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   The Problem.You hit your head in a auto wreck six months ago and you still don't feel like your old self..... You had a whiplash in a fall on the job last year; your doctor says you 're ok, but most days you feel as though you are in a fog.....  Your 16 year old son had a pretty bad head injury five years ago, he used to be an "A"  student but, now he may not graduate high school.... 

     You took-out your temporal lobe when you fell down a flight of stairs nine months ago but, now you have the feeling of being outside of your body and your doctors don't have any answers for you....   Your head was "dinged," or "your bell" rung in practice last year, you're still up to par in the class room.... 

     Back at work you just don't seem to be able to get things done the way you used to....  In the classroom learning has become more difficult; things don't stick in your mind the way they did before your head injury....  You fly off the handle with little or no provocation....   Your behavior is erratic and often inappropriate....  You have difficulty expressing your self ...

     The Explanation. Though not always visible and sometimes seemingly minor, brain injury is complex. It can cause physical, cognitive, social, and vocational changes that affect an individual for a short period of time or permanently. Depending on the extent and location of the injury, symptoms caused by a brain injury vary widely. 

     Some common results of brain injury are difficulties with memory, mood, and concentration. Others include significant deficits in organizational and reasoning skills, learning, cognitive, and executive functions. Recovery from a brain injury in many cases is incomplete. In such cases recovery becomes a lifelong process of adjustment and accommodation. 

     Recovery from a brain injury can be inconsistent. In many cases gains are be closely followed by setbacks and plateaus. A "plateau" is not evidence that functional improvement has ended. Typically plateaus are followed by a series of gains.

     Changes in memory and organizational skills after a brain injury makes it difficult to function in complex environments. This page and its links has been designed to help you create a compensatory system, teach you how to use it and monitor how well it is working. 

     This page provides  practical suggestions for gathering information and developing effective action plans for coping with the memory, cognitive and organizational difficulties casued by brain injury. 

      It describes methods for collecting critical information and facilitating communication among your support network. Links to worksheets and interview guides helps identify goals and gives step by step information on achieving your goals.

     This page was designed to give meaning and form to the nature and scope of brain in daily living. It can be used identify current strengths, needs and strategies for restoring lives shattered by brain injury. 

     Links to checklists and compensatory strategies will proviede a foundation for negotiating accommodations at home, in school, and in the work place. It can be used independently or with therapists to identify current strengths, weaknesses, and strategies to long-term goals 

 The solution.   Mild traumatic brain injury can cause impairments in thinking skills that can result in long term difficulties. If this happens to you and your difficulties last longer than a few months you should contact us for  referrals and information on strategies for coping with brain injury.

     Below is a list of essential skills for everyday functioning that can become impaired by mild traumatic brain injury. The skill builders below can help you strengthen the infrastructure on which you rebuild  your life after brain injury. Our mission is to assists you to reach your potential by providing quality information, referrals and direct services. 206-621-8558
 


Essential Skills for Everyday Functioning ©


Functional area # 1

Q:To Behave Appropriately in situations that are:

1. Routine & Familiar 
         a. Essential skills you need include: 
A:  A General Fund of Information and Social Common Sense
Common Sense Skill Builders:
(1) Bone up on social skills. 
(2) Stop, and think before acting. 
(3) Reaffirm your values and priorities. 
(4) Become more sensitive to emotional needs of others. 
(5) Plan Activities
(6) Use a planning calendar, electronic or paper.
(7) Keep birthday and social calendars. 
(8) Keep a personal Journal of Daily Activities
(9) Keep a Wellness Journal.
(10) Sharpen your mental edge, read, study, attend lectures and continuing education courses. 
(11) Practice being in the moment. 
(12) Reacquaint your self with meaning and uses of social cues, social subtleties, and body language. 
(13) Keep up with current events, and topical matters of interest to you. 
(14) Anticipate responses of your self and others. 
(15) Role Play situations that might startle, or upset you. 
(16) Request clarification of matters at hand, even when you think you understand. 
(17) Review and reaffirm roles of parties, and timelines. 
(18) Re-negotiate deadlines 
(19) Clarify Goals and Objectives
(20) Refine and review your personal Safety Net
(21) Thank those who have helped you.

Q: To Behave Appropriately in situations that are: 
1. Complex & Novel 
           A. Essential skills you need include: 
           1. Logical, analytical skills 
           2. New concept formation skills
                 3. Problem solving skills
                 4. Attention skills
 
Problem Solving &  Analytical Skill Builders:
(1) Review and refine critical thinking skills.
(2) Review and refine problem solving skills
(3) Give yourself extra time to review and consider all options. 
(4) Perform risk benefit analysis. 
(5) Examine your motivation. 
(6) Engage in low stress, attention building activities such as computer games, jig saw puzzles, mazes, card, electronic, board games, etc. 
(7) Analyze how you spend your time
(8) Practice biofeedback, meditation, or deep relaxation.
 
