The Rehabilitation of Attentionai and Hemi-inattentional Disorders

There is much evidence to suggest a close link between attentionai and hemi-inattentional disorders. It is proposed in this chapter that the results of neglect rehabilitation are actually less encouraging than has previously been assumed. Many apparently positive results, it is argued, are actually attributable to similarities between training and test materials. Attempted replications of some of the New York training procedures have frequently found generalisation only to tests similar to the training procedures. One reason proposed for this is that visual neglect is associated with more general attentionai problems that may impede recovery. The evidence for the effectiveness of rehabilitation of attentionai disorders is more positive than it is for visual neglect, though there are also negative findings here. The possibility of training neglect by attempting to modify nonlateralised attentionai difficulties is discussed. Furthermore, the author describes some preliminary studies on the rehabilitation of visual neglect which attempt to bypass the presumed limited attentionai resources of neglect patients. One method evaluated in this way involved teaching patients to use their partially hemiplegic left arms as “perceptual anchors” to which leftward scanning responses were conditioned. A related method involved an avoidance conditioning paradigm where left arm responses (if necessary aided by the right arm) were made on the neglected side. The positive results of these studies suggest that neglect rehabilitation may in the future produce more positive results.