Inattention/Neglect
This film will try to help you understand some difficulties a person may have if their stroke has affected their perception. Perception means the way we understand the world around us. It is not an eye sight problem. Inattention and neglect is a perceptual problem which affects the person’s awareness to one side of the body and the space around it on the affected side.

Look at this table. You can see all the objects from right to left and closest or furthest away from your view. You can pick out all the items individually.

This shows how a person with a left sided neglect or inattention would see the same table. Notice how all the objects on the left side are now out of view. Greg will show us how difficult left neglect and inattention can be.
He needs a prompt or cue to look to his left side.

“Greg can you see the paper on the table?” “Not the newspaper, there’s some writing paper.” “Bring it towards you.” “Can you see what it says on the paper?”

Greg “Clock”

“There are some more words on the left.” “Can you see what the other words are?”

Even when he has the writing paper in front of him, he still has difficulty looking at all the words until he is prompted again to look to the left of the page.

“One more word.” “Can you see it on the left?”

Greg “Draw a clock.”

“Could you do that for me.” “Can you draw a clock?”
As he starts to draw, notice how he starts from the middle to the right side of the page.

“Can you put the numbers on the clock?”

As he begins to add the numbers to the clock, he begins well but he can’t quite see where to put the number 9, which should be further to the left.
When he gets to the number 6 he adds another number 6 and continues to add the correct numbers outside the circle he has drawn.
Greg does not have a memory problem; he knows what a clock should look like and the numbers which should be on it. Because of his inattention and neglect to the left, he does his best to complete the drawing. Even when he is asked to add the hands to the clock, they are also placed to the right side.

“Could you write a sentence Greg?” “Something about the weather?”

When Greg is asked to write a sentence, he starts in the top right side of the page and he quickly runs out of space to complete the sentence. This sometimes happens when the person is trying to read a line of print. They may start in the middle of a sentence rather than at the left of the page.

“Can you see the pink stickers on the left?” “That’s it.” “Can you start the sentence so you can still see the stickers?” “You can write the same sentence again if you like.”

To help Greg notice the left side of the page, brightly coloured stickers were attached to the paper down the left side. The stickers help him to start his sentence in the correct place and as he writes each word, he uses the last word as the reference point to start the next word. This time he has enough space to complete his sentence across the whole page.

Tips for inattention and neglect.

• Give prompts.  (this can be verbal, or physical by guiding the persons hand across their body from side to side.)
• Encourage looking to both sides.
• Consider safety. (the person may not know there is a danger in the neglected space.)
• They may neglect their own body. (for example they may sit on their affected hand without realising it or not recognise their own hand on the neglected side.)
• Extra care outdoors. (There are lots of moving objects, people, noises, distractions and obstacles which the person may not see.)
• Scanning games. (Sometimes scanning games such as dominoes, connect four, word searches or dot to dot puzzles can help with inattention.)