Applied behavioral analysis of traumatic brain injury and cognitive functioning

APPLIED BEHAVIORAL ANALYSIS ON HOW BRAIN INJURIES IMPACT ONE'S COGNITIVE ABILITY LEVELS

HOW BRAIN INJURIES IMPACT ONE'S COGNITIVE ABILITY LEVELS

How Brain Injuries Impact One's Cognitive Ability Levels

How Brain Injuries Impact One's Cognitive Ability Levels

Traumatic brain injury (TBI) has considerable impacts on the normal functioning or operation of the brain. In most cases, brain injuries damage the nerve cells to an extent that these cells no longer transmit information to each other in an ordinary manner. Brain injuries are usually divided into three major categories like mild, moderate and severe depending on the extent of neurological damage that takes place. Given their impact on neurological functioning, brain injuries have an impact on one's cognitive ability levels. Some of these impacts include cognitive disabilities, depressive symptoms, life satisfaction, and effect on life roles at different development stages and ages. Therefore, the extent of which brain injuries affect a person's cognitive ability levels is an important topic of study. Is there a direct link between brain injuries and how cognitive ability is impacted? How does the cognitive ability level decrease or is maintained due to the brain injury?

The purpose of this research is to examine the ability of an individual to gain, maintain or lose his/her cognitive ability levels depending on the severity of neurological damage from brain injury. This is an important issue to study to understand how different categories of brain injury affect cognitive ability levels of an individual. As a result, this study will provide insights on the impact of brain injuries on cognitive ability levels. In this case, the ability for an individual to carry out a cognitive function or assessment is examined against brain injuries like depression and post-traumatic stress (Massy, Meares, Batchelor & Byrant, 2015). The research strategy for this issue is an applied behavioral analysis that will focus on examining the level of individuals' cognitive abilities in the aftermath of a traumatic brain injury. For this study, the researcher will rely on the principle of learning theory to conduct a study of the behaviors of individuals undergoing an intensive intervention program after suffering a traumatic brain injury or other brain injuries.

Research has shown that brain injuries, notably severe or moderate Traumatic Brain Injury (TBI), can be long-term or short-term. There are different variations in which people that have experienced TBI exhibit these conditions. For instance, the points of dimensions come with the severity of the initial injury, the completeness and the rate of healing, the nature, and types of the functions of affected by TBI (Gefvert, 2016). Thus, it is essential to know that the effects of brain damage are varied in the different people affected. The damage caused by brain damage, notably TBI, is dependent on some dimensions as stated earlier, meaning that most of the damages depend on how an individual responds to the injuries and their severity at any given time.

Purpose

Traumatic brain injury is a common problem in society that can have a wide range of different consequences for the patient that range from mild to severe. The presence of brain injuries in individuals and the potential for cognitive ability impairment has been popularized in the media recently because head impacts in National Football League (NFL) have been associated with many cognitive impairments later in life. This analysis will conduct a brief literature review to determine what research has been conducted in the field of neurology and related fields to identify evidence that has been published related to the long-term effects of repeated head impacts.

Target Population

Using a population of individuals involved in contact sports, such as football, represents a convenient sample to study brain injuries due to the higher prevalence of head impacts that occur in these sports. It has been estimated that sports-related mild traumatic brain injuries (MTBI) or concussions affect a population of individuals in the U.S. that ranges from approximately 1.6 to 3.8 million annually (McAllister & et. al., 2012). Populations used for studies related to MTBI are typically divided into collegiate and professional categories of different sports.

Expected Findings

My paper is expected to look at brain injuries have an impact on one's cognitive ability levels. It is expected that the most horrific of a brain injury, the longer and slower the process of changing people's cognitive ability. The lesser the brain injury, the more likely an individual can take their current cognitive level and improve it based on the treatment plan. Pivotal response treatment and the naturalistic approach are used most commonly at treatment (Mohammadzaheri, Koegel, and Rezaee. & Rafiee, 2014). Most importantly functional assessments have been productive because they are individualized based on the clients specific needs.

