What is Cognition?

Cognition is the brain’s ability to carryout the act of targeting, perceiving, processing, reasoning, executing, and recalling information obtained from the environment. A person’s cognition may be affected as a result of injury to the brain due to stroke, traumatic brain injury (from motor vehicle accidents, falls, blows to the head, etc.), concussion, tumors, anoxia/hypoxia (lack of oxygen to the brain), and other neurological conditions.

Related Skills

The individual may experience difficulty starting a conversation or keeping a conversation going. The individual may also have difficulty starting an activity or completing a project independently. The person may appear unmotivated to do activities as a result of poor initiation.

Processing Information:
The ability to process (think about and understand) information may be slow, resulting in delayed responses. Individuals may benefit from extra time to process information and reply, or from having information repeated due to inattention or impulsiveness. Some individuals have a tendency to respond to partial information when someone is speaking which can lead to misunderstanding of the information being given. Processing may also include the ability to cohesively express thoughts and ideas in a short and effective manner. The individual may have trouble finding the correct words to say or express information in a confusing manner.

The individual may be easily distracted by his or her own thoughts, or by people or activities in the environment. The person may have difficulty concentrating on what is being said and may lose track of a conversation. Poor attention may also interfere with a person’s ability to perform tasks and to recall information.

The individual may have trouble remembering newly learned information or recalling biographical information. By contrast, they may remember events or people from the distant past. During lengthy conversations, the individual may forget the topic being discussed. They may also perseverate (repeat) information they have already stated, because they have forgotten they have said it.

The individual may be confused about people in the environment and may mistake strangers for familiar people. They may also be unable to consistently recall the date, time, place, and what has recently happened to them.

Note: Memory and orientation difficulties can lead to confabulation. Confabulation occurs when an individual states and believes information that is inaccurate or untrue. Some people confabulate to compensate for not knowing the correct answer to a question or due to confusion about the situation.

Problem Solving/Reasoning:
The individual may have difficulty solving everyday problems and conflicts. As a result, the ability to make appropriate judgements may be affected. Sometimes they may be able to explain how to solve the problem, but are unable to carryout the steps involved in a functional situation.

Safety Awareness:
The individual may be impulsive and act without considering the consequences of actions. Appreciation of personal limitations may be poor, which may lead to a lack of good judgement skills and decreased safety awareness.

The individual may have difficulty in verbally and/or physically sequencing the steps of daily routines. For example, the person may omit telling you some of the steps of a recipe or may brush their teeth before putting the toothpaste on the toothbrush.

Executive Functioning:
The individual may know how to complete a task or action and even be able to explain how to do it, but may have difficulty with functionally planning, organizing, initiating, and carrying out the task or action. For example, the person may know that they have to take the elevator to the 3rd floor, and may know how to do this. However, due to poor initiation, they may be unable to proceed beyond waiting outside the elevator doors on the 1st floor.

Abstract Thought:
The individual’s ability to think abstractly may be impaired. They may take things literally rather than interpret the underlying message. For example, although the expression, “I’ll only be a minute.” usually means, “I’ll be gone for a brief period of time.” the cognitively impaired individual may literally expect you to return after 60 seconds. The ability to understand humor may also be affected.

Expressing and Reacting to Emotions:
The individual with cognitive problems may have difficulty appropriately showing reactions, both facially and verbally, in response to situations or comments. For example, when told about the anticipated arrival of a new grandchild, the individual may not provide the expected response, such as smiling (facial response) or commenting, “That’s wonderful – congratulations!” (verbal response). This limited emotional reaction can be very distressing to family members and may give the impression that the individual is “unfeeling” or “uncaring”.

During a conversation, the individual may not be able to pick up or recognize the emotional content in the speech of others and, as a result, would not be able to respond appropriately. Consequently, the person may appear insensitive to the needs of others and may seem rude or impolite during a conversation. In contrast, some individuals may be excessively emotional or labile. They may cry or laugh in inappropriate situations, experience mood swings, and have difficulty controlling/understanding these displays of emotion.

Social Appropriateness:
The individual may behave in a uninhibited, inappropriate manner and not realize that actions or words may be socially unacceptable. For example, the person may curse or display anger at an inappropriate time, or may reveal personal information to strangers. The appreciation of humor and responses to humor may be affected and seem off target (ie. They may laugh inappropriately or show now awareness of humor.) They may not look at others when they are speaking and may interrupt frequently.

Related Symptoms

  • Seizures
  • Fatigue
  • Physical Changes – spasticity or weakness
  • Sensory Loss – numbness or tingling
  • Headaches (mild or severe) – often brought on or worsened by excessive stimulation
  • Vertigo – imbalance and dizziness
  • Changes in Hearing – hypersensitivity to noise or decreased acuity
  • Visual Disturbances – hypersensitivity to light, decreased acuity, decreased perceptual clarity or depth perception
  • Behavioral/Emotional Changes – change in personality, mood swings or outbursts
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