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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
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
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
steps required to complete the
intended goals. This arch also
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.
Communication Disorders
Communication disorders are
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
after the injury and reflect
disorders of thinking. Some
examples include: decreased
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
job assignments and from
satisfactory interaction with
others.
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