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Attention and concentration are cognitive (thinking) tools that allow us to choose to focus on something, and stick at it to the end. While doing this, we can be taking notice of some things, and ignoring others.

I might read a letter, while listening to music but ignore the noise of my children playing; I might be listening carefully to what someone is saying, while ignoring other conversations in a room.

Attention means we choose what is important for us to focus on at any moment. Concentration is what enables us to focus our attention for long enough to complete the tasks we wish to.

Last week I made a rather long attempt at ‘summarising’ the working of the brain. I hope this sets the scene for understanding more about how cognitive abilities, like attention and concentration, are used in the work of our brain. And what happens with cognitive changes, after brain injury.

Attention, or attending to information, and concentrating on this information are important parts of being able to manage the many messages coming to the brain every second.

This video clip gives you a firsthand explanation of how it is to live with attention and concentration difficulties:

Sometimes paying attention to the right things for the right length of time and concentrating long enough to get things done, can be much more difficult following brain injury.

The following link is to an article from ‘Lifehacker.com’. It is not specifically about brain injury but it does give a great explanation of attention and concentration, along with a range of things we could all try to better focus our attention:   [box style=”rounded” border=”full”]Train Your Brain for Monk-Like Focus[/box]

What might happen if you had trouble with attention and concentration?

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• It may be hard to pay attention and focus on the priority e.g. in a meeting you are looking at people outside the window rather than listening to the person talking in the meeting.
• It might be difficult to choose what is important to focus on. You might pay attention to everything rather than  filter out what is not important. If you cannot filter out what is unnecessary, attention is spread across too many things at once.
• It might be hard to concentrate on a task, for the time it takes to complete it e.g. starting to watch a movie but finding after a few minutes you just cannot keep up with the plot.
• Become more easily distracted by other things around, maybe appearing restless, and agitated. This might increase if the surroundings are noisy, there is a lot of movement, or other things that draw attention e.g. a child in a classroom is constantly moving around the room seeing what others are doing, and looking at posters around the walls.
• It may be difficult to keep track of what is said or done.
• It may be difficult to do more than one task at a time.
• It may appear a person is being difficult, or disruptive because they interrupt others, become restless, or move from one activity to another.
• Without support or prompting it may not be possible to finish tasks, or follow instructions.

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Remember that to pay attention, and to concentrate requires intense mental effort; if attention and concentration is impaired a person can feel easily overwhelmed and become frustrated.

What Can You Do?

What can you do about it? Well like most cognitive difficulties even learning more about it can help. Understanding gives you clues about how you could assist a person manage it.

Below is a list of strategies you might be able to use as a starting point. Remember before using new strategies::[unordered_list style=”tick”]

• Work with everyone involved to select the best strategies.
• Decide what might work and what best fits the person you are supporting, and their network.
• Choose the key strategy or strategies that might suit (don’t do too much, all at once) and don’t be afraid to modify a strategy to suit the person, their situation and lifestyle.
• Keep the change manageable and minimal for everyone involved.[/unordered_list]

Suggestions:

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• Do the things that need more intense concentration and attention when energy is up and the person is more alert. Often this might mean in the morning.
• Work together to find out what the best length of time for concentration is. Then work for within that span of attention and concentration. Change the task before attention and concentration are lost, whenever possible. Concentration may be only a few minutes.
• Encourage regular breaks, resting when needed, or try an alternative, less focussed activity, (something the person finds restful or not requiring concentration), and then come back to what you were doing.
• Where possible, when concentration is needed, keep surroundings minimal, simple; reduce noise, the number of people, and any other distractions that interfere with concentration and attention.
• Encourage, remind, and positively support the person to stay focused on the task or activity they are involved in, without causing frustration and fatigue.
• Stimulants such as caffeine and alcohol can further reduce concentration, take note of factors that effect attention and concentration and reduce, or stop, if possible.
• Break tasks down into small and achievable steps, that fit within the person’s concentration and attention span.
• Together plan how to approach a task with a simple, step-by-step approach. Record the steps in whatever way works and mark off each completed step. Use the method that works best for the person e.g. phone app, diary, written list, computer program.
• Give prompts and instructions simply, concretely, clearly and as often as required.
• Refer to the strategies for cognitive fatigue as these may help improve concentration. The extra effort needed to pay attention and concentrate can cause fatigue.
• There is a lot of information available now about “mindfulness”. Exploring what this means, and using techniques to encourage mindfulness may be helpful.
• When you need to give information or instruction:[/unordered_list] [unordered_list style=”tick”]
  • Gain the person’s attention, make eye contact, check that they are looking at and hearing you.
  • If agreed and appropriate you might need to use gentle touch to get attention.
  • Stop; then repeat information if they are not hearing you.
  • Ask the person to repeat back what they have heard and give reminders.[/unordered_list]

Still more information –

Here are a couple of links to further articles about attention and concentration that I think help explain it more clearly:

[box style=”rounded” border=”full”]Attention and Brain Injury

How can I Improve my Concentration[/box]

I would welcome any further resources you know about. Please share any experiences, strategies or questions you have in the Comments below or you can send me an email HERE