Glossary of Terms for Acquire Brain Injury (ABI)

| A | B | C | D | E | F | G | H | I J | K L M | N O | P Q | R | ST | U V W |

Absence seizure
Short period of unconsciousness, characterised by cessation of voluntary motor activity, and amnesia of the event. See epilepsy and petit mal.

Abstract reasoningProcess of reaching conclusions associations or generalisations rather than concrete, factual information.

Abstract thinkingConcepts that are not concrete or are difficult to understand. Being able to apply abstract concepts to new situations and surroundings. The person living with an ABI may be unable to perform abstract thinking.

AbuliaAbsence or inability to exercise will power or to make decisions. Also, slow reaction, lack of spontaneity, and brief spoken responses. Usually associated with damage to a cerebellar vessel. See also cerebellum.

Acalculia
Inability to perform even very simple mathematical calculations.

Acute Care
The phase of managing health problems which is conducted in a hospital on patients needing medical attention.

Adaptive/Assistive Equipment
A special device which assists in the performance of self-care, work or play/leisure activities or physical exercise. See also adaptive equipment catalogue.

Adjusted
Emotional adjustment.  Having achieved a state where one is relatively stable and emotional responses are within a typical range.

AdvocacyFull, active and open support for, and representation of an individual, group, cause or idea.

Adynamia
Difficulty initiating activities, gives the appearance of lethargy.

AffectThe observable emotional condition (feeling, emotion, mood and temperament) of an individual at any given time.

Ageusia
Loss of the sense of taste.

AggressionHostile action or behaviour which causes fear or flight or self-defensive action by the victim.  See rage, anger, violence and hostility.

Agnosia
Inability to recognise familiar objects, sounds etc, although functioning of sense organs, intelligence and consciousness are normal.  Can be visual, auditory, or tactile.

Agraphia
Inability to express thoughts in writing, seemingly because the individual can not translate mental image of word into arm and hand movements.

Alexia
Sometimes called word blindness.  Inability to read including language, symbols and music, ie. to gain any meaning from printed words.

Ambulation
The ability to move or mobilise.

Amnesia
Loss of memory, inability to recall past experiences when recall would be expected.  Can be temporary or permanent, can effect distant, recent events. See also anterograde amnesia, retrograde amnesia, post-traumatic amnesia.

Anarthria
Loss of speech due to impairment of muscles caused by injury to the nerves supplying speech muscles.

Aneurysm
A balloon-like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a haemorrhage.

Anger
Aroused emotions such as rage, aggression, violence and hostility etc.

Anomia
Inability to recall names of objects. Persons with this problem often can speak fluently but have to use other words to describe familiar objects. See also parietal lobe.

Anosmia
Complete or partial loss of the sense of smell.

Anoxia
A lack of oxygen in brain cells. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.

Anterograde Amnesia
Inability to consolidate information about ongoing events. Difficulty with new learning.

Anticonvulsant
Medication used to decrease the possibility of a seizure (eg., Dilantin, Phenobarbital, Mysoline, Tegretol). See also pharmacology guide.

Antidepressants
Medication used to treat depression. See also pharmacology guide.

Antisocial behaviour
Behaviour which results in social disapproval eg. vandalism, because it is harmful to maintaining social order.

AnxietyA continuous fear (which can be low- or high-level) that something wrong is going to happen.

Aphasia
A debilitating communication disability caused by damage to the language processing centres of the brain. An individual with aphasia may have difficulty understanding, talking, reading and writing, but their intelligence is not affected

Apraxia
Apraxia (of speech) is a motor speech disorder. The messages from the brain to the mouth are disrupted, and the person cannot move his or her lips or tongue to the right place to say sounds correctly, even though the muscles are not weak. The severity of apraxia depends on the nature of the brain damage. Apraxia can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage). Apraxia of speech is also known as acquired apraxia of speech, verbal apraxia, and dyspraxia.

Aprosodia
A condition in which there is a loss of production or comprehension of the meaning of different tones of voice.

ArousalBeing awake. Primitive state of alertness managed by the reticular activating system (extending from medulla to the thalamus in the core of the brain stem) activating the cortex. Cognition is not possible without some degree of arousal. See also brain stem.

Articulation
Movement of the lips, tongue, teeth and palate into specific patterns for purposes of speech. Also, a movable joint.

Astereognosia
Inability to recognise things by touch. See also parietal lobe.

AtaxiaA problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person's ability to walk, talk, eat, and to perform other self-care tasks.

Attendant Care
Provision of assistance in activities of daily living for a person with disability. Daily number of hours of required assistance, either physical or supervisory.

Atrophy
A wasting away or decrease in size of a cell, tissue, organ, or part of the body caused by lack of nourishment, inactivity or loss of nerve supply.

Attention
Applying the mind exclusively to some situation or task.  Akin to concentration.

Attention seeking behaviour
Behaviour, often unpleasant, used to attract the attention of others. Usually an expression of the need for help.

Attention span
Period of attention or concentration given by an individual to a particular task or situation.  Normally increases with age.

Audiologist
One who evaluates hearing defects and who aids in the rehabilitation of those who have such defects.

Auditory
Hearing

Auditory memory
Ability to retain and recall information which has been heard. Reduced auditory memory affects educational performance.

Auditory sequential memory
Ability to recall heard information in its correct order.

Augmentative and Alternative Communication
Any type of communication strategy for people with a range of conditions who have significant difficulties speaking.  The strategy or technique used by the person aims to maximise an individual's communication skills (i.e., production as well as comprehension) for functional and effective communication of their needs, preferences and wishes.

ADL
Activities of daily living. Routine activities carried out for personal hygiene and health (including bathing, dressing, feeding) and for operating a household.

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Backward chaining
Method of teaching a pattern of behaviour, where the last step is taught first e.g. tucking in the shirt.  See forward chaining.

BalanceThe ability to use appropriate righting and equilibrium reactions to maintain an upright position. It is usually tested in sitting and standing positions.

