A patient after a left CVA presents with mild left neglect. During therapy, what strategy is most appropriate to address neglect?

• A. Sit on the right side of the patient to assure that he is attending to the session
• B. Encourage the patient to look at his left extremity during therapeutic activities
• C. Avoid providing tactile cues to the patient's involved hand and arm
• D. Compensate by using the right upper extremity instead of the left

Answer: (B)

Addressing unilateral neglect involves directly directing the patient’s attention to the side that’s neglected so that visual and motor exploration can include that space and limb. Encouraging the patient to look at his left extremity during therapeutic activities provides a concrete, task-relevant cue that anchors gaze and awareness to the left side. This simple, active cue helps reorient spatial attention, improves recognition of stimuli on the neglected side, and promotes integration of left-side movement with the task at hand, leading to better functional engagement.

Sitting on the right to “keep him engaged” doesn’t actively train attention to the left side and can encourage dependence on the therapist. Avoiding tactile cues misses an additional multisensory prompt that can reinforce attention to the neglected side. Relying on the right upper extremity instead of the left is a compensatory approach that does not address the underlying neglect.