Cite: Towey, G.E., Fabio, R.A., & Caprì, T. (2019). Measurement of attention.

In
Caprì, T., Fabio, R.A., Towey, G.E., & Antonietti, A. (Eds). Psychology Research
Progress. New York: Nova Science Publisher. ISBN: 978-1-53615-441-2

Chapter 2

MEASUREMENT OF ATTENTION

Giulia Emma Towey, Rosa Angela Fabio

and Tindara Caprì*
Department of Clinical and Experimental Medicine,
University of Messina, Messina, Italy

INTRODUCTION

New neuropsychological methods regarding the measurement of

attention have been developed, which render the measurement of attention
to be quite complex. These methods are related to different theoretical
models of attention, and diverse aspects have been integrated into a
neurocognitive model of attention. This neurocognitive framework
involves separate but interacting brain areas, underlying the attentional
functions of alerting, orienting (selection), and executive control (Fan,
McCandliss, Sommer, Raz, & Posne 2002; Petersen & Posner, 2012;
Posner & Petersen, 1990). There are many ways to measure attention.
Here, we focus on quantitative techniques which provide fine-grain

*
Corresponding Author’s Email: [email protected].

Complimentary Contributor Copy

42 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

information regarding attentive responses. An attentive response can be

either measured directly in the brain, or indirectly through a participant’s
behavior. In this chapter, we will present some of the main instruments that
allow the measurement of attention, with the idea in mind of a
multidimensional construct. The first section will present the tests that are
widely used in the assessment of attention, in particular visual attention,
followed by some paradigms that measure sustained attention and auditory
attention.

2. VISUAL ATTENTION

In everyday life, we are immersed in an unlimited number of stimuli

that we need to attend to. How do we select and search for things in the
environment? Sometimes the ability to search for a target among others is
very easy, especially if we know what we are looking far (Caprì,
Gugliandolo, Iannizzotto, Nucita, & Fabio, 2019). Visual Selection is a
crucial ability that both allows us to interact with the environment
(Theeuwes, 2010).
Visual attention has been a topic in the field of experimental
psychology since the early studies of Mertens (1956), and later Posner and
colleagues (Posner, 1980; Posner, Nissen, & Ogden, 1978).
Michael Posner was one of the first researchers interested in the study
of visual attention, using a detection paradigm, defined, spatial cueing or
Posner’s paradigm. A spatial cuing task involves the presentation of a
target to the left or right of fixation, and participants have to respond to the
presence of the target (detection) or a stimulus that is identical to the target
(identity) (Posner, 1980).
Further studies have analyzed the selection of stimuli. In this field,
Anne Treisman developed a paradigm, called visual search, in order to
study the mechanisms of visual attention.
The visual search paradigm uses tests that take reaction times into
account, such as the Pearson Test and Oddity paradigm. If reaction times
are the focus of the study, the following tests are used: Posner’s Test, Deux

Complimentary Contributor Copy

 Measurement of Attention 43

Barrages, Benton's Visual Discrimination Test, Mesulam’s Non-verbal

Cancellation Test (Fabio, 2004).

2.1. Test Deux Barrage

Attention is not a unitary phenomenon. Different theories of attention

have been mentioned in the first chapter. Some authors, such as
Parasuraman (2000) distinguished three different aspects of attention: (1)
selection, that is, the ability to discard different inputs, processing some of
them rather than others; (2) vigilance, namely capacity of maintaining
attention over time; and (3) control, that allows conflict solving and
planning different activities. Other than selecting and filtering, attentional
processes need to be active in inhibiting interfering stimuli, so it is
necessary to inhibit task-irrelevant responses. Conflict situations call for
selective and sustained attention, which need to be active all the time. The
ability to inhibit irrelevant responses is sustained by the executive control
system (Botvinick, Braver, Barch, Carter, & Cohen, 2001) and structurally
associated to the activation of prefrontal cortex and the anterior cingulate
cortex.
Sustained attention is the ability to direct and maintain cognitive
activity on specific stimuli. According to De Gangi and Porges (1990), in
order to be able to complete any planned activity or any sequential action it
is necessary to use sustained attention. For example, for a child to solve a
math problem, he must first read, understand what is written, create a
mental image of the situation described, identify the relevant data, set the
solution, perform the operations correctly, and finally give an answer. In
all these sequences, he focuses on the problem and “resists” any
distractions that might interrupt or interfere with the solution.
With reference to the measures, sustained attention was examined with
continuous performance tasks (Rosvold, Mirsky, Sarason, Bransome e
Beck, 1956), such Test Deux Barrage (Di Nuovo & Smirni, 1994;
Feuersten, 1979) and Posner’s Test (Posner, 1980). These paradigms allow
the recognition of targets within a visual stimulus matrix, composed of

Complimentary Contributor Copy

44 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

target stimuli and distractor stimuli. The difficulty of the task is strictly
related to the complexity of the perceptive stimuli used in the different
versions of the test.
The Deux Barraget Test, created by Feuerstein (1979), is composed of
matrices consisting of three stimuli-targets (squares with adjacent segments
coming out of the vertex or the sides) alternating with distractor stimuli
belonging to five different categories (fillers, squares with different
orientations of the segments with respect to the targets). Each matrix is
composed of sheets containing 144 targets and 336 distractors, arranged in
random order. At the top of each page of the matrix, there are three targets
to be identified within the matrix (Antonietti, Balconi, & Fabio, 2000;
Fabio, Caprì & Romano, in press). This instrument can be administered in
classic version, or in dual-task conditions. In the dual-task condition, while
the subjects are identifying the stimuli-targets they are exposed to a second
task that needs a response, for example, listening to the recording of the
reading of some passages. In the Deux-Barrage test, the scores are the total
number of correct responses (number of stimuli-targets identified) and the
number of omissions (number of stimuli-targets omitted).
In a continuous performance task, the individual is asked to respond to
signals, presented in a repeated occurrence (Mackworth, 1951, Casagrande,
Curcio, Tricarico, Ferrara, Porcù & Bertini, 2000). Two factors are
particularly relevant: the ability to keep the activity focused on specific
stimuli and, at the same time, the ability to resist the distraction exerted by
other stimuli (distracting stimuli). Moreover, in the case of prolonged
attentional tasks, the setting is more complex. Kahneman (1973) argued
that the characteristics of information processing over a long time are
related to the ability to allocate resources strategically.
From the analysis of the attentional curves, it is possible to detect
substantial differences in the performance of the subjects. Precisely, in the
Deux Barrage test, a monotonic performance trend was observed, with a
gradual improvement in both parameters (number of correct responses) and
accuracy (number of omissions) (Antonietti, Balconi, & Fabio, 2000).