Behaviour
The total collection of actions and reactions exhibited by a person. Something that can be measured objectively.

Behaviour chaining
Learning a new behaviour in a series of steps, where each step stimulates learning of the next, eg. learning to write name letter by letter.  Can be backward chaining (last step taught first eg. tuck in shirt), or be forward chaining (first step taught first eg. putting arms in sleeves).

Behavioural checklist
A method of measuring or recording actual behaviour eg. duration, frequency, environment.

Behaviour management
A specific behaviour is identified and an intervention method is formulated.  Uses positive reinforcement to encourage desired behaviour, and negative reinforcement to discourage unwanted behaviour. Careful monitoring is an integral component of the behaviour management program.

Behaviour problems
Difficulties encountered by an individual in areas such as interpersonal relationships and in meeting the demands of certain social customs and institutions.

Bilateral
Relating to two sides (of the body).

Blood clot or haematoma
A collection of blood where it should not be.

Brain Injury
Injury to the brain resulting in changes in cognitive, communication, physical and behavioural function.

Brain Injury, Acquired
The implication of this term is that the individual experienced normal growth and development from conception through birth, until sustaining an insult to the brain at some later time which resulted in impairment of brain function.

Brain Injury, Closed
Occurs when the head accelerates and then rapidly decelerates or collides with another object (for example the windshield of a car) and brain tissue is damaged, not by the presence of a foreign object within the brain, but by violent smashing, stretching, and twisting, of brain tissue. Closed brain injuries typically cause diffuse tissue damage that results in disabilities which are generalised and highly variable.

Brain Injury, Mild
A patient with a mild traumatic brain injury is a person who has had a traumatically-induced physiological disruption of brain function, as manifested by at least one of the following: 1) any period of loss of consciousness, 2) any loss of memory for events immediately before or after the accident, 3) any alteration in mental state at the time of the accident (eg. feeling dazed, disoriented, or confused), 4) focal neurological deficit(s) which may or may not be transient; but where the severity of the injury does not exceed the following: a) loss of consciousness of approximately 30 minutes or less; b) after 30 minutes, an initial Glasgow Coma Scale score of 13-15; c) Post Traumatic Amnesia not greater than 24 hours.

Brain Injury, Traumatic
Damage to living brain tissue caused by an external, mechanical force. It is usually characterised by a period of altered consciousness (amnesia or coma) that can be very brief (minutes) or very long (months/indefinitely). The specific disabling condition(s) may be orthopaedic, visual, aural, neurologic, perceptive/cognitive, or mental/emotional in nature. The term does not include brain injuries that are caused by insufficient blood supply, toxic substances, malignancy, disease-producing organisms, congenital disorders, birth trauma or degenerative processes.

Brain Plasticity
The ability of intact brain cells to take over functions of damaged cells; plasticity diminishes with maturation.

Brain Scan
An imaging technique in which a radioactive dye (radionucleide) is injected into the blood stream and then pictures of the brain are taken to detect tumours, haemorrhages, blood clots, abscesses or abnormal anatomy.

Brain stem
The lower extension of the brain where it connects to the spinal cord. The brain stem plays a vital role in basic attention, arousal, and consciousness. It also controls the functions necessary for survival, breathing, heart rate and alertness. All information to and from our body passes through the brain stem on the way to or from the brain. Like the frontal and temporal lobes, the brain stem is located in an area near bony protrusions making it vulnerable to damage during trauma.

Burr hole
A 10-20 mm surgical drill hole made through the skull.

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Case Management
Facilitating the access of a patient to appropriate medical, rehabilitation and support programs, and coordination of the delivery of services. This role may involve liaison with various professionals and agencies, advocacy on behalf of the patient, and arranging for purchase of services where no appropriate programs are available.

Catheter
A flexible tube for withdrawing fluids from, or introducing fluids into, a cavity of the body. Frequently used to drain the urinary bladder (Foley catheter).

Central Nervous System (CNS)
The brain and spinal cord. The main network of coordination and control of the entire body.

Cerebellum
The cerebellum is involved in the coordination of voluntary motor movement, balance and equilibrium and muscle tone. It is located just above the brain stem and toward the back of the brain. It is relatively well protected from trauma compared to the frontal and temporal lobes and brain stem. Cerebellar injury results in movements that are slow and uncoordinated. Individuals with cerebellar lesions tend to sway and stagger when walking.

Damage to the cerebellum can lead to: 1) loss of coordination of motor movement (asynergia), 2) the inability to judge distance and when to stop (dysmetria), 3) the inability to perform rapid alternating movements (adiadochokinesia), 4) movement tremors (intention tremor), 5) staggering, wide based walking (abnormal gait), 6) tendency toward falling, 7) weak muscles (hypotonia), 8) slurred speech (dysphonia), and 9) abnormal eye movements (nystagmus).

Cerebral
Concerning the brain

Cerebral angiogram
An x-ray picture of the blood vessels inside the head. A drug is injected via the groin artery which outlines these cerebral vessels.

Cerebral cortex
Includes the convoluted outer surface of the brain.  It integrates higher order mental functions, general movement and behaviour.

Cerebral dysfunction
Preferred terminology to brain damage.  Applies to damage to a previously undamaged brain and to disorders where the damage was present from birth.

Cerebral hemisphere
One half the cerebrum.

Cerebral-spinal fluid (CSF)
Liquid which fills the ventricles of the brain and surrounds the brain and spinal cord.

Cerebrum
The main part of the brain which sits in the upper part of the skull cavity.

Chronic
Marked by long duration or frequent recurrence.

Circumlocution
Use of other words to describe a specific word or idea which cannot be remembered.

Clonus
A sustained series of rhythmic jerks following quick stretch of a muscle.

Cognition
Thinking processes such as memory and learning, concentration, planning and organisation, thinking and decision-making.

Cognitive  function
The intellectual process whereby a person becomes aware of, perceives or comprehends ideas. It involves perception, thinking, reasoning and remembering.

