To achieve our goals we need to be aware of the world around us, focus on relevant information, and make, remember and follow reasonable plans. Developmental disorders and injuries to the brain can compromise this goal-directed coordination of behaviour (executive function).
The aims of our research are:
- To understand the causes of attention and executive impairments in children and adults.
- To develop and evaluate improved clinical assessments of these problems.
- To develop and evaluate new interventions designed to reduce these difficulties or mitigate their consequences in everyday life.
Our research builds on partnerships with clinicians including at the Oliver Zangwill Centre for Neuropsychological Rehabilitation (established in a unique collaboration between the MRC and the NHS), the Cambridge Centre for Paediatric Neuropsychological Rehabilitation and Cambridgeshire Community Services NHS Trust. Commercial partnerships include with Pearson Assessment and Ounce Technology. We conduct research at the Herchel Smith Building on the Addenbrooke’s Hospital site, in patient volunteer’s homes, in schools and in the Centre for Attention, Learning and Memory (CALM) child development facility at the CBSU
With clinical partners at the Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services and the Cambridge Paediatric Brain Injury Rehabilitation team we are developing a new programme of research in this area. This strongly benefits from our links at the CBU with Tim Dalgleish and Emily Holmes and their expertise in mood theory and intervention in the non-brain injured population.
Key researchers: Fionnuala Murphy, Ausaf Farooqui
Manly, T. & Murphy, F.C., (2012) Rehabilitation of Executive Function and Social Cognition Impairments after Brain Injury. Current Opinion in Neurology, 25, 656-661.
Murphy, F.C., Michael, A. & Sahakian, B.J. (2012). Emotion modulates cognitive flexibility in patients with major depression. Psychological Medicine, 42(7), 1373-1382.
Barnard P.J., Murphy F.C., Carthery-Goulart M.T., Ramponi C., & Clare L. (2011). Exploring the basis and boundary conditions of SenseCam-facilitated recollection. Memory, 19(7), 758-767.
Murphy F.C., Barnard P.J., Terry K.A.M., Carthery-Goulart M.T., & Holmes E.A. (2011). SenseCam, imagery, and bias in memory for well-being. Memory, 19(7), 768-777.
An important issue is how best to help people generalise strategies from training to everyday situations. One approach, based on our experimental work, is to link key messages in the training with a particular cue and send this cue periodically to patients via text messaging, helping to keep the ideas they have developed more actively in mind (Assisted Intention Monitoring: AIM).
In a good example of the links between CBU science and the work of our colleagues in clinical services, we recently completed a 3-year Randomised Control Trial of the effects of brief GMT + automated cues (generously funded by the National Institute for Health Research: NIHR). The outcome of that trial will be reported shortly and the results have already influenced the development of local clinical practice. The challenge ahead lies in combining ideas in goal management with strategies to help patients develop resilience to mood problems.
Research team: Fergus Gracey, Eve Greenfield, Jessica Fish, Andrew Bateman, Gemma Hardy, Jessica Ingham, Mariella Gregori, Jon Evans & Barbara Wilson.
Fish, J., Evans, J. J., Nimmo, M., Martin, E., Kersel, D., Bateman, A., . . . Manly, T. (2007). Rehabilitation of executive dysfunction following brain injury: “content-free” cueing improves everyday prospective memory performance. Neuropsychologia, 45(6), 1318-1330.
Levine, B., Schweizer, T. A., O’Connor, C., Turner, G., Gillingham, S., Stuss, D. T., . . . Robertson, I. H. (2011). Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. Frontiers in Human Neuroscience, 5.
Manly, T., Davison, B., Gaynord, B., Greenfield, E., Parr, A., Ridgeway, V., & Robertson, I. H. (2004). An electronic knot in the handkerchief: “Content free cueing” and the maintenance of attentive control. Neuropsychological Rehabilitation, 14(1-2), 89-116.
Manly, T., Hawkins, J., Evans, J. J., Woldt, K., & Roberson, I. H. (2002). Rehabilitation of Executive Function: Facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychologia, 40(3), 271-281.
Schweizer, T. A., Levine, B., Rewilak, D., O’Connor, C., Turner, G., Alexander, M. P., . . . Stuss, D. T. (2008). Rehabilitation of executive functioning after focal damage to the cerebellum. Neurorehabilitation and Neural Repair, 22(1), 72-77.
