Traumatic Brain Injury (TBI) Flashcards
cognitive-communication deficits (CCD)
damage to cognitive domains underlie language and social interaction
deficits in cognition may be in
- attention and memory
- organization and information processing
- reasoning and problem solving
- executive function and self-regulation
cognitive deficits might impact ?
- hearing, listening, understanding
- speaking
- reading
- writing
- conversational interaction
- social communication
?% of people with TBI have CCD
> 81%
cognitive-linguistic deficits
- getting the gist (key elements)
- details and summarizing
- explaining or retelling
- discourse
- word finding
- linear verbal thinking (before/after)
pragmatic (social cognition) deficits
- communication awareness and intention
- inferences, literal thinking
- no filters
initial assessment purpose
- baseline abilities, performance, and participation
- prior to intervention
ongoing assessment purpose
- document progress
- refine intervention plans
outcome assessment purpose
document the final effects of intervention
quantitative assessment findings
- auditory comprehension
- verbal expression and discourse
- reading (speed, factual, inferential, functional)
- writing (spelling and discourse)
- verbal organization and reasoning
qualitative assessment findings
- attention and memory
- self monitoring and regulation
- organization
- flexibility
- prosodic features
? limitations on detecting CCD
- significant limitations
- aphasia tests may miss classic features
- pattern or error/response types often more informative than actual scores
why do self reports need to be taken with a grain of salt
insight into communication difficulties is often impaired
biggest cause of death and disability in children and young people
TBI
extraordinary and rapid brain growth continues until ? age
5
why is brain maturation important when considering TBI in children
- children may look fine and can appear to make a good initial recovery, problems can become apparent with age and development
- consider myelination (if interrupted, can have huge consequences)
sleeper effect
- immediate stage of brain injury (serious disruption)
- early recovery of brain injury
- latent stage, later path of developmental stage post-injury
cognitive stall
- expectations change (tantrums at 4 and 8 y/o)
- part of brain that was damage may only be called into action later
- effect of a TBI may only appear when a particular skill is required (e.g. executive function during high stress)
2 major processes in the brain between 15 - 29 y/o
- brain pruning
- new connections
common pitfalls in TBI peds assessment
- functional assessment vs formal test contexts
- challenges in differing settings (challenges in daily communicating, learning and social interactions)
last area of the brain to mature
frontal lobe (executive function)
psychosocial and executive dysfunction can lead to ?
emotional and behavioral changes
2 most common psychiatric sequelae of TBI
- Major Depressive Disorder (MDD)
- Generalized Anxiety Disorder (GAD)
fatigue typically arises due to ? than ?
mental > physical exertion
fatigue is worsened by ?
sleep difficulties (insomnia, lack of restorative sleep)
fatigue worsens
- memory
- behavior
? tiredness is common in TBI
pathologixal
physical effects of TBI
- headaches (common, can cause regular or constant pain)
- mobility (adaptations: ramps, handrails)
- epilepsy (may develop seizures)
behavioral changes in TBI
- tolerance lower, may get easily annoyed by the little things
- internal distractors
- external distractors
- personality changes
- lack of insight
internal distractors
- motivation problems
- difficulties starting, focusing, or staying interested in a task
- distracted by negative intrusive thoughts
external distractors
- concentration problems
- difficult to concentrate on tasks or meetings for sustained periods of time
- worsened by background noise or activity
emotional effects in TBI
- depression and sense of loss (grieving)
- loss of confidence
- denial and loss of control
- mood swings (unpredictable, managing emotions)
- impaired empathy (appear insensitive or indifferent)
all effect interpersonal relationships
TBI and substance use
risk of returning to substance use after injury is 10x higher