Complimentary Contributor Copy

 Measurement of Attention 45

2.1.1. Posner’s Test

Michael Posner demonstrated that selective attention was the result of
both overt and covert forms of attentional orienting (Navon, 1977; Posner,
Snyder, & Davidson, 1980). Posner developed an experimental task,
known as Posner’s paradigm, to examine the effects of spatial cueing on
selective attention. Through this task, Posner (1980) demonstrated that
attention can be drawn to a location using a peripheral cue. Different
variants of the paradigm have been created to study spatial attention
mechanisms (Fan, McCandliss, Sommer, Raz, & Posner, 2002) and to
assess attention disorders (Ethier, Muckle, Jacobson, Ayotte, Jacobson, &
Saint-Amour, 2015).
In the classic Posner test, presented on a computer screen, subjects
have to detect a target that will appear in one of the two boxes that are
equidistant from a central fixation cross. The fixation point is positioned
midway between two empty white boxes. In some trials, attention is drawn
to one of the two boxes by flashing one of them (peripheral); in other trials,
a cue arrow points to one of the boxes directing attention “voluntarily”
(central). Valid cues are those in which the cue correctly predicts the
position of the target, whereas invalid cues indicate the wrong box
(Figure 1).

Figure 1. Posner’s Paradigm.

Complimentary Contributor Copy

46 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

Normally, the subtest shows a cue validity effect consisting in faster

reaction times (RTs) and an increase of accuracy for valid cues (apart from
the phenomenon of inhibition described below). This means that the cue
facilitates the process of orienting attention which allows to speed up the
response. A critical issue of the paradigm is the number of “valid” trials
(mostly 80%); in this case, the cues are informative. In other cases, the
cues do not predict the position of the target that may appear in an uncued
location. As is predictable, we can direct our attention to a specific target
in space especially if external stimulation or internal desires orient our
attention, so if an object appears in that position, it will be quickly
processed. However, it seems that people are reluctant to direct their
attention to the previous position. This phenomenon is known as
“inhibition of return” (IOR) (Klein 2000; Posner & Cohen 1984). In this
paradigm, the shift of attention is observed only in short stimulus-onset
asynchronies (SOAs) between cue and target (Maylor, & Hockey, 1985;
Rafal, & Henik, 1994).
Recent studies on the IOR suggest that there are many interpretations
of the phenomenon (Dukewich, & Klein, 2015). For example, it is
questionable if both exogenous and endogenous cues cause IOR; the
central arrow can be considered an endogenous cue as attention moves
voluntarily, and it is logical to assume that there will not be an immediate
inhibition at that location. However, it is more common to observe IOR
with exogenous stimuli when attention is moved reflexively (Klein, 2000).
An important issue is the categorization of the stimuli; for example, many
studies use the arrow referring to this cue as an endogenous cue, while it is
possible that this is an over learnt social stimuli and instead the shift in
attention is reflexive (Prasad, Patil, & Mishra, 2015).
The cueing paradigm has revealed that in everyday life people are
engaged by different characteristics of stimuli that attract purposely with
the aim of obtaining specific goals, and in this case, we talk about
endogenous attention; it is common that we are involuntarily attracted by
aspects of the world around us (exogenous capture) (Prasad, Patil, &
Mishra, 2015).

Complimentary Contributor Copy

 Measurement of Attention 47

These paradigms show how people deal with external stimuli, and that
spatial attention can be directed voluntarily in specify directions.

2.2. Reaction-Time Paradigms

Reaction times have been studied through the following paradigms:

Stroop Effect, Simon Effect and Navon Effect.

2.2.1. Stroop Paradigm

In the Stroop Color-Word Interference Test (Golden, 1978; Stroop,
1935) people are asked to name the colors in which words are printed, and
the word may spell the color names themselves. If there is incongruence
between the meaning of the word (in this case a color) and the color that it
is printed in, repeating the color it is printed in without reading the word
itself is very difficult. Such a task requires subjects to perform a less
automated task (i.e., naming ink color) and to be able to inhibit the
interference of an automated task (i.e., reading the word). Most people
exhibit what is defined as the Stroop effect (Stroop, 1935).
There are many versions of the Stroop paradigm; in general, the
computerized form of the test is composed of four conditions: word-word,
color-word, color-word congruent, color-word incongruent. The condition
in which the Stroop effect occurs is the fourth, i.e., when the subject must
recognize the color with which the word displayed is written. This test
consists of four blocks each containing 10 tests, for a total of 40 items. The
word-word condition is the first block: the subject is placed in front of the
screen and is presented a word, usually the name of a color (written in
black) and two other words positioned laterally, one on the right and one to
the left. The required task is to press the left mouse button when the word
written on the left is the same as the one presented in the center, or vice
versa to press the right button when the word on the right is the same as the
center word. The “color-word condition” represents the second block; in
the middle of the screen a colored square will appear, while on the left and
right side there will be two colored names, as in the previous block. The

Complimentary Contributor Copy

48 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

subject is asked to match the color of the square to the word that describes
the color and, depending on whether the correct word is on the right or left
side, he responds by pressing the mouse button relative to the position. The
“congruent color-word condition” represents the third block; as in the first
block, at the center of the screen a word is placed, which names the name
of a color, which must be combined with another word placed on the right
or left. In this condition, the central word is colored, you can find the word
RED, written in red that must be connected to the word RED, however,
written in black. The “incongruent color-word condition”, represents the
last block; the subject is presented a word, for example RED, but it will be
written in green. On the two sides of the screen there are two other words,
one on the right and one on the left, which in our case will be RED and
GREEN, the task of the subject is to link the color of the written word in
the center to the word, either on the right or left, which describes that
color.
The parameters are the reaction times (RT). When the task is to say the
name of the color, RTs are faster for congruent stimuli than non-congruent
ones (Stroop, 1935).
Some authors state that interference occurs because color naming and
word reading are processed in parallel, so that when only one of the
automatic processes can be articulated, interference occurs when
generating the output response (Cohen, 2014). RTs will be higher for the
color naming conditions, as word reading has been shown to proceed
faster.

