Cognitive difficulties are very common in people with TBI. Cognition (thinking skills) includes an awareness of one's surroundings, attention to tasks, memory, reasoning, problem solving, and executive functioning (e.g., goal setting, planning, initiating, self-awareness, self-monitoring and evaluation). Problems vary depending on the location and severity of the injury to the brain and may include the following:
- Trouble concentrating when there are distractions (e.g., carrying on a conversation in a noisy restaurant or working on a few tasks at once).
- Slower processing or "taking in" of new information. Longer messages may have to be "chunked," or broken down into smaller pieces. The person may have to repeat/rehearse messages to make sure he or she has processed the crucial information. Communication partners may have to slow down their rate of speech.
- Problems with recent memory. New learning can be difficult. Long-term memory for events and things that occurred before the injury, however, is generally unaffected (e.g., the person will remember names of friends and family).
- Executive functioning problems. The person may have trouble starting tasks and setting goals to complete them. Planning and organizing a task is an effort, and it is difficult to self-evaluate work. Individuals often seem disorganized and need the assistance of families and friends. They also may have difficulty solving problems, and they may react impulsively (without thinking first) to situations.
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