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Strategies to Improve Spatial Neglect
Following are general strategies to help individuals who have difficulties with spatial neglect:
- For people with spatial neglect, it is often necessary to offer convincing proof that the individual has difficulties attending to space around them. As such, it is often helpful to point out situations in which the individual is ignoring objects in the surrounding space, such as pointing out when he or she moves toward walls, fails to attend to objects, is unaware of the surrounding room, etc. Videotaping (with the person's consent) can be helpful to demonstrate the nature of the neglect and how it impacts the person's functioning.
- Individuals with spatial neglect will benefit from auditory cues such as verbal reminders or finger snapping to the impacted side.
- Individual with spatial neglect will benefit from being provided with visual cues such as red lines which are pre-drawn on pages to be read or scanned. For example, the individual may be taught that he or she should always begin (or end, with right-sided neglect) reading a line of text at a vertical red line (proactively drawn by a caregiver or treatment professional).
- Remedial approaches that are helpful typically involve the use of repetition, in which the individual repeatedly practices eye scanning movements in which a stimuli is tracked from the attended to neglected space.
- With neglect for body parts, awareness may be improved by tactile stimulation (i.e., vibrating device, mildly hot or cold stimuli). For example, a colorful arm band (such as a handkerchief) may be used to draw attention to the impacted side.
- Individuals working with persons with spatial neglect may frequently quiz the individual regarding the location of body parts, particularly those on the affected side.
- Environmental restructuring can be used to improve neglect by placing objects (e.g., books, food, utensils, tools) on the preserved side.
- It may be beneficial to place signs in hallways/rooms indicating the location of hazards, light switches, and destinations. It can be helpful to write the information on only the preserved half of the sign, or use an orienting vertical line as previously described.
- Maps can be effective to help orient the individual, especially if cuing techniques have been effective in directing attention.
- It will be extremely important to keep the environment as consistent as possible. Furniture and objects used in daily activities (e.g., clothes, tools, dishes, etc.) should be consistently returned to the designated storage place by the individual with spatial neglect and all members of the household.
- Environmental clutter will be detrimental to performance, as attentional resources will be overtaxed and the functional impact of the neglect will be greater. Therefore, those items or sources of stimulation that are not needed should be minimized. It will be helpful to remove items from the environment (e.g., home, work place) that are not necessary.
- Auditory or other sensory distractions can magnify the functional impact of visual-spatial neglect, and should therefore be minimized.
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