Figure 2. Example of Stroop test.

Complimentary Contributor Copy

 Measurement of Attention 49

As outlined above, there are different versions of the test. For example,
a different version created by Delis, Kaplan, and Kramer (2001), (Delise-
Kaplan Executive Function System (D-KEFS) Color-Word Interference
subtest) presents the particularity of an Inhibition/Switching condition.
This condition includes a contextual cue presented in the box which
indicates that participants need to “switch” to reading the word instead of
naming the color. In a recent study that analyzes cognitive flexibility in
Generalized Anxiety Disorder (GAD), the D-KEFS test was used, adapting
it so as to include valence stimuli (Emotional Stoop Test) (Lee & Orsillo,
2014).
The Stroop paradigm has always been considered the “gold standard”
measure for studying focused attention within a competitive response
situation. Even so, attentional processes are not involved in a spatial
selection, as for example in the Posner paradigm, but rather they focus on
specific features, such as the meaning of the word or the font color. Even
though there is an involvement of attentional processes, the situation in
which people are asked to respond to competitive stimulus creates an
interference of executive control. For this reason, the Stroop test is often
used by neuroscientists to evaluate executive control.
In several studies conducted using the Stroop paradigm, it has been
shown that intellectually disabled people suffer most from the phenomenon
of interference. This seems to be due to the fact that the intellectually
disabled subjects have less attention resources at their disposal; they
present the phenomenon of cognitive inertia, a typical characteristic of
intellectual disability understood as “the tendency to persevere on a certain
behavior even when this is no longer adaptive to the situation” (Fabio,
2005; 2007a; 2007b; Fabio, Oliva, & Murdaca, 2011; Fabio, 2012a; 2012b;
Fabio, Caprì, Campana, Buzzai, 2018).
Since early neuropsychological studies, it has been demonstrated that
there is activation of the cingulate cortex during the Stroop task. These
findings induced Cohen (2014) to propose that he activation of the anterior
cingulate cortex (ACC) is associated with conflict monitoring.

Complimentary Contributor Copy

50 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

2.2.2. Simon Paradigm

As with the Stroop paradigm that allows the measurement of the
attentional control component, Simon (Simon, 1969) created a similar task
to evaluate the effect of conflicting cues on information processing. In this
task, participants are presented, on a computer screen, one of two colored
objects (e.g., circles or a light) and need to press a left or right key
depending on the color of a stimulus (e.g., left key when the circle is red
and right key when it is green) ignoring the position of the stimulus. In the
incongruent trials, subjects have to press a key that is on the opposite side
of the stimuli. Results indicate that the location of the object provides an
irrelevant directional cue that interferes with the real cue, that is the color
of the circle (or the light).

Figure 3. Example of Simon’s Task.

Complimentary Contributor Copy

 Measurement of Attention 51

In the Simon effect, RTs are faster when the position of the stimulus
and the position of key responses coincide (both on the right or the left)
than when they do not coincide (one on the left and the other on the right).
The Simon effect shows that an irrelevant feature of the stimulus (its
position in space) has an effect on the rapidity of the response provided on
the basis of the relevant characteristic. Probably, the automatic orientation
of attention, caused by the appearance of the stimulus at the periphery of
the visual field, leads to the encoding of its spatial position.
Even though the Stroop effect and the Simon effect seem to be very
similar, Liu, Banich, Jacobson, & Tanabe (2004; 2016) studied the two
effects, and demonstrated that there are differences in the brain activation.
It is probable that the differences are associated with the characteristics of
the tasks: stimulus–stimulus (Stroop) vs. stimulus–response (Simon) (Liu,
Banich, Jacobson, & Tanabe, 2004; 2016). The authors concluded that the
ACC activation is much more complex and does not refer only to the
conflict monitoring system (Cohen, 2014). Indeed, the ACC is associated
with different cognitive processes, such as executive functions, including
focused attention and response intention (Cohen, 2014).

2.2.3. Navon Paradigm

This effect was described, for the first time, by Navon (1977). In this
task, the subject is presented with large letters (global level) composed of
small letters (local level). For example, the letters may be E or =. Thus,
there are four global-local combinations, two congruent (a global E formed
by local E, or a global = formed by = local) and two incongruent (a global
E formed by local =, or a global = formed by local E). The subject has two
buttons, one for the H answer and one for the S.
There are two types of instruction for the subject: sometimes he must
take into account the global level and neglect the local level (a global H
requires the answer H, regardless of whether it is made up of local H or S);
sometimes, however, he must take into account the local level (a global H
formed by local S and a global S formed by local S both require an
answer). It is clear that global delivery leads the subject to direct attention
to the global level, while local delivery indicates the subject to direct

Complimentary Contributor Copy

52 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

attention at the local level. The Navon effect can be interrupted into two
independent effects. When the relevant level is local, the presence of an
inconsistent letter at the global level (not relevant causes a sharp slowdown
of the RT. When the relevant level is global, the presence of inconsistent
letters at the local level (not relevant) produces a much smaller or even null
interference. The parameter is the reaction time. The Navon effect occurs
because there is an asymmetric interference effect. When the relevant level
is local, the presence of an inconsistent letter at the global level slows RTs
(Navon, 1977). This effect induced Navon to affirm that perception
proceeds from global analysis to a more general perception. Global
analysis is vertiginous as it allows for the economization of processing
resources, thus, studies have demonstrated that if the patterns are
manipulated in terms of stimuli density, there are advantages for local
features.

Figure 4. Example of Navon’s Task.

2.3. Priming

The Priming paradigm is an influential paradigm in cognitive

psychology that was originally developed to measure attentional selection.

