The indication of ability levels by using adjectives is time honored but somewhat problematic. It was introduced by David Wechsler (Wechsler, 1958) and has been replicated in each of the examiner’s manuals for the various Wechsler scales in succeeding years. What is always mentioned by Dr. Wechsler and his colleagues and successors in the examiner’s [...]
I have just completed a forensic case in which one of the key issues was the brain-injured client’s pre-injury cognitive capacity. This is always a difficult issue to pin down and is usually best handled either with grades from school, academic standardized tests, or pre-injury occupational performance. With the first two, it is straightforward to [...]
Functional age is a concept that was first introduced by one of my mentors, James E. Birren, PhD, in the 1960s (Birren, 1964). Dr. Birren argued that a person’s functional age was more indicative of ability than chronologic age. Also, functional age can be controlled to some degree so that the aging process can be [...]
When attention deficit disorder or attention deficit hyperactivity disorder has been identified, concomitant problems with phonologic or auditory processing when hearing tests are normal can lead to serious deficiencies in learning that will persist into adulthood. In my experience, these often are comorbid and can both mask and magnify each other. Attention deficits can mimic [...]
I am always amazed when I recall that Albert Einstein developed his theories of relativity with what he called thought experiments (Einstein, 1920). Einstein was not only very intelligent, he had excellent working memory, defined as “the set of mental processes holding limited information in a temporarily accessible state in service of cognition” (Cowan et [...]
After a brain injury, a useful alternative to the natural development of executive functions (EF) having to do with inhibition and emotional self-control is the reinforcement of rules that prohibit target behaviors. Using prohibitions to develop self-control is useful because it simulates the down-regulation of the limbic system by the orbital-frontal cortex (OFC). The OFC [...]
Three important concepts for us to consider are cognitive work capacity, cognitive work demand, and cognitive reserve, the person’s residual functional capacity. As a person is evaluated to return to work after experiencing a brain injury, a comparison will be made between his or her available work capacity and the job’s demands. If there is [...]
During childhood and adolescence, the development of executive functions such as working memory follows the development of white matter tracts and associations among cortical and sub-cortical structures in the human brain (Nagy, Westerberg, & Klingberg, 2004). Full integration of white matter and gray matter does not conclude until early adulthood, with males and females differing [...]
