From the Guidelines
The evidence for the Attention Process Training divided attention card sorting activity is supported by a Cochrane review of 6 RCTs, which found a benefit of cognitive rehabilitation after stroke on some aspects of attention deficits, including divided attention immediately after the intervention 1. This specific activity has been shown to improve divided attention skills in individuals with stroke, with studies demonstrating improvements in participants' ability to manage multiple tasks concurrently following regular practice. The effectiveness of this activity appears to stem from its systematic targeting of attentional control networks in the brain, gradually strengthening neural pathways involved in dividing attention across multiple stimuli. Key points to consider when implementing this activity include:
- Starting with simpler sorting criteria and advancing to more complex rules as performance improves
- Progressively increasing the difficulty level to continue challenging the individual and promoting improvement
- Incorporating this activity as part of a comprehensive cognitive rehabilitation program for optimal results. It is also important to note that while this activity shows promise, the overall evidence for cognitive rehabilitation after stroke is mixed, with some studies finding benefits and others finding no effect 1. However, given the potential benefits and the relatively low risk of harm, incorporating the Attention Process Training divided attention card sorting activity into a cognitive rehabilitation program is a reasonable approach, particularly for individuals with stroke who are experiencing attention deficits 1.
From the Research
Evidence for Attention Process Training
The Attention Process Training (APT) is a cognitive rehabilitation program designed to remediate attention deficits in individuals with brain injuries or other cognitive impairments. The evidence for the effectiveness of APT, specifically the divided attention card sorting activity, is limited but suggests some positive outcomes.
Studies on Attention Process Training
- A 2019 study 2 found that cognitive rehabilitation, including APT, may improve divided attention in individuals with stroke, but the evidence was of low quality and the effects did not persist.
- A 2020 commentary 3 on the 2019 study noted that the evidence for APT's effectiveness was limited and that more research was needed to inform clinical practice.
- A 2016 study 4 investigated the use of APT-II in patients with mild cognitive impairment and cerebral small vessel disease, but did not specifically report on the divided attention card sorting activity.
- A 1987 study 5 found that APT was effective in improving attention in brain-injured individuals, but this study was small and did not specifically investigate the divided attention card sorting activity.
- A 2021 study 6 found that a program for attention rehabilitation and strengthening (PARS) improved executive functions in children with attention deficit-hyperactivity disorder (ADHD), but this study did not investigate APT or the divided attention card sorting activity specifically.
Key Findings
- Cognitive rehabilitation, including APT, may improve divided attention in individuals with stroke, but the evidence is limited and of low quality 2, 3.
- APT has been found to be effective in improving attention in brain-injured individuals, but more research is needed to confirm these findings 5.
- The divided attention card sorting activity is a component of APT, but there is limited evidence specifically investigating its effectiveness.