Complimentary Contributor Copy

 Measurement of Attention 53

Priming is a phenomenon whereby exposure to one stimulus (prime)

influences a response to a subsequent stimulus (target), without conscious
guidance or intention. In a typical paradigm, a stimulus is presented to a
subject and the first stimulus affects the processing of the second. In
priming, the focus of attention on the first stimuli may result in either faster
responses (positive priming) or slower (negative priming) responses.
In a denomination task, a word-target is presented, this is preceded by
a “word-prime”, in order to understand what influence the latter has on it.
The measure is the reaction time with respect to the emission of the target
word (RT vocal). Priming can be positive, when the response to stimulus is
facilitated; negative, when the response to the stimulus is slowed because
of the characteristics of the stimulus that preceded it (Legrenzi, 1994). The
effect of positive priming, or facilitation of the response, is obtained when
the target of the second test is equal to that of the first one. The effect of
negative priming, or inhibition of the response, occurs, however, when the
target of the second test is equal to the distracting stimulus of the first
(Fabio, 2009). Usually in a primed task, the prime (word) proceeds the
target and provides semantic category for the succeeding word or may be
phonemically associated. The prime can facilitate the decision when the
words are related and reduces RTs.
There are two types of sequences: those in which the majority of
priming words in a series are valid, and those in which prime words are
mainly invalid. In the former, facilitation and inhibition to the succeeding
words are maximal, in the latter, at the first valid prime there is facilitation,
but when the prime is invalid there is no effect (Posner, 1980). Posner
suggested that while positive priming creates a conscious activation,
associated with greater facilitation and inhibition, unreliable primes do not
cause such pathway activation.
Research has demonstrated that priming affects early stages of visual
processing. EEG studies showed that priming causes a latency shift and
amplitude differences in the P1 component (Olivers, & Hickey, 2010).
Given that priming is a phenomenon present in early processing, it would
appear that it takes place without top-down control.

Complimentary Contributor Copy

54 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

The study by Merrill (2004) demonstrates that the processes involved

in the identification task of target stimulus are different from the processes
involved in the location task, for the following reasons:

1) coding and identification process could take place in different parts

of the brain;
2) some types of information are easier to process.

It is probably easier to locate a stimulus than to identify it. Negative

priming might require a very high investment of resources, a hypothesis
that could occur in situations of double task, in which any subject would
have difficulty in providing adequate answers in the negative priming.

2.4. Oddity Paradigm

On a behavioral level, selective attention is evaluated with paradigms

in which subjects have to respond to infrequent targets (odd) (Singh-Curry,
& Husain, 2009). The oddity paradigm investigates situations in which the
target stimulus interacts with the context in which it is inserted. There are
different versions of the oddball paradigm (e.g., auditory or visual), but
they all have the characteristic of presenting frequent, standard stimuli
(e.g., 80%) and infrequent deviant/target stimuli (e.g., 15%). One of the
versions consists of the simultaneous presentation of stimuli, at least three,
two of which are similar or similar to each other perceptually and/or
functionally. The task requires the identification of the extraneous and
incongruent element. The stimuli can be presented in three different ways:

a) strong triplets, when all the stimulus words are strongly correlated
with each other (fork, knife, glass), Figure 5;
b) weak triplets in which the stimulus to be identified is not related to
the other two words, which instead belong to the same conceptual
category, Figure 6;

Complimentary Contributor Copy

 Measurement of Attention 55

c) unrelated triplets where each word belongs to a different category,

Figure 7.

Figure 5. Example of Oddity paradigm.

Figure 6. Example of Oddity paradigm.

Figure 7. Example of Oddity paradigm.

The methodology of this paradigm is very flexible and can be applied

in different study situations.
In a study conducted by Fabio, Perini and Stefanoni (1992) the
influence of the different degrees of “triplet bonding” on the re-evocation

Complimentary Contributor Copy

56 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

rates in children with intellectual disabilities and typical development was

analyzed.
The authors postulate two hypotheses:

1) Subjects with typical development and subjects with intellectual

disabilities exhibit behaviors of selective attention that, although
different in quantitative terms, can be structurally similar in
interactive target-context situations;
2) In the “choice”, the subject must “strive” and understand what the
target stimulus is. In the “reading”, the subject is simply informed
about what the target stimulus is. Thus, in both conditions, the
subjects must recall the proposed stimuli presented.

Also, it was hypothesized that the perceptually distracting elements

could interfere with the attention of the subjects. In particular, subjects
with intellectual disabilities “would be sensitive to the presence of
perceptually distracting elements to a greater extent than normal subjects.
The distraction was represented by the fact that a non-target word was
colored in red.
Different variants of the oddball paradigm are used in the evaluation of
the integrity of selective attention in the clinical population. A large
proportion of neuropsychological studies have associated the paradigm
with EEG evaluations, in particular P3 evoked response associated with the
detection of salient events. Greater amplitudes and shorter latencies of the
ERPs are interpreted in terms of increased attentional process (Delgado-
Pastor, Perakakis, Subramanya, Telles, & Vila, 2013). In this paradigm, the
target elicits the P3 in the parietal lobe, and is absent after familiar non-
targets (Delgado-Pastor, Perakakis, Subramanya, Telles, &Vila, 2013).

2.5. Das’ Test

The Das’ Test is an instrument to measure selected attention. A first

version is composed of targets and some distractor stimuli. The greater or

Complimentary Contributor Copy

 Measurement of Attention 57

lesser difficulty of the task is strictly related to the complexity of the

perceptive stimuli used in the different versions of the tests. Subsequently,
Melnyk and Das (1992) created the physical identity and semantic identity
of pairs of figures tasks.
The figures represent fruit (strawberry and grape bunch), flower (rose
and daisy), tree (palm and elm), face (frontal representation and in profile)
and animal (dinosaur and dog) categories. They are presented in a matrix.
The permutation of the 5 categories in pairs gives a total of 120 pairs. In
the task of physical identity, the subject is presented with the sheet
described above and is asked to identify and circle the pairs in which the
two figures are physically identical; he is also asked to respond as quickly
as possible. The task of semantic identity is equal to the task of physical
identity with the difference that in this case the subjects are asked to search
for the pairs of items in which both figures belong to the same nominal
category. Another way to vary the difficulty of the task is to have the
subjects perform a double task, i.e., the subjects perform the Posner Test at
the same time as a memory recall task.
In a study by Fabio and Cossutta (2001) physical and semantic tasks
were used. The main aim was to evaluate selective attention in subjects
with intellectual disabilities. The measurement parameters were: a) the
number of correct answers, the omission errors (the unidentified target
pairs), the commission errors (incorrectly identified target pairs, i.e., false
alarms) and the time taken by the subjects to complete the task itself
(processing speed). The results showed that subjects with intellectual
disabilities showed automation deficit in coding processes.

