Acquired Brain Injury

We provide comprehensive neuropsychological care to individuals with acquired brain injury including neuropsychological and psychological evaluation, psychotherapy, cognitive rehabilitation and support to caregiving family members
Brain injury rehabilitation, involving treatment of the whole person, is the gold standard for optimizing recovery, productivity and well-being. We provide complete psychological care including neuropsychological (cognitive) and psychological assessment, cognitive rehabilitation (cognitive remediation) and psychological therapy. Persistent cognitive symptoms and psychological conditions, such as depression, anxiety, trauma, can impede reaching your full potential following injury. Our approach to treatment is grounded in the latest research and tailored to your specific strengths, challenges and goals.

What is an acquired brain injury (ABI)?

An ABI refers to injury to the brain that has occurred after birth. Injury to the brain can occur due to:

  • traumatic brain injury following a car accident, fall or assault
  • medical conditions (stroke, aneurysm/arteriovenous malformation rupture, brain tumour or seizure disorder)
  • oxygen deprivation during heart attack, surgical procedure or suicide attempt
  • bacterial and viral conditions (septicemia, meningitis and encephalitis)
  • autoimmune conditions (multiple sclerosis, HIV and Lupus),
  • toxic chemical exposure
  • excessive prolonged alcohol use
  • severe vitamin deficiency
  • side effects of cancer treatment (known as chemo fog or chemo brain)
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Our services are directed toward the following:

  • Injured workers/students who are unsure when/whether they can return to work/school.
  • Injured workers/students who need strategies to compensate for cognitive difficulties.
  • Individuals living with cognitive challenges (e.g., memory, attention, planning) or embarrassing behaviours (e.g., pseudobulbar affect or episodes of uncontrollable laughing or crying) who want to optimize their day-to-day functioning and confidence.
  • Those with depression, anxiety, adjustment and other issues following brain injury.
  • Individuals with moderate-to-severe memory impairment interested in learning to better use their smartphone and apps to enhance functioning and independence.

FAQs about Acquired Brain Injury

There are our most frequently asked questions when discussing ABI (acquired brain injury) with patients. If you have any other questions, please contact us.

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What cognitive symptoms can occur after an acquired brain injury (ABI)?

Due to the large number of potential causes of ABI, the symptoms vary from person to person depending on the location and extent of injury to the brain, and several other factors that can affect recovery. Cognitive changes can be widespread and severe across many thinking abilities or specific and mild. Some cognitive symptoms are also more common than others due to the vulnerability of their supporting brain networks, for instance proximity to bony structures, blood vessels or sensitivity to oxygen deprivation.

Memory difficulties are the most common cognitive symptoms following an ABI. Memory changes can range from a greater frequency in misplacing important items, like keys, wallet and glasses or in forgetting the details of conversations, to severe memory impairment such as forgetting entire conversations, recent events or what happened a few minutes ago. Executive functions, also often affected by ABI, are made up of a diverse set of cognitive abilities including reasoning, mental flexibility, organization, problem solving, multi-tasking, prioritizing, planning, sustaining attention, goal attainment, as well as motivation, impulse-control (not doing or saying the first thing that comes to mind), judgment, social appropriateness, self-awareness and empathy. Other potential cognitive challenges can include slowed mental speed, difficulties interpreting visual information, and speaking or understanding language. Cognitive challenges further interact, such that difficulties in one area (e.g., organization) can create challenges in other areas (e.g., learning and recalling new information, planning, goal attainment).

What psychological conditions can occur after an ABI?

An ABI is a major life event. It is normal to feel sad, down, angry, anxious and/or worried about what happened to you and what it means for your future. Adjusting to the changes you are experiencing as well as future uncertainties can be difficult to cope with. Many people describe their lives as “who I was before ABI” and “who I am after ABI”. The change to self-image, which may be due to changed employment status, physical abilities, and family and social roles, can be significant and have a negative effect on self-esteem. Many people benefit from supportive therapy to process these changes, the loss of their old life and to develop a new sense of identity and purpose.

Psychological disorders are common following an ABI. The most common conditions include depression, anxiety and anger. Often when psychological conditions are diagnosed, there is a pre-existing history of issues or risk factors (such as family history), but this is not always the case. Damage to certain brain structures resulting from ABI can also reduce emotional control which can exacerbate anxiety, anger and the ability to cope with day-to-day stressors. People who have experienced an episode of depression before ABI are at a greater risk following ABI of becoming depressed. Other risk factor for depression often experienced by individuals following ABI include reduced social contact, sense of purpose, meaning and engagement in activities they once enjoyed. Depending on how the ABI happened, a subset of people go on to develop post-traumatic stress disorder. Fortunately, cognitive behavioural therapy approaches have proven effectiveness with the above psychological conditions. As people with ABI may also have cognitive symptoms that interfere with traditional therapy administration (e.g., changes in memory, attention span), in many cases we may be able to adapt therapy to enhance treatment benefit.

