An electronic knot in the handkerchief: "Content free cueing" and the maintenance of attentive control

Rapid changes in consumer technology mean that many of us now carry a range of automated cueing devices. The value of organisers and pagers in cueing specific to-be-remembered items, particularly for people with memory deficits, is clear. Here we investigate whether cueing can serve a more general purpose-not in reminding us of a particular event or action, but in helping us to periodically take a more "executive" stance to our activities. In these studies we use a highly reduced "model task", the Sustained Attention to Response Test (SART)-designed to provoke "absentminded" lapses in action. Seven patients with right hemisphere stroke and who experienced difficulties in maintaining attention completed the task under two conditions. Periodic auditory cues that carried no content other than by association with the patient's remembered goal and which had no predictive value for events in the task were, nevertheless, associated with significant improvements in accuracy compared with an un-cued condition. A second experiment suggests that these improvements are not necessarily accompanied by an overall slowing in performance or a generally decreased tendency to make responses. We speculate that the transient hiatus in responses observed immediately following a cue serves a role in disrupting automatic, stimulus-driven responding and allows a more attentive stance to be re-established. Consistent with this view, in a final study we show that disruption to responses is substantially greater in a variant of the task designed to maximally encourage "unsupervised" action. We suggest that interruption to current activity can-at times-be a useful aid to keeping track of one's overall goals. The potential role of such cueing in helping dysexecutive patients to generalise training from the clinic to everyday settings is discussed.