Cognitive Rehabilitation
Therapy programs which aid persons in the management of specific problems in perception, memory, thinking and problem solving. Skills are practiced and strategies are taught to help improve function and/or compensate for remaining deficits. The interventions are based on an assessment and understanding of the person's brain-behaviour deficits and services are provided by qualified practitioners.

Coma
A state of unconsciousness from which the patient cannot be woken or aroused, even by powerful stimulation; lack of any response to one's environment. Defined clinically as an inability to follow a one-step command consistently; Glasgow Coma Scale score of 8 or less.

Communication aids
An external object or device used by a person to create more effective communication.  Examples of (aided) communication include high technology systems (iPad, tablet, speech generating device) and low technology systems (real objects, communication books, pen & paper, pictures & photos.

Communication disorders
An impairment in the ability to 1) receive and/or process a symbol system, 2) represent concepts or symbol systems, and/or 3) transmit and use symbol systems. The impairment may be observed in disorders of hearing, language, and/or speech processes.

Community Skills
Those abilities needed to function independently in the community. They may include: telephone skills, money management, pedestrian skills, use of public transportation, meal planning and cooking.

Compliance
Yielding to the desires, suggestions, or proposals of another person usually somewhat willingly.  Contrast with obedience.

Comprehension
Interpretation of a piece of knowledge and it's retention.  Second stage in Bloom's taxonomy of educational objectives.

Concentration
The ability to maintain attention on a task without being distracted. Remaining attentive and not easily diverted.

Concrete thinking
A style of thinking in which the individual sees each situation as unique and is unable to generalise from the similarities between situations. Language and perceptions are interpreted literally so that a proverb such as "a stitch in time saves nine" cannot be readily grasped.

Concussion
The common result of a blow to the head or sudden deceleration usually causing an altered mental state, either temporary or prolonged. Physiologic and/or anatomic disruption of connections between some nerve cells in the brain may occur. Often used by the public to refer to a brief loss of consciousness.

Confabulation
Verbalisations about people, places, and events with no basis in reality. May be a detailed account delivered.
Unconsciously making up information to give a fluent answer with no regard for the facts.

Confusion
A state in which a person is bewildered, perplexed, or unable to self-orient.

Contingency management
Arrange reinforcing events in such a way that desired behaviour is encouraged and undesired behaviour reduced.  This is the central principle of behaviour modification.

Contracture
Loss of range of motion in a joint due to abnormal shortening of soft tissues.

Contusion
Bruising of the brain.

Convergence
Movement of two eyeballs inward to focus on an object moved closer. The nearer the object, the greater is the degree of convergence necessary to maintain single vision. See also vision after head injury.

Cortical Blindness
Loss of vision resulting from a lesion of the primary visual areas of the occipital lobe. Light reflex is preserved.

Contrecoup
Bruising of brain tissue on the side opposite where the blow was struck.

Crainiectomy
Surgical removal of the skull in small pieces.

Craniotomy
Surgical removal of a sizeable piece of skull. In effect, a window made in the skull to allow access to the brain and its coverings.

CT Scan/ Computerised Axial Tomography
A series of X-rays taken at different levels of the brain that allows the direct visualisation of the skull and intracranial structures. A scan is often taken soon after the injury to help decide if surgery is needed. The scan may be repeated later to see how the brain is recovering

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Daily living skills
Personal management and social skills which are necessary for adequate functioning on an independent basis.

Deafness
Total loss of functional hearing.  Usually defined as a loss of more than 75 decibels.

Debridement
Surgical removal of dead tissue and foreign matter from a wound.

Decerebrate Posture (Decerebrate Rigidity)
Exaggerated posture of extension as a result of a lesion to the prepontine area of the brain stem, and is rarely seen fully developed in humans. In reporting, it is preferable to describe the posture seen.

Decorticate Posture (Decorticate Rigidity)Exaggerated posture of upper extremity flexion and lower extremity extension as a result of a lesion to the mesencephalon or above. In reporting, it is preferable to describe the posture seen.

Decubitus
Pressure area, bed sore, skin opening, skin breakdown. A discoloured or open area of skin damage caused by pressure. Common areas most prone to breakdown are buttocks or backside, hips, shoulder blades, heels, ankles and elbows.

Deficit
A lack, usually in some aspect of development, that interferes with learning

Depression
Lowered mood, sadness, lowered initiative, gloomy thoughts, and dejection.  

Depth perception
Visual, tactile, or auditory ability to accurately locate an object or sound in relation to self, or in relation to other objects or sounds.

Developmental disorder
Any disorder present at birth or which first appears in early infancy, childhood or adolescence, and are considered to substantially affect normal functioning.

Dexterity
Speed and accuracy of motor movements.

Diffuse Axonal Injury (DAI)
A shearing injury of large nerve fibres (axons covered with myelin) in many areas of the brain. It appears to be one of the two primary lesions of brain injury, the other being stretching or shearing of blood vessels from the same forces, producing haemorrhage.

Diffuse brain injury
Injury to cells in the many areas of the brain rather than in one specific location

Diplegia
Paralysis on both sides of a part of the body eg. both legs but weakness only in both arms.  Compare hemiplegia, quadriplegia and paraplegia.

Diplopia
Double vision

Disability
A lack in one or more functions which make full participation in desired or required activities more difficult.

Discipline
When referring to health care or education it means a particular field of study, such as medicine, occupational therapy, nursing, recreation therapy or others.

Disinhibition
A loss of control over what one says and does which can lead to socially unacceptable behaviour.

Disorientation
Not knowing where you are, who you are, or the current date. Health professionals often speak of a normal person as being oriented "times three" which refers to person, place and time.

Disruptive behaviour
Difficult or problem behaviour by individuals or groups.  Usually refers to antisocial behaviour rather than emotional and behavioural disorder.

