Executive functions refer to those skills and abilities that enable us to accomplish goal-directed activities. After a traumatic brain or head injury, these abilities can be compromised.

Completing a task

• Planning – knowing and / or planning the steps for an activity

• Initiation – starting an activity

• Doing the task - carrying out your plans and at the same time, self monitoring and self regulating

• Evaluating – looking at the results of your work

• Changing and improving – looking at ways of making the task easier next time and avoiding any mistakes

We use these executive functions for all sorts of everyday tasks such as cooking, doing our laundry and shopping. To accomplish a task we must initiate each step, organise and follow through, and while this is going on we need to monitor and adjust our actions as necessary. Most of us do these things without much thought or planning. For a brain injured person however, it is more difficult. A person with a brain injury may not be able to initiate the task in the first place. They may not think about doing the washing or going food shopping, even if they are faced with a pile of dirty laundry or an empty fridge, these cues may not set into action the thought process that makes them initiate a plan of action.

Individuals with an acquired brain injury may initiate an activity but not have thought it through, so they make mistakes. A simple example would be going shopping, but not bringing your wallet or shopping list. Although this could happen to anyone, it happens more regularly if you have a brain injury. Brain injured individuals may not learn from their mistakes and continue to make the same mistake each time they try to accomplish a task.

Rehabilitation and treatment often involves implementing strategies and systems to help us with our executive functioning difficulties:

• Daily planners and organisers
• Home information centre – noticeboards, calendars etc
• Set aside time each day for planning
• Use timers and a Dictaphone for reminders
• Use step by step checklists

Executive functions and regulating thinking and behaviour

• Making inappropriate remarks or statements

• Being rude

• Dominating the conversation

• Continually talking about a certain subject

• Not being able to stay on topic

With the help of a suitably qualified speech and language therapist/ pathologist some individuals with brain injury can be taught to pick up on a listener's reactions or facial expressions to know when they are making communication mistakes.  Recovery from brain injury may mean re-learning social conventions and what facial expressions represent, but it may mean just re-learning to appropriately react to certain facial expression e.g. if I say something and my communication partner looks shocked, I may have said the wrong thing.

You can also find more resources, information and books at our online Resource Centre.