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Attention Therapy Exercises: Find the symbols & Find alternating symbols

Constant Therapy | Apr 2, 2018 |

Staying focused is something that we take for granted – as long as we have it. Without attention, it’s rough to get really anything done in a day, whether it’s grocery shopping, writing an email to an old friend, or just reading a blog.

Find the same symbols is a Constant Therapy task with evidence supporting its use in increasing attention. Discover the science behind this task.

Unfortunately, attention is frequently affected when the brain is injured. It is necessary for just about everything we do, from the more complex projects we complete at work, to simply having a conversation with a loved one or a friend.

Difficulties with attention can result from traumatic brain injuries or stroke. It can also exist in the often-referenced ADHD (attention deficit hyperactive disorder), a difficulty common in many young children and adults. Many people with ADHD can go undiagnosed for years, and may not even know that they have an attention deficit.

Regardless of the root cause of the attention deficit, it can be debilitating. Luckily, there are many varieties of treatment and compensatory strategies available for attention issues.

Are you looking for cognitive therapy activities for adults? Here are two different attention tasks for speech therapy, occupational therapy, and other disciplines: Find the same symbols and Find alternating symbols

Featured Task: Find the same symbols

What is Find the same symbols?

In this scanning exercise, you must locate the target symbols in a grid.

How is Find the same symbols Leveled?

There are 10 levels, with the number of symbols and the details of the symbols becoming increasingly more challenging.

  • Levels 1-4: Symbols are large and colorful. The number of symbols increase from a 3×3 grid in Level 1 to 7×7 grid in Level 4.
  • Levels 5-7: Symbols are black-and-white and more detailed. The number of symbols increase from a 4×4 grid in Level 5 to a 7×7 grid in Level 7.
  • Levels 8-10: Symbols are black-and-white, very detailed, and look very similar to each other. The number of symbols increase from a 4×4 grid to a 7×7 grid.

How is Find the same symbols Scored?

Scores are calculated in a formula involving the number of errors and the total number of symbols presented. There are two types of errors:

  1. Selecting an incorrect symbol
  2. Not selecting a correct symbol

What skills do Find the same symbols target?

This task is often thought of as one of the common selective attention activities for adults or children, but it addresses other skills as well:

  • Selective Attention: Locating the target symbol and ignoring the distractions.
  • Visual Attention: Attending to visual information instead of auditory. You must scan all quadrants of the screen to locate all the information.
  • Visuospatial skills: Conceptualizing the location of the symbols and their relationship to each other in order to select the correct one.
  • Executive functioning: Self-monitoring whether all of the items have been found.

Featured Task: Find alternating symbols

What is Find alternating symbols?

For clinicians looking for high level cognitive activities, take a look at this attention exercise. You are presented with two target symbols (Symbol 1 and Symbol 2) on the left side of the screen. On the right side of the screen, you will see an assortment of symbols. You must tap on all of the target symbols on the right, alternating between Symbol 1 and Symbol 2.

How is Find alternating symbols Leveled?

There are 8 levels, with the number of symbols, details of the symbols, and number of distractors becoming increasingly more challenging.

    • Levels 1-3: The number of symbols increase from Level 1 to Level 3. The target symbols look different from each other. Only the two target symbols are present with no other distractors.
    • Levels 4-6: The number of symbols increase from Level 4 to Level 6. The target symbols begin to look more similar to each other. There are other distractor symbols that visually look different from the target symbols.
    • Levels 7-8: The number of symbols increase from Level 7 to Level 8. The target symbols look more similar to each other. There are other distractor symbols that also look similar to the target symbols.

How is Find alternating symbols Scored?

Scores are calculated in a formula involving the number of errors and the total number of symbols presented. There are two types of errors:

  1. Selecting an incorrect symbol.
  2. Not selecting a correct symbol.

What skills does Find alternating symbols target?

  • Alternating Attention: Switching between stimulus A and stimulus B
    Selective Attention: Attending to the stimulus and ignoring the distractor symbols.
  • Visual Attention: Scanning the entire screen to locate all information
    Executive functioning: Planning how to start the task and what order you will select the items. You must self-monitor performance and assess if you have found all of the items.
  • Visuospatial skills: Understanding the location of the symbols and what their relationship is to each other so that the correct one is selected.
  • Memory: Remembering the sequence of the symbols so that you select them in the correct order.

Are You On the Search for Divided Attention Tasks?

You can increase the demands on attention by presenting multiple stimuli at one time. For example: your client completes Find alternating symbols Level 4 while listening to a news clip, then answers questions about the news clip to check for comprehension. You client must partake in two activities simultaneously, which puts considerable demands on their attention network.

The Research Behind These Tasks

Research indicates there’s a close link between cognition and language in people with aphasia (Vallila-Rohter and Kiran, 2017). For example, Helm-Estabrooks (2016) discusses the “rather compelling research evidence that attention is a potent factor in the auditory comprehension performance” of people with aphasia (67). One study that is discussed was where people with aphasia participated in a cognitive treatment that targeted attention, memory, numbers and math, problem solving, and visuospatial skills. While this treatment did not target language skills, participants showed significant improvements in auditory comprehension post-treatment.

For individuals working on cognitive skills, there is a well-researched paper on scanning tasks that provides a meta-analysis (a grouping of various research on a specific topic) on whether scanning tasks are effective (Berryman et al., 2010). Scanning tasks can help improve visual field loss and visual inattention, specifically deficits affecting attention following stroke or traumatic brain injury.

These tasks are especially helpful when they accompanied by reduced stress, sharing of information across therapy disciplines, and sensory-motor integration. Sensory-motor integration is frequently referenced in treatment for speech, language, and cognitive deficits, and refers to integrating your sensory system (your 5 senses: sight, hearing, taste, touch, and smell) and also your motor system (anything requiring your muscles).

That’s one of the reasons that we love to have you use those fingers in our tasks at Constant Therapy, keeping you tapping away at your device.

Enjoy our tutorial videos, and we’d love your feedback as you incorporate Find the same symbols and Find alternating symbols into your therapy!


  • Berryman, A., K. Rasavage, and T. Politzer, Practical clinical treatment strategies for evaluation and treatment of visual field loss and visual inattention. NeuroRehabilitation, 2010. 27(3): p. 261-8.
  • Helm-Estabrooks, N. (2016). Treating attention to improve auditory comprehension deficits associated with aphasia . American Speech-Language-Hearing Association Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 64-71.
  • Sohlberg, M., & Mateer, C. (1987). Effectiveness of an attentional training program. Journal of Clinical Experimental Neuropsychology, 9, 117-30.
  • Sohlberg, M., McLaughlin, K., Pavese, A., Heidrich, A., & Posner, M. (2000). Evaluation of attention process training and brain injury education in persons with acquired brain injury. <i>Journal of Clinical Experimental Neuropsychology</i>, 22, 656-76.
  • Vallila-Rohter, S., & Kiran, S. (2017). Guest Editor’s Column. Perspectives of the ASHA Special Interest Groups, 3-6.
  • Des Roches, C., Balachandran, I., Ascenso, E., Tripodis, Y., & Kiran, S. (2015). Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. Frontiers in Human Neuroscience,
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