Awareness of deficit after traumatic brain injury: a literature review

Much of the research literature on long term psychosocial adjustment to traumatic brain injury (TBI) suggests that persons with TBI do not adequately perceive their deficits of higher cortical functioning and, as a consequence, they may adopt maladaptive responses to their social environment. This issue poses a major challenge for occupational therapists and other rehabilitation professionals involved in the social and vocational rehabilitation of persons with TBI. However, the literature is characterised by disagreement concerning the nature and extent of unawareness of deficits in this group. In addressing this issue, several factors are considered: severity of injury, time since injury, prevailing neuropsychological and psychosocial perspectives, and access to intensive rehabilitation programmes. Implications for occupational therapists as practitioners and researchers are discussed.