Background 
Attention deficits are common after an acquired brain injury (ABI). Attention can be trained with attention process training, APT, a golden standard for the chronic stage after ABI. However, most patients undergo rehabilitation within one-year post injury. Recommendations for early cognitive neurorehabilitation and specifically for attention training are inconclusive.

Objectives 
Evaluate the efficacy of intensive attention training after ABI on attention and memory within 4-12 months post-injury in a randomized controlled trial (RCT).

Method 
A group of patients (n=107) (78% stroke and 22% TBI) in interdisciplinary outpatient rehabilitation were randomized to either additional 20 hours of attention training with APT (n=56) or activity-based attention training (n=51). 
The following neuropsychological test were used Ruff 2&7(Ruff 2&7 Selective Attention Test), Digit Span , Letter-Number-Sequences and Block repetition (WAIS-IV), Rey auditory verbal learning task (RAVLT), the Color-word test (CWT) and the Trail Making Test (TMT) from Delis Kaplan Executive Function System (D-KEFS), Patients ratings were; Hospital Anxiety and Depression Scale (HADS), Behavioral Assessment of the Dysexecutive Syndrome BADS) and The Cognitive Failures Questionnaire (CFQ). Assessments were administrated pre and post intervention and at 6 months follow-up.

Results
The results indicate that the largest gains for both groups over time were within the area of psychomotor speed (CWT, TMT and Ruff 2&7 speed but not accuracy), but there were no significant differences between the treatment groups. Behavioral self-ratings (CFQ and BADS) also improved over time, but no differences were observed between the two treatment groups.

Conclusions
No significant differences in treatment effect were observed. One must consider the possibility that also the level of attention treatment in the control group was high, and that APT as add-on rendered little or no extra effect on treatment results.

Training of Attention During the First Year After Acquired Brain Injury