli not important to the task - Alternating attention the ability to shift focus and alter between tasks - Divided attention the ability to respond to multiple tasks How to teach attention processing exercises to the service user The aim of attention exercises is to increase the service user s ability to attend to information through a process training programme by using the Brainwave- R Rehabilitation Programme (Cognitive strategies and techniques for Brain Injury Rehabilitation). The Brainwave-R attention exercises aim to address each of the following areas:- - Focused attention - Sustained attention - Selective attention - Alternating attention - Divided attention
Procedure 1. Check plan for the exercises that the Occupational Therapist has requested you carry out and the length of the session. Ensure you have a quiet room that is free from any distractions e.g. no clutter, well lit, and a suitable temperature, have a notice as visual ready to put on the door so that the session is not interrupted to enable the patient to carry out these exercises. Have the exercises ready and familiarise yourself with the exercises prior to the session ensuring you have all the suitable equipment ready e.g. a suitable pen/pencil, paper, table, watch and seating set up before the session begins, refer to the patients plan. 2. Explain the reason for the exercise e.g. the aim of this session is to work on improving your concentration by carrying out some paper games/exercises. Ask the patient if they consent. Once consent is given check if the service user wears glasses for reading or has a hearing aid (bring these to the session) then take the service user to the treatment room (referring to there manual handling plan). 3. Position the Service User so that they are sitting upright with a table in front of them and their affected arm well supported (in accordance with their treatment plan). Check with the service user that they are seated comfortably and are able to reach the table to carry out the exercises with ease. 4. Position of the Rehabilitation Assistant You need to sit facing the service user, unless their treatment plan specifies differently. 5. Explain how to perform the exercise Each exercise has clearly written instructions read out these to the patient and ask them if they have followed the instruction. It may be helpful to have a trial run before starting the exercise to ensure they can hear you, and have understand the task. 6. Ready Each of the exercises should be carried out for five minutes or the length of time as specified by the Occupational Therapist and the service user s results are then recorded on a daily basis for one week or until they achieve a full score. Throughout the exercise the service user should be observed. If they are fatigued, distressed, in pain or does not want to continue with the task then stop immediately. 7. Completion Feedback to the service user and seek feedback from them regarding the session. Check the service user is comfortable and not in pain
8. Document clearly in the service user s notes the outcome(s) of the session 9. Feedback clearly to the Registered Practitioner who has delegated that task regarding how the service user did, how easy the task were and any pain or discomfort.
SUPERVISED TASKS/EXERCISES CARRIED OUT BY REHABILITATION ASSISTANT COMPETENCIES NAME: TAUGHT MODELLED COMPETENT OT15 ATTENDTION TRAINING DATE DATE DATE 1 Read plan and identify the exercises to be carried out. 2 Demonstrate knowledge of: i. When and why service users have attention problems ii. The purpose of attention training exercises and how to carry them out 3 Give a verbal explanation of what you are going to do with the service user and gain their consent 4 Position of the Service User (check if wears glasses or has a hearing aid) 5 Position of the Rehabilitation Assistant relative to the Service User 6 Read the exercise instructions to the service user, check they have heard and understood 7 Carry out the exercises with the service user and score them 8 Feedback to the service user on how they have done and seek feedback from them.
OT15 ATTENTION TRAINING DATE DATE DATE 9 Documentation 10 Feedback to registered practitioner who delegated exercise/task Sign and date when achieved Signature of Learner Signature of Assessor Date of Review