DEFICITS ADDRESSED

Basic Attention Disturbances
A cluster of deficits relating to insufficient arousal, or alertness and vigilance, or to inability to focus attention selectively, or to maintain one's train of thought.

• Poor arousal/orientation/alertness
• Poor attention: difficulty screening out internal/external distracters; "focusing-in"
• Poor concentration: difficulty maintaining attention to complete an entire task

Basic Energy System Disturbances

• Adynamia: Insufficient mental force, energy, will, initiative, spontaneity.
• Difficulties initiating actions
• Paucity of ideation
• Lack of spontaneity

Dysinhibition: Excess of poorly aimed or poorly controlled energy

• Impulsivity
• Poor modulation
• Irritability/Low frustration tolerance
• Hyper-sexuality
• Emotional "Flooding"

Impaired Information Processing and Communication Skills
A cluster of deficits related to reduced effectiveness or information processing and ability to communicate thoughts verbally.

• Difficulty comprehending, manipulating, or responding to stimuli
• Gaps in interacting with others in a timely/complementary way
• Imprecise verbal communications: word finding problems, aphasia, vagueness

Impaired Memory Functions
A cluster of deficits related to problems acquiring, retaining, or recalling information/messages/learned materials.

• Immediate memory
• Short term
• Long term
• Discontinuous (Swiss cheese) memory

Deficiencies in Reasoning
A cluster of deficits in logical reasoning, in planning and implementing problem-solving activities, and in drawing conclusions or inferences.

• Poor convergent reasoning: (main point)
• Poor divergent reasoning: (options, "big picture")
• Poor Executive Skills (planning, organizing, carrying-through, self-monitoring, trouble-shooting)

Inadequate Awareness and Understanding of the Consequences of Brain Injury
Problems related to insufficient awareness of the main cognitive and/or behavioral deficits that have resulted from the brain injury, coupled with the lack of understanding of the functional implications of these deficits.

• Lack of awareness of core problems
• Poor understanding of how these effect their daily life functioning
• Poor understanding of how treatment can help
• Poor understanding of realistic outcomes of rehabilitation
• Poor motivation to comply with therapy or coaching staff

Inadequate Compensation
Problems related to reliable use of strategies in all situations.

• Difficulties recognizing when to use strategies
• Difficulties applying strategies learned
• Difficulties accepting cuing to use strategies
• Difficulties applying strategies without cuing

Deficiencies in Malleability
Problems related to insufficient openness and/or favorable responsiveness to the influences and remedial interventions of others.

• Prone to question/debate doing things in a prescribed manner
• Prone to feel slighted, unappreciated, disrespected by others
• Overly guarded as to sharing information about oneself
• Reluctance to allow a trusted other to guide/prioritize activities

Inadequacies of Interpersonal Behavior
A cluster of deficits in interpersonal judgment and/or behavioral repertoires (note: pre-existing personality characteristics also influence these areas)

• Poor social judgment
• Antagonizing style of communications
• Insufficient tact and social grace

Inadequacies in Acceptance
A cluster of deficits in accepting the long term aspects of brain injury.

• Difficulty "living within ones own skin"
• Difficulty taking pleasure in quality of life
• Difficulties with self-acceptance and ego-esteem
• Difficulties with personal philosophy that "life goes on" and that "life as is, is meaningful"