Strategy Training for Optimizing Attention for Individuals With Spatial Neglect (SOAR)

Examining Strategy Training for Optimizing Attention in Rehabilitation for Community-Dwelling Individuals With Spatial Neglect

It is common for individuals after stroke to have a cognitive perceptual impairment called unilateral spatial neglect (neglect). Individuals with neglect have difficulty paying attention to one side of their body or one side of the environment and therefore experience difficulty performing daily activities. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' attention and awareness of their neglect. This study seeks to examine the effects of strategy training on neglect, self-awareness, and disability, specifically for individuals who are living in the community after their stroke.

Study Overview

• Status: Recruiting
• Conditions: Stroke; Neglect, Hemispatial
• Intervention / Treatment: Behavioral: Strategy Training; Behavioral: Attention Control

Detailed Description

Unilateral spatial neglect (neglect) post stroke is characterized by a lack of attention to one side of the body or one side of the environment. Individuals with neglect experience significant disability and are often unaware of their neglect symptoms which can make it even more difficult to treat. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' attention and awareness of their neglect. Strategy training teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. While strategy training shows promise for individuals with neglect, no studies have tailored the intervention for this group of individuals or examined the effects of strategy training for individuals with neglect specifically with individuals living in the community. This study examines whether strategy training facilitates reductions in neglect and disability and improves self-awareness.

• Study Type: Interventional
• Enrollment (Estimated): 45
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Emily Grattan, PhD, OTRlL; Phone Number: 412-648-0619; Email: esg39@pitt.edu

Study Locations

• United States
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15260
      • Recruiting
      • University of Pittsburgh

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• had a stroke
• presence of neglect as determined by score of <18 or 2 or more collisions on the Virtual Reality Lateralized Attention Test (VRLAT); score below established cutoff for neglect on one of the six subtests of the Behavioral Inattention Test (BIT); OR reported signs/symptoms of neglect
• ≥18 years old
• lives within 30 miles of the University of Pittsburgh in a community dwelling.

Exclusion Criteria:

• Boston Diagnostic Aphasia Examination (BDAE) Severity Scale score of 0
• dementia per medical record
• active major depressive disorder per medical record
• not willing to be videotaped
• subject is currently receiving rehabilitation therapy as part of their usual care

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Strategy Training; The strategy training intervention teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. Participants use a workbook to support their application of the strategy training.	Behavioral: Strategy Training; This intervention will use an adapted form of strategy training for people with neglect.
Active Comparator: Attention Control; The attention control intervention controls for the non-specific effects of strategy training. The study team will administer the standardized and dose-matched protocol, using scripted open-ended questions to facilitate participants' reflections on their rehabilitation activities and experiences. Participants complete a daily journal, merely reviewing their rehabilitation activities.	Behavioral: Attention Control; This intervention will use a reflective listening protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in attention/neglect	Change in attention/neglect measured with the Catherine Bergego Scale. Total scores on the Catherine Bergego Scale therapist-rated assessment range from 0-30 (higher=greater neglect). The a priori criterion for change was a medium effect size of change (Cohen's d≥0.5)	Baseline to Post-intervention (up to 60 days)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Client Satisfaction with Strategy Training	Client satisfaction is measured using the Client Satisfaction Questionnaire-8. The a priori criterion for satisfaction was: ≥90% of participants report mean satisfaction score ≥3 on the Client Satisfaction Questionnaire-8 items. Item scores on the Client Satisfaction Questionnaire-8 range from 0-4. Higher scores on the Client Satisfaction Questionnaire-8=greater satisfaction.	Post-intervention (up to 60 days)

Collaborators and Investigators

• Sponsor: University of Pittsburgh
• Investigators: Principal Investigator: Emily Grattan, PhD, OTR/L, University of Pittsburgh

Study record dates

Study Major Dates

• Study Start (Actual): April 6, 2026
• Primary Completion (Estimated): January 1, 2029
• Study Completion (Estimated): January 1, 2029

Study Registration Dates

• First Submitted: December 26, 2025
• First Submitted That Met QC Criteria: December 26, 2025
• First Posted (Actual): January 12, 2026

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 8, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Neurobehavioral Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Stroke; Perceptual Disorders
• Other Study ID Numbers: STUDY25090119

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: At present, there is no plan to share data.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No