Attention and Concentration - Fact Sheet
Damage to the brain may reduce an individual’s ability to pay attention or to concentrate, which may impact upon their ability to work, study or even maintain their life at home. However, the injured person may not immediately recognise that their ability to concentrate is any different to what it was prior to the injury.
In addition, there may not be any visible signs to alert other people that a problem exists. This often leads to misunderstanding by members of the community who may think a person who has difficulty maintaining attention is lacking intelligence or motivation. This problem is of particular concern with children who return to the classroom after acquiring a brain injury and may be seen as disinterested or lazy students. People who have sustained a brain injury may:
- Become easily distracted
- Have trouble keeping track of what is being said or done
- Have difficulty doing more than one task at a time
- Experience information overload
- Be slower at taking in and making sense of information.
The effects of these difficulties on people’s everyday lives may:
- Affect their ability to learn and remember information
- Cause them to feel frustrated with themselves and other people (have a ‘short fuse’)
- Make them feel overwhelmed and easily confused
- Lead to fatigue, headaches and dizziness
- Encourage them to withdraw from other people and avoid socialising
- Result in low levels of achievement.
Causes of lack of concentration
A lack of concentration can be caused by many factors, including:
- Fatigue and tiredness, particularly from sleep disorders or viral infections
- Pain and other physical sensations, particularly headaches but including joint, muscle or organ pain.
- Illness, including short-term infections or long-term disease
- Hunger
- Dietary inadequacy, particularly B-group vitamins and iron.
- Legal or recreational drugs or environmental toxins such as carbon monoxide
- Mental health conditions, particularly depression and mania.
- Extremes of mood, including fear.
- Injury to relevant areas of the brain
Somebody with an acquired brain injury is at an increased risk of cognitive or physical fatigue and headaches, as well as pain arising from injury to the head or body from the incident that caused the injury, or referred neurological pain, particularly in the case of whiplash. Acquired brain injury is also associated with an increased incidence of depression and other mental health disorders.
A region of the brain called the lateral intraparietal cortex, within the parietal lobe, controls attention by filtering out what is and is not important at any given time. This region then stimulates the medial temporal area which influences the processing of visual information, determining what visual information is attended to. If the lateral intraparietal cortex is damaged and is unable to play this prioritisation role, then the ability to maintain visual attention will be impaired, severely impairing the ability to concentrate.
There is also evidence that the cerebellum, at the back at the brain, has an influence upon attention and concentration as well as its core role of coordinating muscle activity. Damage to the cerebellum will therefore result in concentration difficulties.
Approaches for enhancing attention / concentration
Realise that what is happening is influenced by the brain injury. If you are supporting someone with a brain injury, provide reassurance when necessary. Generate strategies from past experience, with an awareness for what is currently working or what has worked in the past, but be aware that what has worked may no longer work due to the effects of the brain injury. Identify specific situations where particular strategies may be effective.
The following strategies may be helpful:
- ‘Put blinkers on’ by reducing all possible distractions in the environment
- Take regular rest breaks, have a nap or a walk
- Meditation, deep breathing and other strategies for physical and mental relaxation, such as having a coffee break or talking to friends
- Plan how to approach a task with a simple step-by-step approach, and;
- Break significant tasks down into small and achievable steps
- Write information down using notes and keep them in specific places
- Use a dictaphone to tape messages that can be regularly played back
- Use a white board to help organise, plan and store information
- Use ‘association’ techniques e.g. putting medication on the table with every meal
- Get into a regular daily routine which has a structure
- Aim for variety within an everyday routine
- Schedule demanding tasks when levels of energy and alertness are greatest, commonly early morning
- Eat a healthy diet and sleep well
- Use self-talk to monitor thoughts and actions
- Use a timer or electronic organiser and set yourself goals to steadily improve duration of concentration in small steps.
Monitoring Success
Practise different strategies to work out which are the most effective in different situations using the following self-guided steps (WSTC):
W
What is the problem?
Ask: ‘Where is my attention letting me down?’
S
Select a strategy
Ask: ‘What are all the possible strategies I could use? ‘Which is the best strategy?’
T
Try out the strategy
Ask: ‘What do I need to do to use this strategy?’ Do it!
C
Check out how the strategy worked
Ask: ‘How successful was the strategy?’ ‘Would I do it differently next time?’
Further Information
BIAQ Fact Sheets:
Concentration difficulties and Inattention at wrongdiagnosis.com
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