Attention and concentration

By brain injury the ability to focus on something or to concentrate may be reduced. This may influence the ability to work, to study or to continue living at home. Sometimes the person in question is not immediately aware of the fact that the ability to concentrate is different than before the injury.

At the outside it is often not noticeable that there is a problem in this area. This often leads to misunderstanding among others who may think that the person is sloppy, paying inadequate attention or has a lack of motivation. This issue is particularly important for children who return to school after a brain injury and are considered indifferent or lazy students. See our special page on this subject.

If a person cannot concentrate on a single subject or a single voice and is unable to ignore the other incentives, this may be caused by overstimulation. Especially with brain injury in the frontal lobes, the brainstem and the little brain problems with alertness are reported.

People with brain injury may have the following problems

• Easily distracted. This causes the fact that a person, for example, cannot escape from distracting stimuli like sounds in the environment. Also attending a conversation in a noisy environment is a problem which can lead to overstimulation

• Have trouble keeping track of what is being said or done,
• Have difficulty doing more than one task at a time,
• Experience all the information he or she receives as information overload,
• Slow in recording and understanding information
• Have difficulty focusing the attention on something (a conversation, an activity, an exercise)
• Have difficulty retaining the attention on to the activity
• Have difficulty dividing attention. If this is difficult, it is almost not possible to perform two things at the same time.  Having a conversation during washing up, for example, does not succeed anymore. Reading a book while the radio is turned on creates a problem. If a person is staying in a noisy environment or living in a family, it can lead to great mutual collisions.

• Have problems with alertness which may vary depending on whether a person can concentrate for a while or is tired

 

Impact on daily life
These problems can affect daily life in the ability to learn and to remember information. It can make a person feel frustrated and be short-tempered. It can give a feeling that everything is too much.

Also, a concentration problem may result in a person to appear confused. It can cause fatigue, headaches and dizziness and performing at lower levels.

A person with an acquired brain injury has an increased risk of cognitive or physical fatigue and headaches, but also on pain in the body caused by the accident and / or neurological pain. With acquired brain injury there is an increased risk of depression and other mental disorders.

 

Brain areas related to concentration

An area in the brains located in the parietal lobe, which is called ‘lateral intraparietal cortex’ checks and filters at any time what is and what  is not important to pay attention to. This region then stimulates the medial temporal region. In this area the processing of visual information occurs and is determined which visual information gets conscious attention.

Damage to the lateral intraparietal cortex may cause the visual attention to get reduced and this may cause serious problems with the concentration.

There is also evidence that the little brain or cerebellum, in addition to the task of muscle coordination, affect attention and concentration. Damage to the little brains may lead to concentration problems.


How to improve attention / concentration?

Be aware that what happens is affected by your brain injury. Try strategies from the past and note what does work, but if that does not work anymore be aware that brain injury may play a major role.

The following strategies may be helpful

• Reduce any possible distraction coming from the environment,

• Take regular breaks, take a nap or take a walk,
• Take a deep breath, look for physical and mental relaxation, for example a coffee break, or a talk to friends,
• Plan your task in a simple step-by-step approach, and divide large tasks into small, achievable steps,
• Make notes and keep them in fixed locations,
• Use a voice recorder from which messages can be periodically played on your smartphone to help you remember,
• Use a whiteboard to help you organize and plan and store information,
• If you use medication, put the medication on the table during every meal or ask your pharmacy for a week delivery,
• Use medication alarms,
• Maintain a daily routine that gives structure,
• Aim for variety in the daily grind,
• Plan demanding tasks at times that your levels of energy and alertness are the highest. This is often early in the morning, but you have to get to know yourself in this. If you are a bad sleeper that is perhaps only after eleven,
• Eat healthy and try to sleep well,
• Talk out loud occasionally in order to monitor thoughts and actions,
• Use a timer or an electronic organizer and set yourself the goal to improve concentration gradually and in small steps,
• Practice different strategies to determine which is most effective in different situations. Then ask yourself what distracts you and what weakens your attention and make a note of it. Also note what you need to do to make a strategy work or what you should do differently next time.