Innovation Takes Courage

Innovation takes courage and leadership: TBI cognitive recovery

October 25, 2021

The photo above is of Clayton doing something that he loves. Clayton grew up loving cars. All throughout his childhood and young adulthood cars were a big passion of his. As you can tell from the above photo, they can still put a smile on his face, and he is still driving himself to work. This is something that many of us take for granted. 

A few years ago, Clayton suffered a severe traumatic brain injury (TBI) and required a multitude of surgeries and acute care, along with post-acute medical care to treat the injuries that he sustained. Following his acute care medical intervention Clayton engaged very well in physical therapy to treat his orthopaedic injuries and with great medical support he continued to see significant physical improvements. He was progressing. However, one of his main goals for rehabilitation was to drive again. To achieve this goal, he would have to improve his cognitive capacities that were impacted by his TBI. 

In much of Physical Rehabilitative medicine the approach that a therapist uses with their clients is active and focused on improving function. This approach is logical and works (for the most part). 

However, in much of the cognitive rehabilitation the approach is often rooted in the deployment of strategies to help an individual like Clayton to better navigate his newly reduced cognitive capacities. This can be a necessary approach once one has exhausted other neuroplastic/brain changing Rehabilitation opportunities. 

Compensatory strategies involve the utilization of approaches that steer around deficits in a given ability in order to complete a given task. However, what happens the next time that individual is presented with a task that will require significant cognitive effort? 

Clayton's vision for success in his Rehabilitation was to drive again. However, when he went to take an assessment prior to having the opportunity to operate a vehicle again his assessment revealed that he had significant cognitive weaknesses that would not enable him to safely operate a vehicle. 

Conventional wisdom needed to be challenged! 

At that time most believed that after suffering a TBI the individual only had up to 24 months to regain some of what they had lost. 

Clayton, with the support of his mother and family chose to engage in the ABI Wellness BEARS platform to help him to assess, target and improve his cognitive deficits.

Clayton engaged in his rehabilitation program and made great progress inside of the program. He was achieving benchmark expectations etc...

The big test came when he went to try to pass his driver re-training again. As you recall his cognitive deficits that were seemingly fixed for life would not allow him to improve those deficits. 

The photo above says it all. Because Clayton engaged in a program that targeted his attention, memory, processing speed and planning capacities he was able to improve his cognitive driving assessment scores and that enabled him to pass his driver re-certification. 

Now, what would have happened if he and his family accepted the well-intentioned advice that his cognitive deficits were "fixed" and WOULD NOT change? He would not be driving, he may not be employed, his self-efficacy would not be where it is.

The message: 

1) The brain has a remarkable capacity to change and improve and like in physical rehabilitation, cognitive rehabilitation can also be rooted in improving baseline capacity. 

2) Be inspired by positive change. We all can do it the question is, are we being provided the opportunity we deserve to do so?

3) Be very careful underestimating an individual’s desire to improve.