Distractibility
Marked inability to concentrate on one activity to the exclusion of all others for any length of time.  Associated with attention deficit disorder and attention deficit-hyperactivity disorder.

Divergent thinking
Ability to create new ideas based upon a given topic. 

Dorsiflexion
When applied to the ankle, the ability to bend at the ankle, moving the front of the foot upward.

Drug abuse
Excessive use or misuse of drugs, causing physical, emotional, mental, or sensory injury or impairment.

Drug addiction
Characterised by four conditions: 1. Intolerable craving for the drug. 2. Increasing tolerance so larger quantities are required for the same effect. 3. Physical dependency on the drug so it becomes part of the modified body chemistry.  4. Harmful effects upon the user's mental and physical health together with long term social problems.

Dysarthria
A weakness, paralysis or poor coordination of the breathing and speech muscles that can affect a person’s speech volume or cause them to slur their speech.

Dyscalculia
Disturbed ability to learn and perform mathematical skills.

Dysfunctional
Not working optimally.

Dysgraphia
Difficulty writing, or even more simply, it's very messy writing, that is often illegible and incomprehensible.

Dyskinesia
Disturbed ability to control and coordinate voluntary muscles resulting in clumsy movements or inability to produce some actions.

DysphagiaA term used to describe difficulty swallowing; meaning someone has difficulty chewing food, keeping food / liquid in their mouth and / or difficulty drinking fluids safely.

Dysphasia
A milder form of aphasia, impacting on the comprehension and use of language

Dyspraxia
Partial loss of the ability to do purposeful movements while still being able to move and be aware of movement.

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Echolalia
Imitation of sounds or words without comprehension. This is a normal stage of language development in infants but is abnormal in adults.

Edema
Collection of fluid in the tissue causing swelling. Also spelled Oedema

Electroencephalogram (EEG)EEG is a test used to record any changes in electrical activity of the brain by placing electrodes on the scalp. An EEG is used in the testing for epilepsy, coma and brain death.

Electromyography (EMG)
An insertion of needle electrodes into muscles to study the electrical activity of muscle and nerve fibres. It may be somewhat painful to the patient. Helps diagnose damage to nerves or muscles.

Egocentric
Concerned with one's own self, but not necessarily in an improper way.

Emotional disorders
Persistent, serious emotional disorders and resulting behaviour problems. Compare with emotional problems.

Emotional Lability
Exhibiting rapid and drastic changes in emotional state (laughing, crying, anger) inappropriately without apparent reason.

Emotional problems
Transient emotional difficulties, usually the result of a specific event or situation, which may give rise to behavioural problems.  Compare with emotional disorders.

Empathy
Direct understanding of another's state of mind without feeling as they do (sympathy).

Endotracheal Tube
A tube that serves as an artificial airway and is inserted through the patient's mouth or nose. It passes through the throat and into the air passages to help breathing. To do this it must also pass through the patient's vocal cords. The patient will be unable to speak as long as the endotracheal tube is in place. It is this tube that connects the respirator to the patient.

Environment
The sum total of all circumstances, people and things, which are acting upon a person.

Epilepsy
Name given to a group of disorders of the central nervous system characterised primarily by seizures, which may be of any degree of frequency or severity.

Evoked Potential
Registration of the electrical responses of active brain cells as detected by electrodes placed on the surface of the head at various places. The evoked potential, unlike the waves on an EEG, is elicited by a specific stimulus applied to the visual, auditory or other sensory receptors of the body. Evoked potentials are used to diagnose a wide variety of central nervous system disorders.

Expressive language
Language which is produced by the person.  See expressive vocabulary.

Expressive vocabulary
The total rang of language which can be produced by a person.  See expressive language.

Extinction
Eliminating unwanted behaviour by removing the reinforcer, e.g. not providing attention for attention-seeking behaviour.

Eye-hand coordination
Ability underlying manipulative skills which need the simultaneous use of eyes and hands, eg catching a ball.

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Fading
Gradually withdrawing the cues and prompts which help a student to learn the correct response to a situation or problem until the response can be made unassisted.

Figure-Ground
The differentiation between the foreground and the background of a scene; this refers to all sensory systems, including vision, hearing, touch.

Flaccid
Lacking normal muscle tone; limp.

Flexion
Bending a joint.

Focal brain injury
Injury restricted to one region (as opposed to diffuse).

Forward chaining
Method of teaching a pattern of behaviour, where the first step is taught first e.g. putting the arms into the sleeves of a shirt. See backward chaining.

Frontal lobes
Division of the cerebrum, situated directly behind the forehead.  The frontal lobe holds the motor cortex, which controls voluntary muscular activities. The frontal lobe plays an important role in organising thoughts, controlling behaviour, remembering things, personality and a variety of higher cognitive functions.

Frontal (lobe) syndrome
Behavioural and personality changes observed after a frontal lobe lesion. The person may become boastful, uninhibited, exhibitionistic and subject to outbursts, irritability or violence. In other cases they may be depressed, apathetic, lacking in initiative, and negligent about personal appearance or perseverate.

Frustration Tolerance
The ability to persist in completing a task despite apparent difficulty. Individuals with a poor frustration tolerance will often refuse to complete tasks which are the least bit difficult. Angry behaviour, such as yelling or throwing things while attempting a task is also indicative of poor frustration tolerance.

Functional assessment
Evaluates the extent of a person's ability to perform the activities associated with everyday life.  Identifies areas of deficit which can be developed through training or assisted through the use of specialised equipment.

Functional literacy
The basic level of reading and writing skills needed for a particular occupation or lifestyle.

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Gait Training
Instruction in walking, with or without equipment; also called "ambulation training."

Generalisation
Able to produce the taught skill in a similar but unfamiliar situation.

GI Tube
A tube inserted through a surgical opening into the stomach. It is used to introduce liquids, food, or medication into the stomach when the patient is unable to take these substances by mouth.