2.6. Mesulaum and Weintraub’s Symbol Cancellation Test

Symbol Cancellation tests are often used to evaluate selective attention

or visual spatial capacities in clinical subjects (e.g., stroke or neglect).
Cancellation tasks involve selective and sustained attention, psychomotor
speed, visual searching and motor coordination (Dozzi Brucki, Mansur,
Carthery-Goulart & Nitrini, 2011). Cancellation tasks involve the search

Complimentary Contributor Copy

58 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

for letters or symbols among distracting stimuli that are arranged either
randomly or in organized rows and columns.
Mesulaum and Weintraub’s Symbol Cancellation Test (SCT;
Mesulam, 1985) is composed of four test forms: verbal and non-verbal
stimuli, presented as random and structured arrays. In the non-verbal part,
examinees are presented with a sheet in which there is a series of familiar
(e.g., circles, triangles, and stars) or non-familiar symbols (60 targets for
each sheet). Participants are asked to draw a line through all the target
shapes that they can see. In the random symbol version, 60 target stimuli
are presented in a page among many distracting stimuli. The performance
is evaluated according to the number of correct targets that have been
identified and the time to complete the task.
Even though the test is prevalently used in neuropsychological
assessment, it often needs qualitative analysis. For example, Mesulam
(1985) found that healthy adults carrying out the test usually proceed using
a systematic approach, from left to right or starting in the first row and
continuing from right to left for the subsequent row. This means that it is
important to evaluate the strategy used in completing the task. Moreover,
the number of omissions, if concentrated only on one side of the sheet, can
give information about neurological disorders, such as hemiattentional
neglect (Lowery, Ragland, Gur, & Gur, 2004).
Studies have demonstrated that visual search tasks are influenced by
different variables such as age and educational level (Lowery, Ragland,
Gur, & Gur, 2004; Ostrosky-Solis, Ardila, Rosselli, Lo ́pez-Arango, &
Uriel-Mendoza, 1998). While it seems that age does not influence the
number of errors, the elderly need greater time in completing the task
(Dozzi Brucki, Mansur, Carthery-Goulart & Nitrini, 2011; Lowery, et al.,
2004) while young adults complete the test in under 2 min.
Mesulam (19885) affirm that there are differences in the way people
use scanning strategies, with erratic search strategies mainly used when the
stimuli are organized in unstructured arrays, while structured arrays are
associated to systematic search. The effect of educational level has been
analyzed in a study with participants having zero schooling against 3 years
of education.

Complimentary Contributor Copy

 Measurement of Attention 59

Ardila and Moreno (2001) demonstrated that non-educated subjects

have difficulties in visual discrimination tasks, and this may be due to low
exposure to cognitive strategies that are employed in the typical scanning
techniques used in writing and reading (grapheme–phoneme mapping).
Dozzi Brucki, Mansur, Carthery-Goulart and Nitrini (2011)
demonstrated that education levels influence cognitive strategies used in
the SCT; more precisely, illiterate participants used random strategies
much more that participants with a minimal school attendance,
demonstrating that even low exposure with reading and writing associated
with scanning in lines, modifies visual searching.

2.7. Benton Visual Form Discrimination Test (VFD)

The Benton Visual Form Discrimination test (VFD) is a non-verbal

task used to evaluate visuo-perceptual capacities that can be affected in
brain-diseased patients. It is a test of exploration and visual comparison in
which a group of three geometric figures, one of which, the peripheral one,
of reduced size compared to the other two must be recognized among four
alternatives. The three incorrect alternatives contain a rotation or distortion
error of one of the two major figures. The errors are distributed randomly
in the 4 quadrants (Figure 8).
In particular, the four items indicate: 1) correct reproduction of the
original stimulus (correct); 2) rotation or displacement of the peripheral
figure (peripheral error); 3) rotation of the major figure (rotation error); 4)
distortion of the major figure (distortion error). Two points are given for
each correct response, and 1 point for every peripheral error. Other error
responses are given 0 points.
The test has been used mainly with clinical populations, in particular
with cognitive impairment such as Alzheimer’s disease (AD; Iverson,
Sherman, & Smith-Seemiller, 1997), thus, it is a useful screening test for
detection of dementia.

Complimentary Contributor Copy

60 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

Figure 8. Sample of the Benton Visual Form Discrimination Test (VFD; Item 9).

Kasai, Ishizaki, Ishii, Yamaguchi, Yamadori, & Meguro (2009)

demonstrated that the VFD, other than presenting an effect in performance
for dementia, is also affected by age and education levels in a non-clinical
population. In particular, the total score is higher in younger elderly and
there is a greater performance in groups with higher levels of education.
They also found that while there was a relationship with educational levels
and the number of correct responses, there were no significant age or
education effects in relation to the pattern errors (peripheral, rotation and
distortion errors).

2.8. Sustained Attention

2.8.1. Visual Continuous Performance Task

As has been reported previously, one of the major characteristics of
attention is the capacity to maintain it over time, which is sustained
attention. The ability to remain vigilant over time is essential in everyday
life and in every aspect of adaptive behavior.

Complimentary Contributor Copy

 Measurement of Attention 61

We can say that there are different types of sustained attention, and
sustained attention tasks imply different components of attentional
processes. It is very different if subjects are asked to respond to rare events
or implement complicated motor responses in a continuous way.
Nevertheless, many of these tasks implicate different attentional skills,
such as inhibitory components (that is executive attention), focused
attention, and sensorimotor processing (in terms of selection). Even though
these subcomponents are implicated in the evaluation of sustained
attention, there is a major difference. In particular, they are not defined in
terms of “temporal inconsistency of performance” and the ability to
maintain attention over time is associated with those “neural mechanisms
that enable iterative or recursive processes” (Cohen, 2014).
There are many disturbances that affect sustained attention, for
example difficulties are correlated with learning, behavioral, and emotional
difficulties in adolescence, sub-groups of attentional deficit hyperactive
disorder (Fabio, 2005; 2017; Fabio & Antonietti; 2012; Fabio & Caprì,
2015; 2017; Fabio, Castriciano, & Rondanini; 2015; Fabio & Urso, 2014;
Fabio, Caprì, Mohammadhasani, Gangemi, Gagliano, & Martino, 2018;
Hawkins, Hillyard, Luck, Mouloua, Downing, & Woodward, 1990;
Martino, Caprì, Castriciano, & Fabio, 2017; Mohammadhasani, Fabio,
Fardanesh, & Hatami, 2015; Mohammadhasani, Fardanesh, Hatami,
Mozayani, & Fabio, 2018) and neurodevelpmental disorder (Gangemi et al,
2018; Fabio, Gangemi, Caprì, Budden, & Falzone, 2018).
The tests that are designed to evaluate sustained attention, and in
particular vigilance components, are usually characterized by monotonous
tasks that last for a long period of time; there are many versions, but in
general we refer to these as continuous performance tests (CPT). Despite
the presence of many forms of the task (Greenberg, 1994), there are two
primary versions. In both tasks, participants are required to maintain
vigilance for a long period of time in a boring task, in front of a monitor
that displays stimuli that may be letters or figures. In one version of the
test, participants have to respond pressing a key, only in the presence of the
target (e.g., the letter X; discrimination version), while in the “successive
discrimination version” the objective is to respond to the target only after a

