The Gazette 1992

GAZETTE

SEPTEMBER 1992

Primary Structures of The Brain

Reticular Formation (Balance) (Arousal) Cerebellum Spinal Cord Coordination

Schematic of Left and Right Lateralisation

Left Lateral View

Communication Disorders Communication disorders are

may be very concrete in their thought such that they interpret information literally. An example might be the literal interpretation of idioms such that the expression "green with envy" might carry the expectation of a person actually changing colour. Thinking disorders are difficult to describe because they include such a wide range of skills areas, yet they are extremely important as they affect the way a person approaches every aspect of his or her life. Executive Functions Executive functions refer to those cognitive components which allow an individual to carry out goal directed activity. The basic components of executive functions include the ability to create a strategy or plan for achieving a goal, as well as to initiate and follow through with includes the ability to monitor one's performance and revise behaviour as necessary. Many brain injured individuals have difficulty with the selection and execution of goal related activities and are unorganised in their approach to solving problems. steps required to complete the intended goals. This arch also

has as little negative effect on his or her ability to function as possible. This may mean using a memory book (e.g., a diary), setting up an "information centre" at the home, or having some other external cueing system. Different types of information are processed differently; thus, a person may be able to recall certain things but not others. Also, factors such as stress, fatigue, and the importance or salience of information may also affect how well something is encoded or remembered. It is possible that a person may remember something that happened last week but not be able to recall events from that morning. These memory deficits greatly impair the learning of new information and again may preclude an individual from returning to gainful employment and independent living. Reasoning/Judgment Problems This is a broad area including deficits in higher level thinking, where an individual experiences difficulty in analysing and synthesising information. Often individuals have disorders of thinking manifested as a decrease in abstract reasoning, poor judgement and problem solving. Individuals

another frequent deficit following brain injury. Often people have speech disorders that are motorically based, rendering their speech difficult to understand. Language problems may also be present. Early on, many individuals have problems thinking of the words they want to say, as well as difficulty in constructing complex sentences. Language is closely tied with other cognitive dimensions such as memory and attention, thus adequate communication may require the remediation of related deficits. Higher level language impairments often persist long organisation of expressing thoughts in logical sequences, an inability to generate multiple ideas about a topic, and poor communicative behaviour such as decreased eye contact and voice inflection. Once again, loss of ability to communicate effectively may prevent an individual from adequate performance of certain after the injury and reflect disorders of thinking. Some examples include: decreased

job assignments and from satisfactory interaction with others.

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