Glasgow Coma Scale (GCS)
A standardised system used to assess the degree of brain impairment and to identify the seriousness of injury in relation to outcome. The system involves three determinants: eye opening, verbal responses and motor response all of which are evaluated independently according to a numerical value that indicates the level of consciousness and degree of dysfunction. Scores run from a high of 15 to a low of 3. Persons are considered to have experienced a `mild' brain injury when their score is 13 to 15. A score of 9 to 12 is considered to reflect a `moderate' brain injury and a score of 8 or less reflects a 'severe' brain injury.

Global cognitive impairment
Difficulties in learning, achieving developmental milestones, and integrating skills due to impairments in all cognitive areas including memory, concentration and the senses.

Grand Mal
A major seizure seen in epilepsy in three phases. Pre-convulsive phase: May show irritability and have minor seizures (petit mal). Convulsive phase: Tonic contractions followed by a clonic spasm. Post-convulsive phase: Brief comatose, followed by deep sleep possibly for hours.  No memory of the entire event is retained.

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Habit
A predictable pattern of learnt responses to specific events.

Haematoma
A collection or clot of blood.

Head Injury
Refers to an injury of the head and/or brain, including lacerations and contusions of the head, scalp and/or forehead. See also Brain Injury.

Hematoma
The collection of blood in tissues or a space following rupture of a blood vessel. Regarding Brain:
Epidural--Outside the brain and its fibrous covering, the dura, but under the skull.
Subdural--Between the brain and its fibrous covering (dura).
Intracerebral--In the brain tissue.
Subarachnoid--Around the surfaces of the brain, between the dura and arachnoid membranes.

Hemianopia/Hemianopsia
Visual field cut. Loss of sight in the same sides of both eyes. This can cause an inability to see things on the left or right side.

HemineglectLoss of attention for things in one half of space.

Hemiparesis
Weakness on one side of the body.

HemiplegiaParalysis affecting one side of the body.  Compare diplegia, quadriplegia and paraplegia.

Hemianopia
A loss of half of the visual field.

Heterotopic ossification
Abnormal deposits of bone in muscle.

Hostility
Tendency to feel anger toward and to seek to inflict harm upon a person or group.

HydrocephalusEnlarged ventricles due to an increase of fluid (CSF) on the brain.

Hypoxia
Insufficient oxygen reaching the tissues of the body.

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Idiopathic
Condition without cause.

Impairment
General term for any injury, damage or defect which prevents normal physical or mental functioning.

Impulsivity (impulsiveness)
A tendency to rush into something without reflecting on the consequences or thinking first.

Impulse Control
Refers to the individual's ability to withhold inappropriate verbal or motor responses while completing a task. Persons who act or speak without first considering the consequences are viewed as having poor impulse control.

Incentive
An external factor thought to encourage the desired behaviour e.g. offering a ribbon for winning a race.

Incidence
How often and under what circumstances something occurs.

Incontinent
Inability to control bowel and bladder functions. Many people who are incontinent can become continent with training. See also Bowel and Bladder Training manual.

Infarct
An area of brain cells which have died as  result of a loss of blood supply.

Inhibition
A mental condition in which the range and amount of behaviour is curtailed, beginning or continuing a course of action is difficult, and there is a peculiar hesitancy as if restrained by an external force.

Initiation
The ability to begin an activity without prompting.

Initiative
Refers to the individual's ability to begin a series of behaviours directed toward a goal.

InsightAwareness of one's difficulties, their impact on ability to do tasks and activities, and how they may affect other people.

Intellectual disability
Measured intelligence quotient of 70 and below, coupled with poor adaptive behaviour.  Incidence is 2% of the population.

Interdisciplinary Approach
A method of diagnosis, evaluation, and individual program planning in which two or more specialists, such as medical doctors, psychologists, recreational therapists, social workers, etc., participate as a team, contributing their skills, competencies, insights, and perspective to focus on identifying the developmental needs of the person with a disability and on devising ways to meet those needs.

Intervention
Action performed to direct or influence behaviour.

Intra-cerebral haematomaBlood clot in the brain that occurs due to trauma.

Intracranial pressure (ICP)
Cerebrospinal fluid (CSF) pressure measured from a needle or bolt introduced into the CSF space surrounding the brain. It reflects the pressure inside of the skull.

Intracranial pressure monitor
A monitoring device to determine the pressure within the brain. It consists of a small tube (catheter) in contact with the pulsating brain or the fluid cavity within it. ICP is measured by means of a metal screw or plastic catheter connected to an electronic measuring device.

Introverted
Literally a turning inward.  Generally a preoccupation with one's own thoughts and how others perceive self.  Particularly occurring when under stress.

IQ (Intelligence Quotient)
Formal measurement of intellectual development in relation to the average values for people of the same age group

Irritability
A response to changes in the external surroundings, generally relatively mild anger largely expressed verbally.

JargonThe use of nonsensical words and phrases when speaking. These utterances typically retain sentence structure but lack meaning. The person is usually unaware of how they are speaking.  This is typically seen in Wernicke’s aphasia.

Job Analysis
Involves the systematic study of an occupation in terms of what the worker does in relation to data, people, and things; the methods and techniques employed, the machines, tools, equipment, and work aids used; the materials, products, subject matter or services which result, and the traits required of the worker.

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KinesthesiaThe sensory awareness of body parts as they move (see Position Sense and Proprioception).

LabellingPractice of categorising individuals and by extending to them all the characteristics of that group, regardless of evidence.  Can lead to stigmatisation and influence the individual to fulfil the negative expectations which the label carries.

Learning difficultyUmbrella term increasingly used to cover all learning problems.

Learning disorder
Profound problem in learning resulting from another disability or deprivation.  Compare with learning disability.

Learning disability
Profound problem in learning in the absence of a clear indication of brain damage or deprivation.  Can be in the motor, cognitive, motivational and somatic areas, and be general or specific.  Compare with learning disorder.

Left hemisphereThe cerebral hemisphere which controls movements on the right side of the body.  It contains the areas that control speech.

