Flow Experience During Attentional Training Improves Cognitive Functions in Patients with Traumatic Brain Injury: An Exploratory Case Study

Objective/Background: Flow is the holistic experience that occurs when an individual acts with total involvement. The objective of this study was to examine the effects of attention training that induces flow experience for patients with attention-deficit disorder after traumatic brain injury (TBI). Methods: A two-patient case report with a within-subject AB design was conducted. Two patients with attention deficit after TBI were recruited for attention training. Two types of video game tasks for attention training were created, one inducing flow (flow task) and the other not (control task). Patient A performed the flow task for 14 days after receiving general occupational therapy (OT) for 11 days. Patient B performed the flow task for 15 days after performing the control task for 10 days. We examined training effects using neuropsychological tests. The Flow State Scale for Occupational Tasks was administered to identify the patient's flow state. To evaluate the training effect, we used visual analysis, the two-standard deviation band method, and effect-size analyses. Results: Both Patient A and Patient B showed improvement on the Continuous Performance Test, Symbol Digit Modalities Test, and Moss Attention Rating Scale after the flow task. Patient B also showed improvement on the Trail Making Test. Conclusion: The results for Patient A suggested that the flow task was more effective than general OT for improving attention deficits. Moreover, the results for Patient B suggested that the flow task was more effective than the control task. Attention training inducing flow experience may thus facilitate improvement of attention. Copyright (C) 2015, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.