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Executive Function

Executive Function and the Challenges of Traumatic Brain Injuries

Wesley Thurman MS Ed
17 June, 2022

When you’ve been injured in an accident or trauma to the brain, one of the top problems contributing to difficulty with executive function. You may have gaps in your memory or trouble processing and putting together things coherently. These changes can be scary and challenging. 

Traumatic Brain Injury Can Lead to Executive Dysfunction

What makes us who we are? What separates us from the next person? Is it our upbringing, education, or ability to lead and follow through on tasks? Scientists suggest that as it relates to a person’s personality and how they learn, there is most likely a direct correlation to how the brain is structured. 

Some areas of the brain, known as the frontal lobes, direct one’s behavior, modify responses towards different stimuli, and enables an individual to see a problem in its entirety or scope. Those with healthy frontal lobes can manage their impulsive behavior, learn new things, and achieve tasks assigned. When working properly, the frontal lobes control executive function. 

Traumatic brain injury (TBI) can profoundly impact executive functions, which are the skills that help us plan and organize our lives.

Executive dysfunction may be caused by a lack of motivation or initiation, loss of organizational and planning skills, impaired memory, loss of cognitive flexibility, impulsivity, attention problems, and other factors.

Symptoms of Executive Dysfunction After a Traumatic Brain Injury

Traumatic brain injury is the leading cause of death in young people in the United States. And while traumatic brain injuries can happen at any age and result from several causes (including falls), they most often occur among young adults during sporting activities such as skiing or football.

A traumatic brain injury can lead to a wide range of symptoms, including short-term memory loss, difficulty concentrating and multitasking, impaired judgment, disorientation with time/place/personality changes (dissociation), mood swings (irritability), and more. These symptoms are collectively known as “executive dysfunction” because they impact our ability to plan (executive function), inhibit inappropriate responses (inhibitory control), and more. 

Lack of Motivation or Initiation

People with TBI often find it challenging to initiate tasks and activities they used to perform with ease before their injury occurred. This is often referred to as psychomotor retardation or apathy.

Loss of Organizational and Planning Skills

 Executive functions include planning, organization, time management, and task prioritization. These skills allow us to stay on track with our goals and objectives, which are necessary for success in school and work. Executive dysfunction may have difficulty organizing their thoughts or tasks, completing projects promptly, or keeping track of dates, appointments, and commitments.

Impaired Memory

Remembering facts and information is an essential part of our mental functioning. Executive dysfunction can cause problems with short-term memory loss, which makes it challenging to recall information recently learned or previously stored in long-term memory. If you have executive dysfunction, you might have difficulty remembering what you read or studied minutes ago. You may also forget where you put things like your keys, wallet, or glasses when they aren’t immediately in front of you.

Loss of Cognitive Flexibility

Cognitive flexibility refers to thinking about multiple things at once and switching between tasks quickly when necessary. While some people with executive dysfunction may have difficulty thinking about various things at once (known as cognitive rigidity), others may struggle with being able to switch between tasks quickly (known as cognitive perseveration). This can make daily activities such as cooking dinner more challenging because someone with executive dysfunction might not be able to focus on two things simultaneously.

Impulsivity

Impulsivity is a tendency to act on a whim without considering the consequences of your actions. People with executive dysfunction may struggle with this problem because they don’t think through their decisions before acting on them. Impulsivity can cause people to take unnecessary risks or make decisions without thinking about possible outcomes.

Attention Problems

Executive dysfunction often presents as attention problems because these skills help us focus on what’s important and ignore distractions when trying to accomplish a task. People with executive dysfunction may find it challenging to focus on one thing at a time because they have trouble shifting their attention from one task to another as needed. This can lead to difficulty concentrating while driving or reading a book; it could also cause someone to lose track of time while cooking dinner or cleaning the house. 

Healing Through Cognitive Training

Cognitive training is a new approach to healing from traumatic brain injury (TBI). Cognitive training is a treatment program that involves repeated exposure to specific tasks that may improve functioning and recovery in people with TBI. Cognitive training aims to improve brain function by strengthening connections between neurons in the brain.

Cognitive training can be provided in an individual or group setting, often in conjunction with other physical or speech therapy therapies. Computer programs may also provide cognitive training and specific exercises for increasing attention and memory skills.

Cognitive training has been shown to improve cognitive functioning in people with TBI. However, it is not known whether cognitive training may improve patients’ everyday functioning, such as their ability to perform daily activities independently or participate in social interactions with others.