Assessing the long-term consequences of traumatic brain injury can be a long and complicated process. The basic questions to be addressed involve what the injured persons can and cannot do in everyday life: at work, at home and at play. It is particularly important to assess the individual's relationships with other people. Most often assessments of cognitive and emotional function are carried out in a clinician's office. The more functional aspects of daily life are often evaluated in simulated setting such as a model kitchen at a rehabilitation centre, where the mechanics of food preparation and cooking can be observed. While these types of formal assessment can provide valuable information, they tend to lack ecological validity: that is, they do not provide an adequate assessment of the types of situations that the brain-injured individual has to face in everyday life. It is for this reason that Waldee Services uses a situational/functional assessment to augment Neuropsychological and Occupational Therapy assessments.
Functional assessments provide a unique and powerful way to evaluate and quantify impairments of higher cognitive functioning and social behaviour in individuals who have suffered a traumatic brain injury. This approach to assessment is particularly useful in situations where standardized neuropsychological assessment tests are not yet available, are not sensitive enough, or do not provide sufficient information for assessment or treatment purposes. At Waldee Services a functional assessment is guided by known brain-behaviour relationships and neuropsychological principles. The assessment is done by a rehabilitation specialist under the direction of a Neuropsychologist, and takes place in the client's own community.
Problems resulting from damage to the frontal-lobe systems of the brain such as:
- distractibility in noisy environments,
- difficulties in moving from thought to action,
- forgetting to remember to carry out certain planned actions (prospective memory), and,
- inappropriate behaviour in social situations
are particularly difficult to evaluate in a quiet office setting, but can often readily be observed and documented in the client's own community. A functional assessment can provide specific and concrete information about a client's day-to-day performance and pinpoint areas of actual and potential difficulty. |
