Visual Vigilance

About the Visual Vigilance exercise

Watching for a name to come up on a waiting-room screen, keeping an eye on a pot that is about to boil, or scanning a long list for one entry all ask for attention that holds for minutes with not much happening. After a stroke or a brain injury the first minute can go well and the third can drift, with the slips arriving late, when no one is watching.

Visual Vigilance puts that watch on screen as attention span practice. In stream mode, circles, squares, and triangles arrive one at a time for one to ten minutes, and the person responds each time the target pattern completes. In rows mode the same task is a grid, like the paper worksheet. Results split the run into thirds to show whether accuracy and reaction time held up.

What Visual Vigilance practices

Sustained attention

Targets make up 5 to 25 percent of the symbols and the rest is waiting. Holding a response ready through a stream of up to 10 minutes with nothing to do most of the time is the core of the task.

Response inhibition

Near misses are runs one symbol off the target. They have to be checked and passed over, and a tap on one is counted as a false alarm.

Working memory

A pattern of two or three symbols only completes across time. With the last two symbols hidden, the person holds the run in mind as it forms and decides on the final symbol alone.

Visual scanning

Rows mode is the paper grid, 15 to 35 columns wide, worked left to right and top to bottom. Hits are split by the left and right side of the grid.

How the tool works and what it records

Stream mode runs 1 to 10 minutes at 0.6 to 2.0 seconds per symbol, with targets at 5 to 25 percent, a pattern 1 to 3 symbols long, near misses set to some or many, filled shapes (six symbols instead of three), two rules with two buttons, and the last two symbols shown or hidden. Rows mode is a grid of 15 to 35 columns by 6 to 18 rows: tap every matching run, or with two rules, circle one pattern and cross out the other. Pro unlocks the dials; large-print mode and thicker outlines are free.

A stream round reports targets found of total, false alarms, median reaction time, and time, then each third of the run with its hits and median reaction, summed up as held steady, slowed, or missed more in the last third. A rows round reports targets found, false positives, left and right hits, and time, with found, missed, and wrongly marked cells colored on the grid. Free accounts get 5 rounds per tool per day; Pro adds unlimited rounds and PDF grid sheets, and accounts with the session log feature have each round saved.

Screen or paper?

The screen is the only way to run the stream: symbols arriving on a clock for minutes at a stretch, with reaction times and the thirds split worked out at the end. Paper suits the rows format when circling with a pen is the practice, when a therapist wants to watch the scan path across the sheet, or when there is no device or wifi to hand.

The printable version is the Visual Vigilance worksheet set on rehabworksheets.com, and there is a free visual vigilance worksheet to try first, with no email required.

Using it well

• Start with the 2-minute pair. The first preset, a 2-minute stream with a two-symbol pattern and the last two symbols showing, is the baseline. Move to the 3-minute triple when the last third matches the first for a few rounds in a row.
• Read the thirds line, not just the total. The line under the tiles gives hits and median reaction for the first, middle, and last third. A good total can hide a weak last third; that line is the one to watch across sessions.
• Change one load at a time. Longer runs, rarer targets, filled shapes, a second rule, and hiding the last two symbols each raise the load in a different way. Adjust one per session so the thirds line says which change mattered.
• Adapt the response. In stream mode a tap anywhere on the board or the space bar counts, and a response within half a beat after the symbol changes still lands on the one before. Large-print mode and thicker outlines are free for low vision.
• Use rows mode with a partner. Rows mode has no pace to keep up with, so a partner can sit alongside, agree the scan route out loud, and let the person do the tapping. The left and right split shows whether one side was skipped.

Common questions