E V E R Y D A Y SURVIVAL | Connecting You to Helpful Ideas
nlike occupational, physical or speech
therapies, which dictate that certain
steps be done in certain ways to
improve an ability, recreational therapy
begins with the interests of the patient.
What are the survivor’s interests and
hobbies? How can equipment be adapted as needed?
What approach will work best?
Adapting fun activities in ways that help pull attention
to the neglected side can be beneficial for survivors with
spatial (or one-side) neglect. As Dr. Joan Toglia explained
in the July/August 2010 issue of Stroke Connection,
“Spatial neglect involves decreased ability to pay attention
or respond to information on one side. It is not caused by
loss of vision or movement but involves the way the brain
interprets information.” It always occurs on the opposite
side of the body from the side of the brain injury and
most commonly occurs with a right-brain injury. The area
neglected can vary from neglect of one’s own body, to a
lack of awareness of things within reach, to not noticing far
spaces, like entire rooms or the street.
Many of the small things that we do in recreation
therapy can be tremendously helpful. For instance, we
always set up treatment sessions on the neglected side,
which encourages survivors to address that side. Simple
things like tying a helium balloon or a bright ribbon on the
neglected side of the survivor’s bed or wheelchair reminds
him or her to look to that side. When the bright, floating
object catches their eye, it helps call attention to what is
happening on the neglected side.
When survivors are placed in a room with a TV, make
sure the TV is on the neglected side, so they’ll be working
that side while they watch. With that idea in mind, here
are some ideas for activities you can adapt to encourage
survivors to shift attention to their neglected side while
doing something they really enjoy.
Playing cards – A simple Google search
shows numerous types of adaptive card holders
that make it easy for a survivor to play with
family and friends, even if they’re limited to using one
hand. Put a bright sticker on the side of the holder to which
attention should be drawn.
Planting and gardening – Set a pot on the
neglected side, put the affected hand in dirt and
ask the survivor to try to grasp the soil. Place
bright flowers to be planted on the affected side to encourage
looking toward that side.
Lawn games – Play games like lawn darts,
bocce ball, beach ball, scoop ball or pitch-n-catch
in such a way that the survivor must participate
with their affected side, or at minimum that encourages them to
turn or move toward the neglected side.
Music – Listening to music has been proven
to improve recovery (see Healing Vibrations,
September/October 2008) and is an inexpensive,
easily accessible and portable activity. Set the music-playing device on the neglected side so the survivor turns to
acknowledge the sound or select the next song. If playing
music on a laptop or other portable digital device, there may
be colorful visuals available in the media player software that
can be set on the affected side to further draw attention.
Crafts – There are many adaptive devices to
help survivors re-engage in crafts after a stroke.
These include cross stitch/needlepoint that can
be set up on the neglected side to assist with the activity when a
survivor only has the use of one hand.
Remember that the key to recreation that helps with neglect
is to pull the survivor’s attention to the affected side — and
By Margaret M. Kierl, CTRS/L ATRIC & Chris Armstrong, TR Student
Valir Rehabilitation Hospital Therapeutic Recreation Department
Adapting hobbies and other fun activities to
help survivors improve one-side neglect