How Can You Improve Executive Function After A Neurological Event?
After a neurological event such as an ABI what are some strategies to improve executive function? Be it to assist with achieving tasks at home or in the workplace?
What Are Executive Functions?
Executive functions are a cluster of higher level cognitive skills which are believed to be mediated by the front lobes. According to Perna et al (2012) executive dysfunction is quite common following an acquired brain injury. People with executive dysfunction may commonly experience deficits with:
- Insight, awareness, self awareness
- initiation and social pragmatics,
- higher-order thinking,
- judgment, planning
- reasoning and problem solving (Lezak, 1995)
It’s likely executive dysfunction may have a direct impact on a person’s ability to complete instrumental activities of daily living (IADL) such as work, leisure, budgeting and driving for example. These tasks involve multiple sequences, are dynamic, non linear and may require various cognitive skills to be successfully completed.
Evidence To Improve Executive Function
Cicerone et al.(2000) reviewed 14 studies which were focused on executive function and problem solving. The recommendation arising form this review was,
training of formal problem-solving strategies and their application to everyday situations and functional activities
Within the acute and rehabilitation environments commonly a therapy focus is on improving other cognitive functions which impair activities of daily living (ADL).
As an occupational therapy service we’re inclined to treat people within the context of their everyday lives, within the community and it is likely many months or even years when we are engaged. We’re inclined to use tasks and familiar environments as the rehabilitation setting and for a person experiencing executive deficits this is important especially when treating self awareness.
General Strategies To Improve Executive Function
Callaghn (2001) suggest the following strategies:
- Repetition and rehearsal
- On a continuum, start with tasks which are less cognitive demanding ( simple) and increase the complexity.
- Identify strengths or preserved skills to help compensate for impairment
- Leverage joy and motivation
- Modify the task demands to reduce novelty, time pressure or fatigue
- Set a structure about the day, create a routine
- Identify personal expectation and pace task completion. Being mindful not to take on too much.
How To Improve Executive Function At Work?
For the therapist and client the work environment offers a fantastic opportunity to
- observe new learning
- assess and prescribe tasks which meet a person’s current level of tolerance for novel and complex tasks.
- observe problem solving skills and how they affect work performance.
The Research Environment To Improve Executive Function
With an ageing population, vocational recovery will likely be a meaningful goal into tradition retirement years. No doubt this will create more demand for robust research which is translated into clinical applications.
The assistive technology environment offers remedial and enabling solutions though there is greater need for research to support practical rehabilitative techniques within the field of executive dysfunction for people residing in the community.
If you’re in a situation where you believe you’re experiencing executive dysfunction we encourage you to liaise with your doctor or therapist to plan a program suitable for your needs. The information in this blog posts serves as health promotion initiative only.
Alternatively, you can Contact Us or phone us at 1300 783 200 to discuss your situation.
- Perna R, Loughan AR, Talka K. (2012) Executive functioning and adaptive living skills after acquired brain injury. Appl Neuropsychol Adult. 2012;19(4):263-71
- Callaghn, C (2001) The Assessment and Rehabilitation of Executive Function Disorders in Rehabilitation of Neuropsychological Disorders: A Practical Guide for Rehabilitation Professionals. Brick Johnstone, Henry H. Stonnington
- Tyerman,A ( 2011) Executive function and return to work after brain injury. https://slideplayer.com/slide/10436738/
- Lezak, M.D, ( 1995) Neuropsychological Assessment, Oxford University Press, USA
- Remediation of Executive Functioning: https://erabi.ca/
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The Occupational Therapy Blog is a news and health promotion initiative. It by no means aims to be a source of medical or therapeutic advice. We enjoy sharing information and will attempt to curate it as best we can. You’d appreciate we like to lighten our blog articles which often tackles very serious and personal issues. It’s our way of sharing. The information contained on this blog is not intended to be a substitute for professional advice, or intervention. Always seek the advice of your GP or qualified therapist with any questions you may have regarding your personal situation. Never substitute or delay seeking professional advice because of information you’ve read on this website.