Complimentary Contributor Copy

62 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

warning signal, that may be another letter of the alphabet. The two versions
imply different cognitive processes; for example, successive discrimination
tasks need memory activation.
There are two outcomes that can be considered: 1) accuracy, that
considers omission (miss) and commission (false-alarm) errors. 2) RTs.
Accuracy does not give realistic information because of the absence of
variability among the population (ceiling effect).

Figure 9. Example of successive discrimination version of the CPT.

Because vigilance involves frequent fluctuations over time, researchers

have modified the CPT so that it adapts to a subject’s attentional
performance, in an continuous manner, during the task (Cohen, 2014).
Nevertheless, the most important parameter is the variability of RT. One of
the major criticisms refers to the impossibility of relying on RTs with a
clinical population because of motor confounds. To overcome these issues,
many versions of the CPT have been created, but they suffer from the same
trade-off, and the major risk is the overlap with different cognitive
components (Shalev, Humphreys & Nele Demeyere, 2018). CPT tasks
evaluate attentional shift and engagement, followed by target selection;
they are characterized by the presence of alternative targets and distractors
in a sudden way that acts as a cue causing attentional capturing, followed
by target discrimination (Shalev, Humphreys & Nele Demeyere, 2018).
Variations of the paradigm were created (e.g., continuous temporal

Complimentary Contributor Copy

 Measurement of Attention 63

expectation task; O’Connell et al., 2009) to limit the involvement of

orienting mechanisms.
Studies that have used CPT demonstrated differences between
adolescents and adults, with surprising results. Participants were selected
within the same families, allowing the evaluation of heritability of
selective attention. Results demonstrated that adolescents showed better
performances on spatial rather than on verbal stimuli, and the differences
merged even when comparing the performances with adolescents
presenting better performances in spatial processing. Moreover, while the
performance of adults was not influenced by distractors, adolescents’
performance levels improved when distracting stimuli were introduced.
This means that they shifted toward a more conservative response strategy.
The alerting system that is measured through CPT is associated with
the activation of right frontal hemisphere, dorsal parietal regions (Petersen
& Posner, 2012), mesial frontal cortices, thalamus and basal ganglia.

2.8.2. Clock Test

The Clock Test of Moron (1997) measures visual attention and
automatic and controlled attention (Valle, Massaro, Castelli, & Marchetti,
2015). It is composed of a sheet in which 400 stimuli are shown (20 x 20).
The stimulus is an icon depicting a clock that marks a certain time, for
example 4 o'clock. Among the stimuli there are 40 targets (clocks
indicating 4 o'clock) and 40 distractors (clocks indicating 5 o'clock). The
other icons serve as a disturbance of the context, they are, in fact, very
different from the target perceptually. The time to complete each table is
three minutes.
There are different indices to consider for the evaluation of the
performance: 1) Inaccuracy index: is the sum of errors and omissions
(range 0–160); 2) Automation index, calculated subtracting the number of
correct answers in the third table and the number of correct answers in the
first table (range 40–40); 3) Rigidity index, calculated subtracting the
number of correct answers in the third table and the number of correct
answers in the fourth table.

Complimentary Contributor Copy

64 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

One of the ways to evaluate the effect of automation with the clock test
is to administer it several times over a period of time. Fabio, Pravettoni,
and Antonietti (2007), used the clock test to investigate automatic
processes. The results indicated a decrease in the number of errors and an
increase in speed as the subjects perform the same task of visual attention;
the subjects that best automate have higher cognitive rigidity indices than
those that automate more slowly.
The results of the study by Fabio, Pravettoni, Antonietti (2007) are in
line with a study by Szymura, Slabosz and Orzechowski (2001) which
found higher levels of rigidity in those with higher automation rates.

2.9. Auditory Attention

Most of the studies on attention have focused on the visual system,

seeing as it is the most predominant sensory modality for humans to
interact with the environment. While the brain systems associated with
visual attention have been recognized for many years, there are still
relatively few studies that have analyzed the neural mechanisms that
sustain auditory attention. Most of the early studies of attention were
centered on dichotic listening (Treisman, 1964), nevertheless only with the
introduction of brain imaging techniques has this topic received more
attention.
Modern neuropsychological evaluation of auditory attention is
motivated by the fact that this capacity is essential for language and higher
cognitive functioning. FMRI studies have demonstrated that the activation
of some brain systems overlaps with visual attention, while others are
specific for auditory attention.

