Five Levels of Attention

Did you know? Individuals with cognitive-communication disorders (e.g., TBI, aphasia, and dementia) show marked difficulty with attention, memory, and executive functions. One frequent aspect of TBI secondary impairment is disordered attention.

Five Levels of Attention: 

Focused, Sustained, Selective, Alternating, and Divided

  1. Focused Attention: The ability to respond discretely to a particular visual, auditory, or tactile stimuli. Sometimes called “orienting” to stimuli. It is the lowest level of attention or alertness.
  2. Sustained Attention: The ability to sustain a steady response during continuous attention. On average, adults have an attention span of about 15-20 minutes.
  3. Selective Attention: The ability to maintain attention in the face of distracting or competing stimuli.
  4. Alternating Attention: The capacity for mental flexibility that allows the shift of focus between tasks. People with alternating attention deficits are slow to shift their attention from one task to another. This can also affect conversations. The person will have difficulty with switching conversational topics quickly.
  5. Divided Attention: The ability to respond simultaneously to multiple tasks or to do more than one activity at a time. People with divided attention deficits might have difficulty driving and holding a conversation or cooking and listening to the news.

Strategies for Maintaining Attention

  • Avoid areas near doors, windows, and traffic patterns
  • Provide opportunities to take breaks.
  • Use a written or picture schedule and check off progress
  • Schedule most important work for times of greatest concentration
  • Break assignments into smaller and shorter segments
  • Limit the amount of information you put into your brain
  • Repeat the information in your mind
  • Create and maintain a quiet and non-distracting environment
  • Break larger tasks into smaller ones & redirect your attention back to talook-a-squirrelsk when needed
  • Allow breaks during or between tasks to reduce fatigue from extended attending

Try the sustained/selective attention tasks below by scanning through the stimuli to find the number 2 (first link), and the word “sun” (second link).  These handouts are great resources for individuals with cognitive-communication deficits, and even may be used with our young ones with attention deficits! To make these exercises more challenging, add some background distractions (e.g., music, white noise) to increase the level of difficulty for which the individual needs to attend to. Thanks for reading! 🙂



Amanda Weiner MS CF-SLP, TSSLD


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