Cerebral gymnastics: part two

To the best of my recollection, (I'm not kidding I don't recall exactly but) the second round of activities in speech (cognitive) therapy addressed issues of the quality of the attention- the first round having worked on quantity i.e. duration of attention. The activities in round two all involved tasks that demanded "active" listening and reading for comprehension with testing of recall as the measurement /"forced use" aspect of the therapy's design.

In comparing the strategies and tactics of my physical and cognitive therapies I now see parallels in the sense that as the prescribed physical activities presented movements choreographed to "force" the use of my weakened affected side, the mental gymnastics prescribed for speech (cognitive) therapy presented tasks orchestrated to "force" the use of the affected areas of my brain --or the use of thought processes conventionally associated with the right hemisphere of the brain where CT-Scans and MRI's indicated cell damage from the loss of oxygen for the period of time when the normal flow of oxygenated blood through my middle cerebral artery (MCA) was interrupted by the stroke.

A sample of tasks involved included something as simple as listening or reading a passage then repeating a summary of the pertinent details. More challenging exercises involved reading a passage rich in details such as names of people performing various tasks or in possession of various objects and then completing a grid that represented who was doing what--with the trick being that the passage would not provide a"linear" or "complete" inventory of who was doing or was holding what-- so completing the grid required "active" comprehension in reading and re-reading the passage to gather pertinent data and to record "known" items on the grid -The final phase for completing the grid was , then, using what was known to induce or deduce by process of elimination other pieces of the puzzle.

paying for attention deficit

One of the first goals of my speech (cognitive) therapy was simple but critical: to increase the length and quality of attention. The trauma of hospitalization and attending sleep deficit presented significant challenges in sustaining focused attention. After a week or so, once my physical condition had improved to a point where I showed signs of being well-rested, I began working with a speech therapist to address the impairments from damage of a stroke that according to physical evidence depicted by CT-Scans and MRI's caused injury to areas on the right side of my brain. As, an introductory course in cognitive neuroscience or an attempt to hold a brief conversation with me even four days after my stroke would reveal -my injuries on the right hemisphere of the brain had little or no impact on my speech at least in terms of generating words;-) written or verbal expression if anything tended towards too much not too little. So the preliminary work focused on cognitive vs speech therapy of a verbalization nature. The first exercises were appropriately "mind-numbing" to the extent that the assigned tasked required me to control a racing, wandering mind to acquire a state of focus we all know or describe as "paying attention." Not something as simple as awake -vs asleep. but a state of mind that demonstrates an awarenes of and ability to intelligently respond to external stimuli. The first exercises which were I surmise both diagnostic as well as therapeutic involed listening to a recorded voice that read a list of letters and or numbers and pressing a buzzer each time I heard a specific letter or number. This would go on for what appeared to me for 5-10 minute strethches over the course of an hour or so with small breaks for changes of instruction to listen for the number 4 or the letter N. The challenge for me was
(partially) physical like trying to stay focus on driving while extremely tired. The other challenge was allocating sufficient band-width to rember what letter I was waiting for and to press the buzzer when the voice finally spoke the target letter or number. I couldn't help but to feel that I was in a battle of wits with the drone on the tape, who dilligently read his script of random letters and numbers with the dispassion of a mid-western boy-scout brought in to call bingo at a nursing home in vegas recently scandalized by cheating scheme involving a bingo caller on the take. So, my attention available to hear and to respond correctly was in competitio with idle thoughts such as imagining the face or the setting behind the voice on the tape . I did not receive immediate scores or feedback on my performance on these attention deficit tests but recall that my weekly report on goals for the upcoming week and performance against goals for previous week. contiued to note progress with the duration and quality of my attention