Frequency and duration of inattentive behavior after traumatic brain injury: Effects of distraction, task, and practice

Traumatic brain injury (TBI) is associated with impairments of attention, m ost typically measured through tests of information processing, or by subje ctive symptom endorsement by patients, families, and clinicians. We have pr eviously shown increased rates of off-task behavior among patients with TBI versus controls as defined by videotaped records of independent work in di stracting environments. In this research, we report on a more detailed meth od of coding such videotaped records which allows measurement of the precis e number of off-task behaviors, their durations, and their relationship to distracting events. Using this method, we studied 20 patients with recent m oderate-to-severe TBI and 20 demographically comparable controls as they pe rformed independent work tasks while being subjected to controlled distract ing events. This research confirms that patients are markedly less attentiv e than controls both in the presence of distractions and in their absence, that distractions have an influence on off-task behavior in both groups, an d that the disruptive impact of distracters wanes relatively quickly for co ntrols but not for patients. The duration of distraction produced by variou s classes of distracting events appeared similar for patients and controls, although the power to detect differences in behavioral duration between gr oups was limited. The pattern of inattentiveness among patients showed mini mal relationship to measures of injury severity within this sample.