Stories of Executive Functioning after Brain Injury
The following are stories of real life survivors of brain injury. Clicking on the titles will take you to their actual story.
Perhaps the biggest obstacle for reemployment for someone with a brain injury is the issue of mistakes and reliability. Angela was someone who prided herself in the accuracy of her work pre-injury.
Chris’s Mom talks about problems Chris continues to have: difficulty with motivation, planning, reasoning & making decisions, impulsiveness, roller coaster moods and emotions, self-centered behavior (i.e.,tendency to understand and see the world only from her perspective), difficulty inhibiting her emotions, and poor insight. These problems are typical of frontal lobe.
The neuropsychologist was able to identify other specific deficits through his assessment. Helena continues: “But in terms of the neuropsychology, subtracting backwards, remembering sequences of words, waiting a half hour trying to remember the same sequence. So what they identified was that I had problems, my deficits were in thinking things out and I guess they call it executive function, trying to figure out what goes next, or how are things different.”
There’s a way you put the numbers on the page. There’s a way you write the numbers. There’s how you line them up. How the line goes if it’s addition, subtraction. Everything has its own process. Same thing with writing. You start on the left side of the page and a T has a downward stroke and a cross stroke but then you have to make the word the. So it’s every process she has to think about and I think that’s why the handwriting is so difficult for her. Verbal tests, if she gets to give a verbal test or does a verbal assignment or uses Dragon Speaks, no problem. And she’s very intelligent. She can put her, her thoughts in order most of the time.
What are the deficits did that identify?: “There are many. There’s judgment issues; there’s some disinhibition; there’s short-term memory; overall concentration; overall multitasking; pretty much anything related to executive functioning, had
some deficits on this test.”Executive functioning is the most difficult thing to test, in neuropsychological testing. Did they rely significantly on clinical interview with you, in reaching those conclusions?: “I don’t believe so. There was just
a very small portion of the interview with me. The rest of it was with him, and then he had two days of testing after that.”
Executive functions can be thought of as the brain CEO, the manager of the brain’s resources. Foremost among managing those resources, is managing time.