Leg Bag
A small, thick plastic bag that can be tied to the leg and collects urine. It is connected by tubing to a catheter inserted into the urinary bladder. See also Bowel and Bladder Training manual.

Life skills
Those skills needed to function in society as an independent adult.

Locked-in SyndromeA condition resulting from interruption of motor pathways in the ventral pons, usually by infarction. This disconnection of the motor cells in the lower brain stem and spinal cord from controlling signals issued by the brain leaves the patient completely paralysed and mute, but able to receive and understand sensory stimuli; communication may be possible by code using blinking, or movements of the jaw or eyes, which can be spared.

Magnetic resonance imaging (MRI)Scanning by machine to take detailed pictures of the brain, central nervous system, musculoskeletal systems and soft tissues using a strong magnet rather than x-rays.

Malingering
Faking illness or disability, but this generally covers up some other real mental health problem.

Memory
The process of perceiving information, organising and storing it, and retrieving it at a later time when needed.

Memory, Episodic
Memory for ongoing events in a person's life. More easily impaired than semantic memory, perhaps because rehearsal or repetition tends to be minimal.

Memory, Immediate
The ability to recall numbers, pictures, or words immediately following presentation. Patients with immediate memory problems have difficulty learning new tasks because they cannot remember instructions. Relies upon concentration and attention.

Memory, Long Term
In neuropsychological testing, this refers to recall thirty minutes or longer after presentation. Requires storage and retrieval of information which exceeds the limit of short term memory.

Memory, Short Term
Primary or 'working' memory; its contents are in conscious awareness. A limited capacity system that holds up to seven chunks of information over periods of 30 seconds to several minutes, depending upon the person's attention to the task.

Money Management
Ability to distinguish the different denominations of money, count money, make change, budget.

Mood
Relatively mild and enduring or recurrent emotional state.

Motivation
The reason for carrying out an activity in preference to any other.  The reasons vary in strength.

Motor Control
Regulation of the timing and amount of contraction of muscles of the body to produce smooth and coordinated movement. The regulation is carried out by operation of the nervous system.

Motor Planning
Action formulated in the mind before attempting to perform.

Muscle Tone
Used in clinical practice to describe the resistance of a muscle to being stretched. When the peripheral nerve to a muscle is severed, the muscle becomes flaccid (limp). When nerve fibres in the brain or spinal cord are damaged, the balance between facilitation and inhibition of muscle tone is disturbed. The tone of some muscles may become increased and they resist being stretched--a condition called hypertonicity or spasticity

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Nasogastric Tube (NG Tube)
A tube that passes through the patient's nose and throat and ends in the patient's stomach. This tube allows for direct "tube feeding" to maintain the nutritional status of the patient or removal of stomach acids.

Negative reinforcement
Increasing the likelihood of desired behaviour recurring by using, then terminating, an unpleasant experience.  Used in behaviour modification.  Contrast with positive reinforcement.

Neglect
Paying little or no attention to a part of the body.

Neologism
Nonsense or made-up word used when speaking. The person often does not realise that the word makes no sense.

Neurologist
A physician who specialises in the nervous system and its disorders.

NeurologyThe study of the nervous system.

Neuron
A nerve cell.

Neuropsychologist
A psychologist who specialises in evaluating (by tests) brain/behaviour relationships, planning training programs to help the survivor of brain injury return to normal functioning and recommending alternative cognitive and behavioural strategies to minimise the effects of brain injury. Often works closely with schools and employers as well as with family members of the injured person.

Non-ambulatory
Not able to walk.

Non-verbal communication
Information is conveyed or gained through methods other than speech or vocalisations.

Nystagmus
Involuntary horizontal, vertical, or rotary movement of the eyeballs. See also vision after head injury.  

Obsessive-compulsive disorder (OCD)
A psychiatric disorder in which anxiety is associated with preoccupation with unwanted ideas (obsession), and with persistent impulses to repeat certain acts over and over (compulsion).

Occipital lobes
The region in the back of the brain which processes visual information. Injury here can cause visual impairment.

Occupational Therapy
Occupational Therapy is the therapeutic use of self-care, work and play activities to increase independent function, enhance development and prevent disability; may include the adaptation of a task or the environment to achieve maximum independence and to enhance the quality of life. The term occupation, as used in occupational therapy, refers to any activity engaged in for evaluating, specifying and treating problems interfering with functional performance.

Oedema
Increased water content in the brain, causing brain swelling.

Orientation
Awareness of one's environment and/or situation, along with the ability to use this information appropriately in a functional setting.

Orthopaedics
The branch of medicine devoted to the study and treatment of the skeletal system, its joints, muscles and associated structures.

OrthosisSplint or brace designed to improve function or provide stability.

OutpatientThe patient residing outside the hospital but returning on a regular basis for one or more therapeutic services.

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Paraplegia
Paralysis of the lower limbs (from the waist down).  Compare hemiplegia, quadriplegia and diplegia.

Paranoia
Serious mental health problem in which the person holds delusions of grandeur and/or persecution.

Parietal lobes
Two lobes of the brain located behind the frontal lobe at the top of the brain.

Perception
The ability to make sense of what one sees, hears, feels, tastes or smells. Perceptual losses are often very subtle, and the patient and/or family may be unaware of them.

Performance IQ
IQ based on a test requiring observation and action rather than spoken or written answers.  See verbal IQ.

Perseveration
Getting stuck on a word, an idea or an activity and not being able to move on from it.

Persistent Vegetative State (PVS)
A long-standing condition in which the patient utters no words and does not follow commands or make any response that is meaningful.

Petit Mal
A minor seizure seen in epilepsy.  Characterised by a sudden, brief loss of consciousness, in which all voluntary motor activity stops.  Involuntary motor movements can occur but the person has no awareness of these.

Phonation
The production of sound by means of vocal cord vibration.