Work at the CBU has demonstrated that persistent USN is linked to problems in maintaining an alert state and that temporary increases in alertness reduce spatial bias. This led us to examine whether other groups with poor alertness might also be at risk of spatial bias. We have demonstrated in a series of single-case and group studies with children, for example, that quite marked biases away from the left occur in children who had problems sustaining their attention. This, in turn, led us to examine changes in spatial awareness in the normal population with low alertness (e.g. as a result of sleep deprivation or long-periods spent performing repetitive tasks). The results were consistent with members of the general public showing a similar pattern to patients with USN, albeit in a much more subtle form.
Our current projects are looking into the neural basis of this relationship, how it might inform our understanding of USN, the clinical implications of spatial bias in development, and, critically, how we can best harness the effect for rehabilitation.
Key researchers: Tristan Bekinschtein (A Wellcome Trust funded researcher at the CBU) Corinne Bareham, Fionnuala Murphy, Ausaf Farooqui.
Manly T, Robertson IH, Verity C. Developmental unilateral visual neglect: A single case study. Neurocase. 1997;3(1):19-29.
Robertson IH, Manly T, Beschin N, Daini R, Haeske-Dewick H, Homberg V, et al. Auditory sustained attention is a marker of unilateral spatial neglect. Neuropsychologia. [Clinical Trial]. 1997 Dec;35(12):1527-32.
Dobler VB, Manly T, Verity C, Woolrych J, Robertson IH. Modulation of Spatial Attention in a Child with Developmental Unilateral Neglect. Dev Med Child Neurol. 2003;45(4):282-8.
George M, Dobler V, Nicholls E, Manly T. Spatial awareness, alertness, and ADHD: the re-emergence of unilateral neglect with time-on-task. Brain Cogn.
George MS, Mercer JS, Walker R, Manly T. A demonstration of endogenous modulation of unilateral spatial neglect: the impact of apparent time-pressure on spatial bias. J Int Neuropsychol Soc. 2008 Jan;14(1):33-41.
Manly T, Dove A, Blows S, George M, Noonan MP, Teasdale TW, et al. Assessment of unilateral spatial neglect: scoring star cancellation performance from video recordings–method, reliability, benefits, and normative data. Neuropsychology. 2009 Jul;23(4):519-28.
Manly T, Dobler VB, Dodds CM, George MA. Rightward shift in spatial awareness with declining alertness. Neuropsychologia. 2005;43(12):1721-8.
Dobler VB, Anker S, Gilmore J, Robertson IH, Atkinson J, Manly T. Asymmetric deterioration of spatial awareness with diminishing levels of alertness in normal children and children with ADHD. J Child Psychol Psychiatry. 2005 Nov;46(11):1230-48.
Recent evidence from controlled studies suggest that a particular form of intensive, progressive Working Memory training can produced generalised gains on untrained tasks (see LINK TO SUES PAGES).
Our current projects are examining whether we can systematically enhance generalisation of training gains to everyday situations and, in a collaboration with John Duncan, Duncan Astle and Polly Peers, the benefits for adults with attention problems following brain injury.
Manly T, Anderson V, Nimmo-Smith I, Turner A, Watson P, Robertson IH. The differential assessment of children’s attention: the Test of Everyday Attention for Children (TEA-Ch), normative sample and ADHD performance. J Child Psychol Psychiatry;42(8):1065-81.
Manly T, Davison B, Heutink J, Galloway M, Robertson IH. Not enough time or not enough attention?: Speed, error and self-maintained control in the Sustained Attention to Response Test (SART). Clinical Neuropsychological Assessment. 2000;3:167-77.
Manly T, Robertson IH. The Sustained Attention to Response Test (SART). In: Rees G, editor. Neurobiology of Attention. New York 2005.
Manly T, Robertson IH, Anderson VA, Nimmo-Smith I. TEA-Ch – The Test of Everyday Attention for Children. London: Pearson Assessment; 1998.
Manly T, Dove A, Blows S, George M, Noonan MP, Teasdale TW, et al. Assessment of unilateral spatial neglect: scoring star cancellation performance from video recordings–method, reliability, benefits, and normative data. Neuropsychology. 2009 Jul;23(4):519-28