Functional area # 2

Q: To Follow detailed procedures in an adaptive fashion you need a:
      1. Reliable Memory --  go to Memory Survey

A. Essential skills you need include: 
     1. Sequential thinking and cognitive flexibility. 
     2. Learning and recall of verbal and nonverbal information. 
Memory Skill Builders:
(1) Routinize your activities identify each step involved, follow each step in its proper sequence. 
(2) Stop, and think before acting.
(3) Remain flexible. 
(3) Keep detailed notes and records. 
(4) Utilize a reliable storage and retrieval system. 
(5) Employ cross references. 
(6) Review and update your reference materials. 
(7) Take review and refresher courses. 
(8) Take a memory enhancement course. 
(9) Keep an appointment book. 
(10) Write yourself reminder notes. 
(11) Post cheat sheets at eye level in your work station. 
(12) Utilize, reference materials, highlighters, margin notes, and tabs. 
(13) Plan your daily schedule in advance. 
(14) Mental repetition. 
(15) Make associations with other things that will trigger your memory. 
(16) Keep things you need to do in a prominent place where you will notice them. 
(17) Employ a reminder or tickler system. 
(18) Trust your instincts. 
(19) Practice being in the moment. 
(20) Utilize reminder or tickler system.
(21) More Memory Builders

Functional area # 3

Q: Effective Communication Skills

1. Expressive and receptive language
A:   Essential skills you need:
       1. People Skills
       2. Listening skills
Communication Skill Builders:
1) Tape record your favorite commentators, use the tapes to rebuild and refine your own expressive style. 
(2) Include dictionaries of language usage among your recreational reading materials. 
(3) Practice listening skills. Ask for clarification of roles and timelines, especially when you think you understand. 
(4) Summarize action plans and/or agreements
(5) Put action plans in writing. 
(6) Anticipate and role play responses typical and novel situations. 
(7) Refine your management and leadership skills.

Functional area # 4

Q: Academic Skills 

1. Manage correspondence 
2. Manage finances 
3. Manage reading
A:  Essential skills you need
     1. Writing, spelling, math, reading recognition and comprehension
Academic Skill Builders:
(1) Organize your correspondence. 
(2) Write down your thoughts as they come to you. 
(3) Utilize charts to track correspondence and finances. 
(4) Use an electronic dictionary and thesaurus. 
(5) Use calculators, the wrist watch style is convenient and handy. 
(6) Tackle difficult or complex matters when you are fresh and rested. 
(7) Read and re-read difficult or complex materials. 
(8) Utilize dictionaries of language usage. 
(8) Confirm your impressions of the meaning of written materials with a trusted, knowledgeable friend, family member, or associate. 
(9) Take bonehead or refresher courses. 

Functional area # 5

Q:   Manipulatory tasks and self-care activities 
         1. Essential skills you need

A. Speed, strength, fine motor coordination, tactile skills, vision
 

Strength and motor Skill Builders
(1) Start a fitness program, but first, consult your doctor. 
(2) Activities that enhance your motor coordination, strength and response time. 
(3) Analyze your feelings, especially those that you think of as pain responses. 
(4) Have your vision checked by a doctor who specializes in treating vision disorders that result from head injury.

Functional area # 6

Q:   Driving, and use of dangerous tools and appliances 
 

1. Essential Skills you need
    a. Judgment and flexibility, attention, nonverbal memory, constructional skills, right-left discrimination.
Safety Skill Builders
(1) Take a defensive driving course. Drive only when you are rested, fresh and traffic is light. 
(2) Plan you route, use a map, allow extra time. 
(3) Empty your head of other thoughts while you are in traffic. 
(4) Be extra tolerant of other drivers.
(5) Let go of  your ego. 
(6) Choose a familiar route and stick with it. 
(7) Practice being in the moment. 

Functional area # 6

Q:   Reality orientation 
       1. Essential Skills: 

A. Correct appraisal of potential limitations and strengths
 

Skill Builders
(1) Seek feedback from trusted friends and associates.
(2) Assess how well you meet your obligations. 
(3) Ask yourself how interesting you are to be with. 
(4) Perform regular self-analysis
(5) Trust your instincts 
(6) Practice being in the moment.

"...The internet elevates a doctor-patient relationship into a partnership."
    "Patients have been finding ways to be better informed and have been acting as their own best advocates for some time."    "Doctors generally welcome a more educated patient."     --The New York Times 7/9/98 

  "We are in the early stages of a transformation that will lead to the real practitioners of medicine  --being the lay person in the family, and  in the community--  and  we health professionals can be coaches and supporters of self-care." 
  -- Tom Ferguson, MD Founder of Medical Self Care Magazine;  Medical Editor of the Millennium Whole-health Catalogue; Author of Health On-Line, Addison Wesley, 1996

 

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