2.9.1. Dichotic Listening Tasks

While visual attention has been studied with a variety of tasks,
auditory attention has always been a greater challenge due to the major
differences in structures and functions. The emphasis on visual attention is
associated with the fact that the measurement is straightforward: people are

Complimentary Contributor Copy

 Measurement of Attention 65

presented with arrays of stimuli that they need to look at, analyze and
select across locations (Cohen, 2014). Auditory attention is much more
difficult to assess; firstly, because the auditory system is independent from
the body position: people listen to auditory stimuli independently from
body orientation and the position of the ears. Secondly, while it is possible
to search for stimuli in a visual way over a period of time, auditory
information requires moment-by-moment vigilance; after the selection
between relevant and irrelevant sounds occurs, the sounds (e.g., words) are
available in the memory system.
Colin Cherry (1953), throughout the so-called cocktail party effect,
described very clearly how selection occurs in the auditory system. There
are situations in which people are exposed to a variety of stimuli,
nevertheless a person can focus on a speaker while tuning out several other
stimuli. Those with a higher priority receive attention.
Researchers have examined auditory attention components (e.g.,
orienting, detection and focus) using different tasks. The most elementary
form of evaluation requires listening to sounds and responding to specific
ones. These tasks have demonstrated that people can detect specific
frequencies, and when asked to orient attention to others, they can re-orient
attention and filter out only the frequencies of interest. Similar auditory
paradigms are based on the capacity of detecting particular sounds within a
noisy environment. This capacity emerges when, for example, we
concentrate attention on the sound of a car, and isolate this from the
background.
Auditory selective attention has been analyzed within other known
paradigms, such as Posner’s cuing paradigm; this test allows us to evaluate
the orienting component, and thus the auditory location. Many studies have
demonstrated that for valid and invalid cuing, auditory location does not
have significant effects (Driver, & Spence, 1994). Other studies that have
used different paradigms confirm that, for auditory attention, detection
based on location is not important. These results demonstrate that spatial
allocation of auditory attention is not linked to detection, as for visual
attention; nevertheless, if the task is cognitively more challenging, as in a

Complimentary Contributor Copy

66 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

complex environment, attentional effects on sound location increase (e.g.,

cocktail party phenomena, Cohen, 2014).
As mentioned previously, one of the first researchers that tested the
cocktail party phenomena was Cherry (1953). The paradigm implicates the
transmission of competitive inputs through earphones in each ear of the
examinees. The subjects are asked to listen to and repeat specific words
that are communicated in one ear, while ignoring irrelevant information
presented in the other ear. Cherry (1953) noticed that people are unable to
listen to the inputs in both ears, and while they could repeat the words
when asked to concentrate on one channel, the performance decreased
when subjects attempted to listen to both messages simultaneously. This
paradigm is called dichotic shadowing task, because of the request of
shadowing the message (repeat the target and ignore distractors). Dichotic
listening tasks were mainly used by early information-processing
researchers, especially for the evaluation of divided attention and cerebral
dominance.
Given that many versions of the task use verbal stimuli (e.g.,
syllables), one of the major phenomena that is described in literature is the
right-ear advantage (REA). There are two conditions for the task: forced
and non-forced. In the latter, examinees are presented with two
meaningless syllables, and the request is to report any syllable. In the
forced-attention variant, participants are asked to repeat the syllables that
are presented in a specific ear. Because of the proprieties of the language
system, in the non-forced condition, participants repeat more stimuli that
are presented in the right ear (REA) (Tallus, Soveri, Hämäläinen,
Tuomainen, & Laine, 2015). What happens is that auditory information
crosses over to the contralateral cerebral hemisphere, while ipsilateral
inputs are inhibited. In the forced-attention variant, if the request is to
concentrate on the left ear, people are forced to impede REA, thus they
actively need to orient attention to the stimuli with much more effort while
inhibiting the right-ear stimuli.
To examine the switching component of auditory attention, Koch,
Lawo, Fels, and Vorländer (2011), associated the classic dichotic listening
paradigm to an explicit task cueing. In this version of the task, two

Complimentary Contributor Copy

 Measurement of Attention 67

auditory stimuli (number words spoken by either a female or male speaker)

are presented dichotically via headphones. A visual cue indicated if the
valid number word was spoken by the male or the female voice. The
request was to categorize the relevant number as smaller or larger than
five. Authors found that a cued switch of the relevant gender decreased the
performance in the number of repetitions.
Dichotic listening tasks have also been used in studies of selective
attention to emotional prosody, by variegating the tone of the speakers
(angry/angry; neutral/neutral; angry/neutral; neutral/angry). Results
demonstrate that angry prosody create much more interference than neutral
ones (Pescharda, Gilboa-Schechtmanb, & Philippot, 2016).

2.9.2. Paced Auditory Serial Addition Test

The Paced Auditory Serial Addition Test (PASAT) is a task developed
for the assessment of attention as an alternative for measuring attention on
a visual level (Sampson, 1958; Sampson & MacNeilage, 1960). The first
application was on a clinical population, in particular regarding traumatic
brain injury, and referred to the evaluation of speed processing. Since then,
PASAT has been used to evaluate auditory components of attention in a
variety of neuropsychological conditions, such as whiplash injury, chronic
fatigue syndrome, and depression (Tombaugh, 2006). PASAT is also
incorporated in various neuropsychological batteries.
Typically, a standard version of the PASAT consists of the
presentation of digits and participants are asked to sum the most recent
digits. For example, if the digits ‘6’, ‘6’ and ‘2’ were auditory presented,
the participant has to respond ’12’ and ‘8’. For the answer to be correct, the
participant must respond prior to the presentation of the next digit.
Normally each stimulus is presented for 4s. The most common score that is
used is the number of correct answers for each trial (maximum = 60) and
the total number of correct responses on all the trials. The use of RTs has
been highly criticized because it does not provide correct information
about the actual average speed at which a person responds (Tombaugh,
2006), even if computerized versions have limited this problem (Demaree,
DeLuca, Gaudino, & Diamond, 1999). The variables that are considered in

Complimentary Contributor Copy

68 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

the evaluation are: percent correct, latency of responding, and number of

errors. It also is important to discriminate between the different types of
errors, in particular omissions, incorrect responses, and late responses. One
of the major mistakes that people make when they do not understand the
instructions is to employ a “chunking” strategy, which is adding two
numbers, skipping one, adding two numbers, etc. This allows to overcome
the difficulties in processing capacities especially when there is a faster
presentation rate (Tombaugh, 2006). Many versions of the test have been
created in time. For example, there is a visual form of the test that is
considered less valid for the measure of information processing speed.
Because of the implication of mathematical abilities, the PASAT has a
tendency to elevate levels of stress in participants (Diehr, Heaton, Miller,
Grant, & the HNRC Group, 1998). For this reason, a shorter form of the
test has been created to reduce the anxiety response (Adjusting-PSAT).
Another valid option is to introduce the task in a virtual gaming
environment (e.g., VR-PASAT; Parsons, Courtney, Arizmendi, & Dawson,
2011). According to Gamberini, Alcaniz, Barresi, Fabregat, Prontu, and
Seraglia (2008) virtual gaming environments allow the reduction of the
levels of stress because of estrangement from the real world.
Regarding normative data, studies have found an important effect of
age, especially after age 50 (Diehr, Heaton, Miller, Grant, & the HNRC
Group, 1998); there are no differences according to sex. While some other
studies (Wiens et al., 1997) have found effects of education levels. Diehr,
Heaton, Miller, Grant, and the HNRC Group, (1998) found that the
implications of math abilities may have an influence on performance,
therefore there is an effect of the level of education and ethnicity.
Seeing as one of the major criticisms of the test is the great implication
of mathematical abilities that can significantly influence the performance
(Tombaugh, 2006).