Physiatrist
Pronounced Fizz ee at' rist. A physician who specialises in physical medicine and rehabilitation. Some physiatrists are experts in neurologic rehabilitation, trained to diagnose and treat disabling conditions. The physiatrist examines the patient to assure that medical issues are addressed; provides appropriate medical information to the patient, family members and members of the treatment team. The physiatrist follows the patient closely throughout treatment and oversees the patient's rehabilitation program.

Physical Therapist
The physical therapist evaluates components of movement, including: muscle strength, muscle tone, posture, coordination, endurance, and general mobility. The physical therapist also evaluates the potential for functional movement, such as ability to move in the bed, transfers and walking and then proceeds to establish an individualised treatment program to help the patient achieve functional independence.

Plasticity
The ability of cellular or tissue structures and their resultant function to be influenced by an ongoing activity.

Plateau
A temporary or permanent levelling off in the recovery process.

Positive reinforcement
Increasing the likelihood of desired behaviour recurring by providing an appropriate reward.  Used in behaviour modification.  Contrast with negative reinforcement.

Post traumatic amnesia (PTA)A very early stage of recovery after brain injury, when the person is confused and sometimes irritable, may not know where they are or when it is.  The person may be unable to recall day-to-day events or information.

PostureThe attitude of the body. Posture is maintained by low-grade, continuous contraction of muscles which counteract the pull of gravity on body parts. Injury to the nervous system can impair the ability to maintain normal posture, for example holding up the head.

Pre-Morbid Condition
Characteristics of an individual present before the disease or injury occurred.

Problem-Solving Skill
Ability to consider the probable factors that can influence the outcome of each of various solutions to a problem, and to select the most advantageous solution. Individuals with deficits in this skill may become "immobilised" when faced with a problem. By being unable to think of possible solutions, they may respond by doing nothing.

Prognosis
The prospect as to recovery from a disease or injury as indicated by the nature and symptoms of the case.

Prone
Lying on one's stomach.

Proprioception
The sensory awareness of the position of body parts with or without movement. Combination of kinesthesia and position sense.

Psychologist
A professional specialising in counselling, including adjustment to disability. Psychologists use tests to identify personality and cognitive functioning. This information is shared with team members to assure consistency in approaches. The psychologist may provide individual or group psychotherapy for the purpose of cognitive retraining, management of behaviour and the development of coping skills by the patient/client and members of the family.

Quadriplegia
Weakness or paralysis affecting all four limbs.  Compare  diplegia, hemiplegia, and paraplegia.

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Range of Motion (ROM)
Refers to movement of a joint (important to prevent contractures).

Reasoning, Abstract
Mode of thinking in which the individual recognises a phrase that has multiple meanings and selects the meaning most appropriate to a given situation. The term "abstract" typically refers to concepts not readily apparent from the physical attributes of an object or situation.

Reasoning, Concrete
The ability to understand the literal meaning of a phrase.

Reasoning, Problem-Solving
The ability to analyse information related to a given situation and generate appropriate response options. Problem-solving is a sequential process that typically proceeds as follows: identification of problem; generation of response options; evaluation of response option appropriateness; selection and testing of first option; analysis as to whether solution has been reached. A patient/client may discontinue making a cup of coffee because the sugar bowl is empty, even though sugar is readily available in a nearby cabinet. A patient/client may easily navigate his way into a room crowded with furniture, but request staff assistance to navigate his way out.

Reasoning, Sequencing
The ability to organise information or objects according to specified rules, or the ability to arrange information or objects in a logical, progressive manner. Nearly every activity, including work and leisure tasks, requires sequencing. For example, in cooking certain foods it is important that ingredients be added and mixed in a specified order; in dressing, undergarments must be put on prior to outer garments.

Recreation Therapist
Individual within the facility responsible for developing a program to assist persons with disabilities plan and manage their leisure activities; may also schedule specific activities and coordinate the program with existing community resources.

Rehabilitation
Comprehensive program to reduce/overcome deficits following injury or illness, and to assist the individual to attain the optimal level of mental and physical ability.

Rehabilitation Counsellor
Also called Vocational Counsellor. A specialist in social and vocational issues who helps the patient develop the skills and aptitudes necessary for return to productive activity and the community.

Rehabilitation Facility
Agency of multiple, coordinated services designed to minimise for the individual the disabling effects of one's physical, mental, social, and/or vocational difficulties and to help realise individual potential.

Rehabilitation Nurse
A nurse specialising in rehabilitation techniques as well as basic nursing care. Nurses assist the patient and family in acquiring new information, developing skills, achieving competence and exhibiting behaviours that contribute to the attainment of a healthy state.

Reinforcement
The strengthening of a belief or behaviour.  See reinforcer.

Reinforcer
Something which changes the probability of a behaviour recurring.  Can be  positive reinforcement or  negative reinforcement.

Retrograde Amnesia
Inability to recall events that occurred prior to the accident; may be a specific span of time or type of information.

Rigidity
Any relative inability to change an aspect of personality or skill performance.

Rote memory
Recall of information without understanding; mechanical repetition.

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Seizure
An uncontrolled discharge of nerve cells which may spread to other cells nearby or throughout the entire brain. It usually lasts only a few minutes. It may be associated with loss of consciousness, loss of bowel and bladder control and tremors. May also cause aggression or other behavioural change.

Self-control
The ability to inhibit impulsive or goal-seeking behaviours for the sake of a more inclusive goal.  See self-assertion.

Self-image
How people think or feel about themselves.  Influenced by the views of others whom are significant in those people's lives. Interchangeable with self-concept.

Self-injurious behaviour (SIB)
Any behaviour in which individuals harm themselves eg. hair pulling, hand biting.  Requires expert intervention.

Sensation
Feeling stimuli which activate sensory organs of the body, such as touch, temperature, pressure and pain. Also seeing, hearing, smelling and tasting.

Sensorimotor
Refers to all aspects of movement and sensation and the interaction of the two.

Sensory Integration
Interaction of two or more sensory processes in a manner that enhances the adaptiveness of the brain.

