Traumatic Brain Injury (TBI)

Question 1

cognitive-communication deficits (CCD)

Answer 1

damage to cognitive domains underlie language and social interaction

Question 2

deficits in cognition may be in

Answer 2

• attention and memory
• organization and information processing
• reasoning and problem solving
• executive function and self-regulation

Question 3

cognitive deficits might impact ?

Answer 3

• hearing, listening, understanding
• speaking
• reading
• writing
• conversational interaction
• social communication

Question 4

?% of people with TBI have CCD

Answer 4

> 81%

Question 5

cognitive-linguistic deficits

Answer 5

• getting the gist (key elements)
• details and summarizing
• explaining or retelling
• discourse
• word finding
• linear verbal thinking (before/after)

Question 6

pragmatic (social cognition) deficits

Answer 6

• communication awareness and intention
• inferences, literal thinking
• no filters

Question 7

initial assessment purpose

Answer 7

• baseline abilities, performance, and participation
• prior to intervention

Question 8

ongoing assessment purpose

Answer 8

• document progress
• refine intervention plans

Question 9

outcome assessment purpose

Answer 9

document the final effects of intervention

Question 10

quantitative assessment findings

Answer 10

• auditory comprehension
• verbal expression and discourse
• reading (speed, factual, inferential, functional)
• writing (spelling and discourse)
• verbal organization and reasoning

Question 11

qualitative assessment findings

Answer 11

• attention and memory
• self monitoring and regulation
• organization
• flexibility
• prosodic features

Question 12

? limitations on detecting CCD

Answer 12

• significant limitations
• aphasia tests may miss classic features
• pattern or error/response types often more informative than actual scores

Question 13

why do self reports need to be taken with a grain of salt

Answer 13

insight into communication difficulties is often impaired

Question 14

biggest cause of death and disability in children and young people

Answer 14

TBI

Question 15

extraordinary and rapid brain growth continues until ? age

Answer 15

5

Question 16

why is brain maturation important when considering TBI in children

Answer 16

• 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)

Question 17

sleeper effect

Answer 17

• immediate stage of brain injury (serious disruption)
• early recovery of brain injury
• latent stage, later path of developmental stage post-injury

Question 18

cognitive stall

Answer 18

• 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)

Question 19

2 major processes in the brain between 15 - 29 y/o

Answer 19

• brain pruning
• new connections

Question 20

common pitfalls in TBI peds assessment

Answer 20

• functional assessment vs formal test contexts
• challenges in differing settings (challenges in daily communicating, learning and social interactions)

Question 21

last area of the brain to mature

Answer 21

frontal lobe (executive function)

Question 22

psychosocial and executive dysfunction can lead to ?

Answer 22

emotional and behavioral changes

Question 23

2 most common psychiatric sequelae of TBI

Answer 23

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)

Question 24

fatigue typically arises due to ? than ?

Answer 24

mental > physical exertion

Question 25

fatigue is worsened by ?

Answer 25

sleep difficulties (insomnia, lack of restorative sleep)

Question 26

fatigue worsens

Answer 26

• memory
• behavior

Question 27

? tiredness is common in TBI

Answer 27

pathologixal

Question 28

physical effects of TBI

Answer 28

• headaches (common, can cause regular or constant pain)
• mobility (adaptations: ramps, handrails)
• epilepsy (may develop seizures)

Question 29

behavioral changes in TBI

Answer 29

• tolerance lower, may get easily annoyed by the little things
• internal distractors
• external distractors
• personality changes
• lack of insight

Question 30

internal distractors

Answer 30

• motivation problems
• difficulties starting, focusing, or staying interested in a task
• distracted by negative intrusive thoughts

Question 31

external distractors

Answer 31

• concentration problems
• difficult to concentrate on tasks or meetings for sustained periods of time
• worsened by background noise or activity

Question 32

emotional effects in TBI

Answer 32

• 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

Question 33

TBI and substance use

Answer 33

risk of returning to substance use after injury is 10x higher