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Thinking Difficulties

Thinking difficulties (often called cognitive difficulties) are common after brain injury. Attention, memory, processing speed, and executive functioning are some of the most common cognitive areas affected by traumatic brain injury.

If you struggle with attention, you don’t get the information into your brain. Your attention is like the information door. If the door is not open, the information will not get in.

Short term memory is usually more impacted than long term memory after brain injury. You might be able to remember an event from a few years ago, but struggle with remembering what you had for breakfast.

More about Thinking Difficulties:

Taking longer to grasp what others are saying

Taking more time to follow directions

Being slower to react

Initiation is the ability to begin a task or activity. Someone with initiation struggles may seem unmotivated and can't get started doing things

Planning and organizing difficulties can make it hard to complete tasks. You might not be able to complete or turn in homework. Planning a meal or an outing would be difficult.

Inhibition or impulse control may be lacking. You know you should not say something nasty, but you do it anyway. A child might run into the street, even when they know better.

Emotional control difficulties might lead you to have emotional outbursts even when you don’t want to.

To improve your thinking, you need to practice it. We improve by practicing. Practicing a little each day is the best way to improve your abilities in anything. Also, practice the tasks you want to learn. If you want to read better, practice reading. If you want to relearn how to cook, practice cooking.

We will give you a few things to help different areas of cognition. But much more can be done to help. At the end, we will tell you who can help you.

    Improve attention problems:

  • Place your full attention on what you are trying to understand. Decrease distractions.
  • Allow more time to think about the information.
  • Ask people to repeat themselves or speak more slowly.
  • Practice attending.

    Improve memory problems:

  • Plan and schedule your day.
  • Stay organized and have a set location for keeping things.
  • Use memory aids such as notebooks, calendars, daily schedules, lists, and computer reminders.
  • Practice learning new information.

    Improve planning and organizing:

  • Use a planner.
  • Make a list of things that need to be done..
  • Break down activities into smaller steps.
  • Practice planning, such as a trip to the store.

    Improve initiation:

  • Break down big tasks into small steps.
  • Plan and schedule the task ahead of time.
  • Reward yourself once the task is done.

Who can help improve cognitive abilities?

  • Speech therapist
    • A speech therapist trained in cognitive rehabilitation can help you improve your cognitive skills and guide you in planning and scheduling your day. They provide cognitive therapy.
  • Neuropsychologist
    • A neuropsychologist can give tests to outline strengths and difficulties with thinking. This can help guide cognitive therapy. Some neuropsychologists will also provide cognitive therapy.
  • Physiatrists
    • Physiatrists (doctors specializing in Physical Medicine and Rehabilitation) can help guide you with cognitive difficulties. They can help determine why you might be having difficulties and help you find providers to help. Some physiatrists treat patients with brain injury and other physiatrists treat musculoskeletal conditions like back pain. Be sure that the physiatrist you see treats brain injury survivors.