Will I make a full recovery?

This is one of the most common questions asked following an ABI and one of the most difficult questions to answer, which can be very frustrating in planning your future. Many factors influence recovery. These can include the location and extent of brain injury, complications, the responsible medical condition(s) causing cognitive and/or emotional symptoms, the severity and nature of symptoms early on in recovery, age, intelligence and educational attainment, motivation, family and social support, availability of comprehensive brain injury rehabilitation, psychological health, continued mental and physical activity, alcohol or drug use, sleep and nutrition.

The content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment.

Will I be able to return to work after an ABI?

The type of injury, resulting symptoms, degree of recovery, in combination with your motivation, the nature of your job, flexibility at work and support of your employer can determine whether returning to work will be successful. Being aware of your challenges and learning strategies to effectively compensate, can also determine whether you will sink or swim at work.

The content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment.

What is a Neuropsychological assessment?

Neuropsychological assessment involves an examination of the brain and behaviour. Your performance on a variety of paper-pencil and computer tests provides a cognitive profile and information about the integrity of your brain function. Cognitive testing can take several hours to complete depending on the reason for referral. For many conditions, objective cognitive tests are more sensitive in detecting brain dysfunction or changes than current neuroimaging methods.

Thinking abilities tested can include attention, IQ and academic abilities, processing speed, learning and memory, language skills, visuoperceptual abilities, motor coordination, and executive functions, such as problem-solving, planning, reasoning, impulse control, and working memory (the ability to hold and manipulate information in mind). Psychological psychometric testing is also completed.

All psychometric scores are compared to normative datasets. Normative datasets can control for the effects of age, education, gender, and neurological or psychological conditions on test scores. In addition to cognitive and psychological testing, neuropsychological evaluations include a detailed clinical interview, diagnostic psychological evaluation, and review of medical, psychological and/ or neurological documentation. Interpretation of the comprehensive neuropsychological profile and formulation of diagnoses are informed by considering the interplay and impact of many variables.

Questions that can be answered by a neuropsychological evaluation, depending on the nature of the referral, can include the following:

  • Diagnosis of neurological or neurodevelopmental disorders and their impact on cognitive function.
  • Provision of clinical opinions and information to assist multidisciplinary care teams in reaching diagnoses of complex conditions or determining whether a medical intervention or medication was successful in improving cognition.
  • Diagnosis of psychological conditions, including their impact on cognitive function.
  • Types of cognitive abilities impaired or preserved.
  • The severity of cognitive difficulties.
  • Factors likely contributing to or causing cognitive difficulties.
  • Improvement or decline in cognitive functioning over time with repeat testing.
  • Recommendations pertaining to treatment plans for neurological and/or psychological conditions.
  • How to optimize cognitive functioning via intact cognitive abilities (cognitive rehabilitation).
  • Recommendations pertaining to accommodations for work and academic settings.
  • Whether cognitive changes are normal for age or indicative of a neurodegenerative process.
  • Guidance on future planning and decision-making in cases of neurodegenerative or brain injury conditions (dealing with finances, medication administration, meal preparation, and driving).
  • Informing prognosis and/ or recovery in neurological and psychological conditions.

Neuropsychologists have advanced training in the administration and interpretation of psychometric tests, psychological and neurological diagnoses, neurocognitive and behavioural interventions, and psychotherapy.

Assessment

An initial consultation is the first step in understanding your challenges and goals.

We offer comprehensive neuropsychological assessments (which include evaluation of both cognitive and psychological difficulties) to inform treatment or as standalone assessments. The length and nature of the assessment is determined by its purpose.

Cognitive rehabilitation

Cognitive rehabilitation addresses specific cognitive challenges that interfere with goals and optimal productivity (e.g., memory, attention, planning). We work with your strengths to buffer the impact of your challenges on your productivity and/or independence. We have in-depth understanding of cognitive neuroscience theory, research, and with designing, evaluating and providing effective rehabilitation programs and approaches that produce real-life results.

Psychological therapy

Our understanding of ABI and the cognitive and psychological symptoms that accompany various conditions, enables us to adapt psychological therapy to your unique needs so that you can get the most out of treatment. This is one of the advantages of pursuing therapy with a neuropsychologist.

Family

Brain injury does not only happen to an individual but affects the family. We provide psychological support to family members (18+ years) of those with brain injury. Family members and/or close friends can also play an integral role in our treatment planning and work together.

Conditions treated

We provide rehabilitation for cognitive difficulties due to most types of brain injury and many psychological conditions that can co-occur with brain injury.