Abstract
“Attention” is the most fundamental function of the brain for processing cognitive performance, At times, however, various types of brain damage can impair attention. More subtle attentional impairments are often overlooked in standard clinical settings. Physicians commonly evaluate attention deficits by having the patients perform neuropsychological tasks. The Japan Society for Higher Brain Dysfunction has recently developed CAT(Clinical Assessment for Attention), a standardized test battery for Japanese subjects. The Trail Making Test(TMT)is also widely used to detect the attentional disturbances. In the previous investigation on the clinical attributes of TMT, the author obtained the following findings : first, the non-dominant hand tended to perform comparably to the dominant hand ; second, the task-completion time was more strongly correlated with the cognitive time(a time obtained by subtracting the motor time from the completion time)than with the motor time(the sum of the times for drawing lines to connect the targets); third, shortened cognitive time was attributable to the learning effect of TMT part-A. The primary concern of cognitive rehabilitation is not task performance, but functional real-world behavior. The author, therefore, developed a new system for rating attentional behavior(Behavioral Assessment of Attentional Disturbance, BAAD). A principle component analysis(factor analysis)identified three principle factors : one related to “arousal”, one related to “sustained attention”, and one related to “selective” attention. The BAAD has fairly good reliability and validity. A number of rehabilitative interventions for attentional deficit have been reported. APT and its later version, APT II are therapeutic programs based on a process-specific approach to directly restore attentional function.
