Long-term memory: Emerging evidence of remote Growing access to pre-trauma Stabilization of recovery of access Contains knowledge of concepts and memory; recognition of familiar contents to pretraumatically acquired words, rules, strategies, and objects and persons Recognition of strong associations knowledge base procedures; organizational principles May assume that contents (e.g., hammer-nail), basic Variable growth of long-term and knowledge frames; goals, are present but inaccessible semantic relations, and common memory, depending on type and experience and self-concept or three- event sequences severity of residual cognitive deficits Aspects of Early Phase Middle Phase Late Phase* Cognition Response system: Severely limited; Speaks or begins augmentative Generally functional Controls all output, including speech, perseverative responses system communication system- facial expression, and fine-and activity: includes motor planning Executive system (“central processor”): May use some gestures and Possible problems Usually speech Sets goals; plans and monitors activity; speech toward end of this stage, or general slowness Possible motor-planning problems directs processing and operations but with motor planning problems Impulsiveness and possible or slowness according to goals current input, and or delayed responses preservation Possible rapid fatigue perceptual-affective set Minimal awareness of self and Variable function depending Shallow awareness of residual current condition on site and extent of injury deficits No apparent self-direction of Growing awareness of self; poor Middle to severe deficits in behavior or cognitive processes awareness of deficits executive functions, related in Weak metacognitive awareness of part to anterior frontolimbic self as thinker damage Minimal goal setting, self- Strategy training possible, or self-inhibition, depending on meta-cognitive level or self-evaluation Functional Integrative Performance Aspects of Early Phase Middle Phase Late Phase* Cognition
Long-term memory: Contains knowledge of concepts and words, rules, strategies, and procedures; organizational principles and knowledge frames; goals, experience and self-concept Emerging evidence of remote memory; recognition of familiar objects and persons May assume that contents are present but inaccessible Growing access to pre-trauma contents Recognition of strong associations (e.g., hammer-nail), basic semantic relations, and common or three- event sequences Stabilization of recovery of access to pretraumatically acquired knowledge base Variable growth of long-term memory, depending on type and severity of residual cognitive deficits Aspects of Cognition Early Phase Middle Phase Late Phase* Response system: Controls all output, including speech, facial expression, and fine-and activity: includes motor planning Severely limited; perseverative responses Speaks or begins augmentative system Generally functional communication system- Executive system (“central processor”): Sets goals; plans and monitors activity; directs processing and operations according to goals current input, and perceptual-affective set May use some gestures and speech toward end of this stage, but with motor planning problems or delayed responses Minimal awareness of self and current condition No apparent self-direction of behavior or cognitive processes Possible problems or general slowness Impulsiveness and possible preservation Variable function depending on site and extent of injury Growing awareness of self; poor awareness of deficits Weak metacognitive awareness of self as thinker Minimal goal setting, or self-inhibition, or self-evaluation Usually speech Possible motor-planning problems or slowness Possible rapid fatigue Shallow awareness of residual deficits Middle to severe deficits in executive functions, related in part to anterior frontolimbic damage Strategy training possible, depending on meta-cognitive level Functional Integrative Performance Aspects of Cognition Early Phase Middle Phase Late Phase* self-
se_traumatic_brain_injury_evaluation_guidance.docx