2.9.3. Continuous Performance Test

The Auditory Continuous Performance Test (ACPT) is one of the many
variations of the CPT that have been mentioned previously. At the auditory
level, it is a test of vigilance and maintenance of attention, in which a

Complimentary Contributor Copy

 Measurement of Attention 69

series of letters of the alphabet, about 120, randomly ordered, are presented
through the aid of a recorder. The subject is asked to raise his hand
whenever he hears, for example, the letter A (present 12 times) and then
lower it immediately afterwards. The measurement parameters are:

a) number of correct answers;

b) errors of omission (unidentified auditory stimuli);
c) commission errors (incorrectly identified auditory stimuli, i.e.,
false alarms).

CPT in all its forms is often used for the diagnosis and treatment of
children and adults with ADHD (Riccio, Reynolds & Lowe, 2001).
Recently, there has been an increase of interest in the auditory form of the
CPT, as authors assume that it is a better measure of the concentration
defect and may give greater discriminating power over visual tests.
Moreover, event related potential studies have demonstrated differences
between ADHD and normal children, as a sign of auditory selective
attention deficits (Fabio, Caprì, Mohammadhasani, Gangemi, Gagliano, &
Martino, 2018; Mohammadhasani, Fardanesh, Hatami, Mozayani, &
Fabio, 2018).
Considering the lack of research that also takes into account the
auditory component of attention in subjects with ADHD, a study by Fabio,
Piran, and Antonietti (2005) investigated deficits in the inhibition of
responses using the CPT paradigm, in conditions of absence and presence
of interference. Through the use of a recorder, a series of letters of the
alphabet is presented in random order. One way to vary the difficulty of the
task is to have the subjects perform a double task; half of the subjects had
to listen to a series of 900 stimuli (consisting of a letter of the alphabet and
a numerical figure) in random order for a total of 30 minutes. The subjects
responded by raising their hands each time they heard the target. At a later
time, the subjects repeated the same test with the elements of the inverted
target (first the numerical digit and then the letter of the alphabet), while at

Complimentary Contributor Copy

70 Giulia Emma Towey, Rosa Angela Fabio and Tindara Caprì

the same time an interference made up of a recorded history on the audio

cassette was inserted and listened to with a headset. The parameters
considered were: a) number of correct answers; b) errors of omission
(unidentified auditory stimuli); c) commission errors (incorrectly identified
auditory stimuli, i.e., false alarms). The task of each subject was to point
out the presence of a specific target, beating his hand on the table
immediately after having listened to and identified this target.
The underling hypothesis are:

1. lower-level school subjects (primary school) will have fewer

correct answers and more ACPT errors compared to the subjects of
higher school level (middle school);
2. subjects with ADHD will have lower performance and more errors
than normal subjects in the ACPT test;
3. subjects with ADHD could elaborate in parallel the relevant
information and the irrelevant information (late selection) and be
more sensitive than normal subjects to the negative effects of the
distractor;
4. subjects with ADHD, unlike normal subjects, will perform worse
in the last part of the ACPT.

The results showed that subjects with ADHD experience falls in the
auditory surveillance test and become less accurate in the presence of
interference. Some authors (Shallice, Marzocchi, Coser, Del Savio,
Meuter, & Ruminati, 2002) argue that it is possible that CPT performance
is mainly influenced by impulsivity factors and the inhibition deficiency of
the answer.
ACPT can also be applied with distractor auditory stimuli. For
example, Broadbent (1958) studied auditory attention in the normal
population by analyzing what happens to auditory selective attention in the
presence of an irrelevant sound. In these cases, we speak of loss of
efficiency when an irrelevant sound is introduced during a task that
involves cognitive work, such as a task of attention, and a decrease in
performance is recorded.

Complimentary Contributor Copy

 Measurement of Attention 71

Typically, the experimental results reveal a fall in the selectivity of

attention due to the introduction of interfering sounds. Interference is very
often generated as a shift of attention takes over while the primary task is
coded. Basically, according to the supporters of late selection, the relevant
information and the irrelevant information would be processed in parallel
up to the stage of the selection of the answer.
According to Lavie and Tsal (1994) what determines whether the
selection will be early or late is the complexity of the task and therefore the
amount of cognitive resources provided by it; if the task is simple there
will not be an activation of resources from the beginning and selection will
be delayed; if instead the task is complex, there will be an activation of
resources from the beginning and selection will be early.
As demonstrated in different studies (Antonietti, Monnier, Gatti, &
Fabio, 2010; Fabio, 2005; 2017; Sempio, Fabio, Tiezzi, & Cedro, 2016), it
would appear that in subjects with ADHD the supervisory status on the
primary task in general does not decrease; the data defer in favor of the
early selection of information.
Moreover, attention deficits were found in other syndromes, as Rett
Syndrome and autism (Castelli, Antonietti, Fabio, Lucchini, & Marchetti,
2013; Fabio, Antonietti, Marchetti, & Castelli, 2009; Fabio, Castelli,
Antonietti, & Marchetti, 2013; Fabio, Gangemi, Caprì, Budden & Falzone,
2018; Fabio, Giannatiempo, Antonietti, & Budden, 2009; Fabio,
Giannatiempo, Oliva, & Murdaca, 2011; Fabio, Magaudda, Caprì, Towey,
& Martino, 2018; Fabio et al., 2014; 2016; 2017; 2018; Martino et al.,
2018; Vignoli et al., 2010).

CONCLUSION

In this chapter, we presented some of the main instruments that allow

the measurement of attention, with the idea in mind of a multidimensional
construct. The first section presents the tests that are widely used in the
assessment of attention, in particular visual attention, followed by some
paradigms that measure sustained attention and auditory attention.

Complimentary Contributor Copy