Sequencing
Reading, listening, expressing thoughts, describing events or contracting muscles in an orderly and meaningful manner.

Short-term memory
Momentary storage of information and then reproduction (not exceeding approximately 30 seconds).

ShuntA procedure to draw off excessive fluid in the brain. A surgically placed tube runs from the ventricles taking excess fluid away draining it into the abdomen, heart or neck veins.

Social behaviour
Behaviour influenced or controlled by other persons or by organised society.

Social competence
The ability to recognise the emotional state and intentions of others in a social communication context.

Social skills (Pragmatics)
Any skill facilitating interaction and communication with others, such as using eye contact, asking questions, taking turns, and using appropriate body language. Social rules and relations are created, communicated, and changed in verbal and nonverbal ways.

Somatosensory
Sensory activity having its origin elsewhere than in the special sense organs (such as eyes and ears) and conveying information to the brain about the state of the body proper and its immediate environment.

Spasticity
An involuntary increase in muscle tone (tension) that occurs following injury to the brain or spinal cord, causing the muscles to resist being moved. Characteristics may include increase in deep tendon reflexes, resistance to passive stretch, clasp knife phenomenon, and clonus.

Spatial Ability
Ability to perceive the construction of an object in both two and three dimensions. Spatial ability has four components: the ability to perceive a static figure in different positions, the ability to interpret and duplicate the movements between various parts of a figure, the ability to perceive the relationship between an object and a person's own body sphere, and the ability to interpret the person's body as an object in space.

Speech Pathologist
A healthcare professional responsible for the evaluation and treatment of problems with eating and drinking (swallowing), speech and language, auditory, cognitive (comprehension), attention, writing, reading and expression skills

Spontaneous Recovery
The recovery which occurs as damage to body tissues heals. This type of recovery occurs with or without rehabilitation and it is very difficult to know how much improvement is spontaneous and how much is due to rehabilitative interventions. However, when the recovery is guided by an experienced rehabilitation team, complications can be anticipated and minimized; the return of function can be channelled in useful directions and in progressive steps so that the eventual outcome is the best that is possible.

Stuttering
Stuttering is a speech disorder that causes interruptions in the rhythm or flow of speech.   These interruptions may include the repetition of sounds (c-c-can), syllables (da-da-daddy), words (and-and-and) or phrases (I want-I want-I want).

Subdural
Beneath the dura (tough membrane) covering the brain and spinal cord.

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Tactile Defensiveness
Being overly sensitive to touch; withdrawing, crying, yelling or striking when one is touched.

Task analysis
Breaking down a defined task into its component skills and possibly further to a sub-skill level; information gained from task analysis can be utilised to develop training curricula or to price a product or service.

Temporal lobes
Two lobes, one on each side of the brain, located at ear level. These allow a person to tell one smell from another and one sound from another. They help to sort new information and are responsible for short-term memory.

  • Right Lobe--Mainly involved in visual memory (ie. memory for pictures and faces).
  • Left Lobe--Mainly involved in verbal memory (ie. memory for words and names).

Thalamus
Part of the brain which relays sensory impulses to the surface of the cerebrum and from one part of the brain to another.

Time-out
Placing a person in an environment where they can not engage in the undesired behaviour. See behaviour management and negative reinforcement.

TinnitusRinging in the ears.

Token reinforcement
Method of shaping behaviour/learning by means of reward.  Tokens as given when the desired behaviour/performance is produced.  A set number of tokens can then be exchanged for a reward.

TracheostomyA breathing tube inserted through the neck just below the voice box, to maintain adequate air passage. The tube may remain in windpipe for a prolonged period.

Tracking, Visual
Visually following an object as it moves through space. See also vision after head injury.

Tremor, Intention
Course, rhythmical movements of a body part that become intensified the harder one tries to control them.

Tremor, Resting
Rhythmical movements present at rest and may be diminished during voluntary movement.

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Unilateral Neglect
Paying little or no attention to things on one side of the body. This usually occurs on the side opposite from the location of the injury to the brain because nerve fibres from the brain typically cross before innervating body structures. In extreme cases, the patient may not bathe, dress or acknowledge one side of the body.

Urinary Tract Infection
When bacteria have reproduced to a large number in the bladder. This can cause fever, chills, burning on urination, urgency, frequency, incontinence or foul smelling urine.

VentilatorThis machine does the breathing for people unable to breathe for themselves.

VentriclesCavities (spaces) inside the brain which contain cerebrospinal fluid.

Verbal ability
Proficiency of general language skills.

Verbal Apraxia
Impaired control of proper sequencing of muscles used in speech (tongue, lips, jaw muscles, vocal cords). These muscles are not weak but their control is defective. Speech is laboured and characterised by sound reversals, additions and word approximations.
Verbal IQ
Measures of intelligence based on tests assessing verbal ability only.  See verbal-performance discrepancy.

Verbal reinforcement
Reinforcement by using the spoken word.  Can be positive or negative.

Verbosity
Excessive talking.

Vestibular
Pertaining to the vestibular system in the middle ear and the brain which senses movements of the head. Disorders of the vestibular system can lead to dizziness, poor regulation of postural muscle tone and inability to detect quick movements of the head. 
Violence
Engaging in behaviour which has the intent to cause harm to oneself or to someone or something.  See hostility, aggression, anger and rage.

Visual cortex
Part of the brain concerned with sight and visual perception.

Visual discrimination
Ability to differentiate between different shapes visually, e.g. recognising individual letters.

Visual impairment
Visual losses that interfere with normal functioning and performance and range from mild to total. See blindness.

Visual sequential memory
Ability to recall things in the order in which they were seen.

Visual perception
Ability to register what is seen and give meaning to it.
Word blindness
Outdated term for alexia.  Inability to read, i.e. to gain any meaning from printed words.

Worry
Feeling of uncertainty that one is able to prevent the occurrence of an unsatisfactory occurrence.

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Last updated: 12 July 2022