Discussion

The presence of MTBIs has been studied from a wide range of different academic disciplines that can range from studying the prevalence of this type of injury, to its effects on the individuals' cognitive impairment, and the options available to treat different types of impairments that result from such injuries. Researchers previously believed that the brain had a level of plasticity, which could perform a self-healing function, and it was hypothesized that children would have greater levels of this plasticity (Stamm & et. al., 2015). However, there has been some evidence that has been published that suggests the opposite and indicates that children and adolescents may be more at-risk than their adult counterparts who also play in contact sports.

Despite the relevance of different types of studies focused on the occurrence of head impacts, it actual damages incurred by head impacts can be difficult to quantify and to study in a quantitative research effort. One method to try to quantify the damages inflicted upon an individual's neurological systems consists of using comprehensive cognitive testing at different points in time relative to head injuries (before and after) as well as specialized equipment (such as helmets) that can collect data about the severity of different impacts to the head (McAllister & et. al., 2012). For example, helmets can be equipped with accelerometers that are specially programmed with algorithms that can detect the magnitude of factors such as rotation, the center of gravity, impact duration, and impact location.

Another related line of research deals with the potential for cognitive rehabilitation after the presence of an injury and such research also deals with the plasticity of the brain to repair itself. Cognitive rehabilitation refers to a set of interventions that aim to improve a person's ability to perform cognitive tasks by retraining previously learned skills and teaching compensatory strategies. Some common interventions have shown improvements in attention, memory, and executive function, as well as the nature of comprehensive programs, which combine treatment modalities that can result in cognitive improvements in the ability to perform many tasks (Tsaousides, 2009).

Individuals who encounter moderate or severe brain injuries and damage notably will experience difficulties and problems in their basic cognitive skills. For instance, the cognitive skills of such people will be altered in some way, as with the sustainability of the attention, concentration on activities that are at hand, together with the ability to remember learned things. Such people will be affected in their mode of thinking in that they may think slowly and hence solve problems with a much slower pace (Sahoo et al., 2016). They might speak slowly and hence respond to things slowly. They might meet situations where they become confused with ease whenever routines are altered or the moment when the simulations level from the present environment exceeds their threshold. Such individuals might persevere at some tasks for a long time as they get some difficulty in switching to a different task or a new tactic whenever they have such difficulties (Boyle et al., 2002). They might have some difficulty in going through difficult situations to an extent that they fail to make decisions that will haul them out of such situations and conditions.

In some situations, individuals who have faced severe brain damage may have cases of jumping to conclusions or situations where they find difficulty in going beyond simple or complex concrete situations. They might find abstract objects, or fail to find such objects, together with principles that will guide their way of thinking and give them a better view of life. Now that they find it hard to learn new situations, it becomes hard to have them navigate through tough situations that require a quick process of making decisions. In some situations, such individuals will experience challenges while making their speech and language stabilities. They experience impairments of the same (Gefvert, 2016). For instance, they face the challenge of word-finding problems, face challenges in understanding the language of others, among others.

According to the National Campaign targets traumatic brain injuries (2016), one of the major classes of cognitive abilities that are likely to be affected by brain damage, TBI is called executive functions. These refer to a complex processing of vast amounts of information that are intricate in nature, and need to function creatively, independently, and competently as bodies in a complex world. After the brain injury, individuals who have TBI might face the challenge of functioning well within their social roles because of their difficulty in making plans, keeping track of time, and coordinating complex events. It also includes making decisions subject to a broad input, adapting to new changes in life, and in many other words, being the 'executive' in one's life (Sahoo et al., 2016).

