Rehabilitation of at tention functions

Attention is what allows one stream of information from the internal or external environment to be selected over others and therefore pervades almost any thought or action we take in our daily lives. It is little wonder then that defi cient attention, a common feature of many disorders of the brain (see Manohar, Bonnelle and Hunter (chapter 34), this volume; Vallar and Bolognini (chapter 33), this volume), can produce such profound functional impairments. With the benefi t of accumulated knowledge from cognitive science, neuropsychology, and neuroimaging, it is now abundantly clear that attention is not a simple unitary process. In addition to being able to select stimuli for preferential processing according to some attribute (selective attention), we must also be able to sustain that selectivity, particularly in conditions of monotony or repetition (sustained attention), and further, we must have the capacity to change the selection from one feature or stream to another (attention switching) (Posner and Petersen 1990; Robertson et al. 1996). Our ever-increasing understanding of how attention is instantiated in the brain is directly fuelling the development of new treatment strategies that can target specifi c attention subsystems (Posner and Petersen 1990). Th e fi eld of cognitive rehabilitation has received a boost in recent years with a number of computer-based training studies reporting promising results. For the most part these studies have addressed defi cits in working memory (Jaeggi et al. 2008; Klingberg 2010). In the present chapter we look at the current state of play in the eff ort to treat defi cits in attention. In so doing we adopt the three-component framework of Posner and Rothbart by reviewing studies that have specifi cally targeted selective attention, sustained attention, and attentional control or switching. Th ere is rather strong evidence for the eff ectiveness of rehabilitation of classically ‘executive’ functions such as initiation, planning, and problem solving (Von Cramon OU P