Computer Based

There are several computerized attention training exercises that have been developed for head-injured patients and these have also been used with psychiatric populations. The Orientation Remedial Module (ORM) is a program developed at NYU Rusk Institute that has a number of attention training exercises and a reaction time test that can be administered before and after each training session. The tasks are intended to improve arousal, alertness, rapid and well-modulated responsiveness, scanning, target detection, and rapid processing of simple information. There are five modules (attention reaction conditioner, zeroing accuracy conditioner, visual discrimination conditioner, time estimates, and rhythm synchrony conditioner) that involve receiving auditory and visual stimuli and eliciting a series of simple visual-motor responses. Progression through one module builds skills necessary for subsequent modules. The tasks are somewhat engaging and feedback is provided to the patients about their performance.

Captain's Log software, available through BrainTrain, and the training exercises developed by Bracey are examples of other computer-based cognitive training packages that include tasks intended to improve auditory and visual attention. There are a number of software exercises available through different vendors, all designed to improve attention, in head-injured or ADHD populations. Although there is no software designed specifically for use by psychiatric populations, some success has been reported in the application of the exercises to this patient group. Psychiatric patients often have severe motivational problems that can affect response to any treatment. Characteristics of software that are best suited to populations with motivational problems include engaging presentation of material, options for personalizing and controlling aspects of the task, frequent feedback, and placing the activity in appealing, relevant contexts. Educational software, developed for use in primary and secondary curriculums, is frequently designed with these features, and some include exercises to improve attention and memory.

Computer-based software exercises are intended to be worked on by individuals, but it is possible to have several individuals working simultaneously at separate computer stations. Depending on the patient profiles, one therapist typically works with one to four clients. The therapist monitors and facilitates productive engagement in the activity and guides the patient to appropriate exercises.

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