The cognitive functions of the brain are tentatively involved in the thinking process, decision making, and planning. This section of the body is very instrumental in enabling a person to be functional in all situations of life. Therefore, the moment an injury happens to the brain, the cognitive parts and functioning of the brain are impaired in some way, hence impairing the execution of all these critical activities by the person (Boyle et al., 2002). Under an appropriate training and support, the person who undergoes a serious TBI can be trained to compensate for some of the cognitive difficulties (Futterman, 2012).

According to the TBI Center at Mount Sinai, brain damage can be managed carefully as it concerns some steps that have to be taken by the healthcare specialists on an individual. Further, according to research done by this body, TBI also affects the mood and the behavior of an individual, all of which are connected to the cognitive functioning of the different parts of the body. With the presence of the TBI, the systems within the brain associated with the control of the socio-emotional lives are often damaged. The consequences that come from the individual and the significant others are much effective as they might be very difficult to manage at many times. The states of personality can be so influential and substantial in that they might modify and change the feelings of someone on somebody or something like life. The effects of the damage might change the perception of the person on others or even change everything universally about a person (Sahoo et al., 2016). For example, a person who might have been excellent negotiator might begin to blur comments that might be embarrassing to those around him or her. The person might begin to possess other unusual characteristics and behaviors like emotional swings, irritability, aggressiveness, lethargy, uninhibited behavior, being not able to modify behaviors to fit different situations, among others. All these are such conditions that do not only affect the person who has experienced the brain damage but also those who are significant to him or her (Boyle et al., 2002).

One of the basic effects that affect individuals with TBI is called the denial, also called the lack of awareness. This condition refers to a situation where the person loses the capability to make comparisons of the post-injury behavior together with abilities attached to the pre-injury behavior together with abilities. In such cases, the effects of TBI are not perceivable for some reasons. The reasons mighty center around the desire not to engage the effects of the TBI in the mind or simply as a way of avoiding the pain while facing with totality the consequences of the injury. It may include other neurological reasons most of which the brain damage itself undermines the individual's ability to get back, make comparisons, make evaluations of the differences, and reach conclusions attached to the process taken (Sahoo et al., 2016).

The cognitive part of the brain is also functional with the aid of the vision from the eyes and many other parts of the body organs. The cognitive processes relay information and acquire information from the different body organs as it seeks to provide feedback for the actions to be taken in different situations. One major aspect of cognitive functioning is the use of information from sight to make decisions. TBI affects the vision, in one way or another. Any of the ways human beings have for sensing and perceiving are affected, certainly, by the occurrence of TBI. Vision is affected in several ways, translating its effects to the functioning of the brain and specifically the cognitive part of the brain. The individual may experience challenges in tracking vision, losing parts of the field of vision, encountering reduced depth of perception and at some instances a disconnection between the visual and the non-visual parts of the brain. All these have a direct influence on the functioning of the cognitive part of the brain (Uzumcuo-lu et al., 2016). With the occurrence of the brain damage, the person might experience a disconnection between the visual comprehension and the visual perception such that the person will not have a breakthrough in knowing what he or she is seeing. Certain changes are also possible to occur within the hearing senses, the senses of smell, touch, among others. In such a case, the individual might enter into experiences of becoming overly sensitive or insensitive (Futterman, 2012).

Further, the effects of visual damage or impairment resulting from brain damage can be felt when the individual fails to locate his or her position in space. In such a case, the cognitive functioning of the brain will be impaired (Park, 2016). The person will not be able to know what is happening, and hence becomes hard for him or her to adjust to the major and minor changes, together with decision making that will lift his or her state of being. The person experiences challenges in balancing the body, managing vertigo and dealing with ringing in the ears. All these have a direct influence on the cognitive performance of the brain and of the individual as a whole (Sahoo et al., 2016). Certainly, some major behavioral changes will occur in the life of the person, most of which calls for the need to engage training and other practices that will guide the person to gain ways of managing the cognitive state of being in life. Individuals who experience TBI or minimal brain damage have the capacity also to face the challenge of experiencing seizures. Seizures are known to kick in immediately after the injury. Seizures affect the manner in which most of the cognitive functions are coordinated in the brain, and hence the working of the person in different situations.

