INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed
Journal of Head Trauma Rehabilitation
Ponsford, J., Velikonja, D., et al. (2023).
Journal of Head Trauma Rehabilitation, 38(1), 38-51.
This clinical practice guideline is an update of the INCOG guideline by Ponsford et al. (2014). This guideline provides recommendations for the management of attention and information processing speed in adults with traumatic brain injury (TBI). The target audience of this guideline is any healthcare professionals, including SLPs, working with adults with TBI. This guideline is part of a series of guidelines published by the INCOG (International Group of Cognitive Researchers and Clinicians) working group.
INCOG Expert Panel
"Clinicians should screen for and address factors that impact attention including hearing, vision, fatigue, sleep-wake disturbance, anxiety, depression, pain, substance use, and medication" in persons with TBI (p. 40; Level C Evidence).
"Metacognitive strategy training using functional everyday activities should be considered for individuals with TBI especially those with mild-moderate attention deficits" (p. 40; Level A Evidence).
Environmental modifications and tasks may be used to reduce the impact of attentional deficits on daily activities for individuals with TBI (Level C Evidence).
Training with periodic random auditory alerting tones is not recommended for facilitate arousal and attentional performance following TBI (Level B Evidence).
Individuals with TBI can use dual-task training to improve dual-task performance on similar tasks (p. 44; Level A Evidence).
"Computer-based decontextualized attentional tasks for individuals with TBI are not recommended because of lack of demonstrated impact on everyday attentional functions. Everyday task-specific training should be considered but cannot be expected to generalize beyond trained or similar tasks" (p. 43; Level B Evidence).
