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Cognitive Challenges Associated With Traumatic Brain Injury

By Edited Oct 12, 2016 2 2

When a person acquires a traumatic brain injury (TBI), many aspects of life can be impacted. As a direct result of the brain injury, a person may experience motor skill problems, speech difficulties, small motor issues and encounter cognitive struggles.

No Two TBI Injuries are Alike

A head injury can result in a number of bodily wounds, including both physical and cognitive problems. A combination of injuries can occur whether the head injury is mild, moderate or severe

Over the course of time, with early intervention and therapy, many issues associated with TBI can lessen, and sometimes even disappear. There are, however, those injuries which cause persistent problems and are more difficult to cope with when going through daily routines.

People often misunderstand individuals with TBI because they can't tangibly see the injuries contained within the confines of the brain. Yet, although unseen to the naked eye except through medical technologies such as CAT scans, MRI and other diagnostic tools, those injuries from a brain injury are present. And they are very real.

The effects of TBI vary from person to person and, while some similarities exist, no two people will experience the same exact effects of a TBI.

fMRI brain scan
Credit: Nathanial Burton-Bradford via Flickr/CC by 2.0

Cognitive Challenges Associated with TBI

While all the effects from a TBI can pose challenges, one of the hardest things a TBI victim has to cope with are those unseen injuries which impact cognitive abilities.

By definition, cognitive functions are those aspects of brain function which affect thinking and learning skills. These are very common problem after a TBI has occurred and, as a result, this impacts decision-making skills.

Cognitive functions may include, but are not limited to:

  • Memory issues either through the ability to retain information or retrieve
  • Decreased capacity to reason, problem solve, maintain an awareness of surroundings
  • Trouble setting goals or being unable to bring to fruition any goals set
  • Loss of ability to pay attention to task without being easily distracted
  • Lack of awareness of surroundings

If areas of the brain are injured which regulate any of these processes are affected, this means the person may have trouble with the ability to effectively perform or maintain these functions. In more severe cases, impaired cognitive skills can severely affect a person’s ability to function in society. A person who has sustained a TBI may find one or many of these symptoms persistent in the post-injury period. Since no two brain injuries are alike, much like two brains are not alike, the problems which emerge can vary from person to person.

Other Cognitive Issues

Cognitive problems may appear in the form of having difficulty with the ability to concentrate and filter out background noise if in a busy room. Multitasking is another common problem associated with TBI and it is often difficult for a person to focus on doing more than one task at a time.

Other issues may relate to the ability to process new information. It may also be hard for the person to absorb large amounts of information at once and, as a result, he or she may need to receive information in smaller bits in order to be able to process the message being given. This is referred to as "chunking" information to make it easier for the person to digest and subsequently absorb.

Executive functioning is one of the most significant aspects of cognitive challenges with brain injury because it affects so many areas of daily living. 

According to LD Online, executive functioning is "The executive functions are a set of processes that all have to do with managing oneself and one's resources in order to achieve a goal. It is an umbrella term for the neurologically-based skills involving mental control and self-regulation.1

When a person experiences issues with executive functioning they may find it difficult to plan, arrange details, problem solve, set goals, be organized and have the capacity to self-regulate. The latter often emerges in the form of behavioral issues.

Credit: NICHD via Flickr/CC by 2.0

Behavioral issues associated with impulsiveness can have a considerable effect on a TBI victim's daily life. This is because the ability to control impulses is impaired and the person may not be able to self-monitor. For instance behaviors, such as inappropriate actions or unsuitable words, may come out unexpectedly without prior thought. What may be perceived as “bad behavior” is really due to the brain's inability to make what is oft perceived as the norm in judgment calls.

Since others cannot "see" the injury, they may have difficulty understanding the behavioral tendencies someone with TBI may show, and this can result in socialization problems. Yet these unseen injuries do exist and are often persistent. This is not to say that people affected with cognitive issues stemming from TBI cannot function in society. But there may be some challenges.

Value of Therapy

Early intervention after a TBI is important because the earlier the diagnosis, the more effective rehabilitation can be. Therapy can often help reduce some of the cognitive problems with traumatic brain injury. Even those persistent problems can be helped through carefully designed techniques and coping mechanisms. Through cognitive and behavioral therapy a person can learn strategies and cues to help him or her deal with situations that help support deficiencies in cognitive areas. Many people find this significantly helps them cope with cognitive problems.

This doesn't mean therapy is a cure-all, but therapeutic intervention can help a great deal. Medical experts have been suggesting this for years, but recent studies are showing early diagnosis and treatment of TBI yields positive results in terms of recovery. 1 It is also important to realize that there is no one-size-fits-all cognitive injury.

Cognitive challenges that develop after a head injury occurs are difficult aspects of TBI to cope with, but with ongoing awareness and research hopefully in the future more treatment options will help those who have acquired a TBI.

Over My Head: A Doctor's Own Story of Head Injury from the Inside Looking Out
Amazon Price: $19.99 $15.50 Buy Now
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March is Brain Injury Awareness Month
Credit: Army Medicine via Flickr/CC by 2.0

Thankfully, public and societal awareness of TBI has grown in recent years. March has been designated as Brain Injury Awareness Month. In the past people often considered concussions to be mild injuries with full recovery. While this can be true, it is not always the case. Hopefully, with more public awareness, the statistics associated with head injury will decrease.



Feb 15, 2016 3:51pm
Great article, couldn't agree more that early intervention with therapy is key during the rehab process
Feb 17, 2016 1:23am
Thanks benedictross for reading and for leaving a comment. TBI affected my family years ago and we learned a lot along this journey
Also, welcome to IB! :)
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  1. "What Is Executive Functioning?." LD Online . 8/02/2016 <Web >
  2. "Traumatic Brain Injury (TBI)." American Speech-Language-Hearing Association (ASHA). 8/02/2016 <Web >
  3. "Cognitive Problems after Traumatic Brain Injury." Model Systems Knowledge Translation Center (Based on Research by TBI Model Systems). 8/02/2016 <Web >
  4. Source: University of Gothenburg "Early rehabilitation important for recovery after severe traumatic brain injury." Science Daily. 28/01/2014. 10/02/2016 <Web >

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