In general, research has shown that most of the people with TBI suffer effects and influences of the brain damage that interfere most with their cognitive capabilities. An individual attaches one of the main features of the injuries to the brain to the state of maintaining attention and concentration. Brain damage affects the processing and understanding of information by those affected (Uzumcuo-lu et al., 2016). They have trouble in memory management. For instance, the person might have a failed memory, which affects almost everything that takes place on the person. Communication is another activity within the brain that is greatly affected by the effects of TBI in an individual. The person will experience challenges in planning, organizing, and assessing whatever is necessary and important in the body (Chatterjee, 2000). The person will experience challenges with reasoning, making decisions, solving problems, and making judgments in most situations and cases that require the brain to engage such parameters of work. Moreover, with the damage to the brain through injuries, a person is likely to suffer from challenges of controlling the impulses and desires that act normally within the body, together with making the person have challenges with being patient to issues.

Cognition is a necessary and important aspect of human management. The cognition is responsible for the processing and understanding of information. When the brain undergoes some injury, as suffering from TBI, the cognitive functions connected with the processing and understanding of information are interrupted. For instance, the person who suffers from TBI takes longer to grasp what other people are saying. They have the possibility and behavior of taking more time to understand and follow instructions (Park, 2016). They face a lot of difficulty understanding television shows, movies, among others. They take longer to read and understand information offered in written form like in books, newspapers, among others. They take time to react generally, as are not responsible when it comes to driving. When driving, have a lot of difficulty to react to driving signs and road signs. They need to face specialists in order to get assurance that they can operate machinery. Moreover, these individuals have trouble in carrying out physical tasks, like routine activities of getting dressed and cooking. All these are coordination activities that require a clear and articulated cognitive brain that does not have impairments of any form.

Individuals who have faced the challenge of TBI also have difficulties in managing language and communication. They have difficulty in understanding and expressing information in certain ways. They face difficulties while thinking of the right words for their use. They have trouble starting and following conversations, together with understanding what others have said. They face the challenge of rambling and getting off topics under discussion with ease. They do not adapt to ways of managing simple language skills, like expressing individual thoughts in a way that is organized. They have trouble communicating thoughts together with feelings by use of expressions like tone, voice changes, and body language, among others. They have the challenge of feeling and understanding the emotions of others, not responding in ways appropriate to these feelings and social situations (Gefvert, 2016). Moreover, such people have the challenge of misunderstanding jokes together with sarcasm. With planning and organizing, people with brain injuries have a challenge planning their days together with scheduling for events and appointments. They face the challenge of organizing for tasks that need a number of steps, probably a multiplicity of steps, as required in the way they should be done, like when in a laundry and cooking.

Conclusion

TBI results in many impairments to the body functioning. Most of these impairments interfere with the way in which a normal body functions, albeit the many sense, organs, among others. The cognitive functioning of the brain, which is much concerned and related with the behavior and mannerism of an individual, has a greater resultant effect from TBI (Park, 2016). The human body is sensitive to any form of injury, but TBI is more influential in the manner in which it directly affects an organ that acts as the driving force in terms of thinking, reasoning, decision-making, communication, and many other human activities. In the case that the body does not suffer completely as with death, the effects of the TBI are more felt on the general way in which the individual will engage the natural environment and yield what is supposed to be supposedly normal life (Park, 2016). Within the instance of acquiring the brain injury, the victims will undergo some form of pain and discomfort which will go towards aggravating and denoting the extent to which the TBI has occurred. Nonetheless, as stated earlier, the effects of the TBI are to be known after some time unlike the impact pain that is sustained immediately and for some time. Moreover, different dimensions that determine the nature of the TBI in an individual are also instrumental in relaying the extent to which TBI is effective and occurring in different people in the world.