So, apparently, Gist Reasoning [is] Indicative of Daily Function in Traumatic Brain Injury. Check it out (bold emphasis is mine):
People with traumatic brain injury may have more difficulty with gist reasoning compared to traditional cognitive tests. This cognitive assessment may in turn be a clearer indicator of a person’s ability to succeed at a job or at home after injury.
A cognitive assessment developed by the Center for BrainHealth at the University of Texas, Dallas evaluates the number of gist-based ideas participants are able to extract from several complex texts. The test provides a more clear assessment of cognitive abilities for patients that are considered “normal” following traditional cognitive testing.
The study, published in the Journal of Clinical and Experimental Neuropsychology, included 70 adults aged 25 through 55, 30 of which had traumatic brain injury one year or longer prior to the study. The subjects went through a series of standard cognitive tests to assess memory, inhibition, and switching.
The group had similar IQ, reading comprehension, and speed of processing scores, however nearly 70% of the TBI subjects scored lower on gist reasoning than controls. These decreased gist-reasoning scores correlated with self-reported difficulties at work and home. Additionally, cognitive tests alone predicted daily function with 45% accuracy, while the addition of gist-reasoning scores boosted accuracy to 58%.
The impairment of gist reasoning could reflect a loss of flexible and innovative thinking in patients with traumatic brain injury.
Gist reasoning is the ability to “get the point” of something. It’s being able to extract the unimportant details from a narrative and figure out the salient / important / significant details… and the “get the gist” of the story. It’s being able to look at a picture and tell what’s really going on — or what other people think is going on, so you can discuss with them.
Gist reasoning is turning out to be a better indicator of impairment after TBI / concussion, which is encouraging to me, because showing up for neuropsychological testing and being told, “Hey, you’re really smart in a lot of ways!” is hugely deflating when you’re struggling with day-to-day issues. Knowing you’re smart just rubs it in, and it makes you feel even more lame and damaged. But being able to measure gist reasoning and see that there’s significant impairment in that… now that’s something to sit up and pay attention to.
After reading about the Center for Brain Health’s published research on improving TBI recovery with certain types of brain training, I’m wondering how I can incorporate that into my own life and ongoing recovery.
My own test results, with two passes divided by 4-5 years of active rehab work, show that I’m way smart in some areas, but I struggle in a few respects. And in 5 of 6 areas of deficit, my deficits have not changed significantly. I guess that’s where Muriel Lezak would say I have not recovered.
On the other hand, the area where I have changed, is how well I’m living my life. And that’s what really matters to me. That, to me, is what recovery is all about, not reversing deficits which would probably change over the course of my life, anyway(!)
I can still tell I’m slower than before. I can still tell I struggle with many things, including fatigue and irritability and fogginess. But these things aren’t wrecking me, the way they used to.
I still need to work at things on a daily basis. And I need help, here and there — although I’ve learned how to behave in a way that doesn’t look like I’m disabled and in need of assistance. I still struggle with things that “should” be easy for me, but haven’t gotten that way — if anything, some of them have gotten harder. Getting going on things can be a huge challenge, when I’m not motivated. And stopping things that I need to stop, to do other things I need to do (like stopping surfing the web in the morning so I can get to work on time), is as hard as ever — maybe harder. My memory is still Swiss-cheesey — especially when I’m tired. And although my temper has calmed down immensely in the past 7 years, I still have my moments, when I just Go Off the rails. Likewise with emotions like sadness and despair. I generally keep those in check, because I can go down a rabbit hole that is terribly difficult to pull out of.
I think those times when I am less effective, are when I am overwhelmed by everything that seems important. And I think — from just a cursory reading of literature — that has to do with my “gist reasoning”, or my ability to pick out the salient / important / significant details from a situation and focus on them.
I’ve been doing a bunch of online research about the SMART training that the Center for Brain Health does, and I found that they’ve actually patented it (thank you Google patent search). If this is indeed intellectual property, and it’s controlled by them, then it’s more valuable to them in terms of money and quality control, than it is to the general populace.
And telling everyone Woo Hoo! You Can Recover From TBI With Our System! … only to say, “Oh yeah, it’s proprietary… but you can visit us and get training here — or at another one of our approved affiliates”… well, now I’m less elated.
Yes, it’s hugely encouraging and motivating to see their research that it’s possible. The thing is, it’s equally out of reach. I am not within easy striking distance of Dallas, TX, nor do I have the time and the money to take 8 weeks to retrain myself on the Strategic Memory and Reasoning Training© (SMART©) program.
Not that this is going to stop me trying to employ their techniques, however. I’m crafty that way, and because I’ve always been on the fringes of the medical/rehab establishment (first because of lack of information in the world I grew up in, and later due to lack of money and resources and my diminished ability to communicate with healthcare providers, thanks to a slew of unaddressed issues)… I’ve had to take a lot of my recovery into my own hands.
Of course, it helps to have access to a competent neuropsychologist to consult with on a weekly basis, but even they are a bit flabbergasted at my recovery. They say they’ve “never seen anything like it.” Woot.
So, yeah. I think I’ve got an approach that works for me – and it may work for others.
I’m going to be doing more research over the coming week and see if I can’t come up with some practice exercises for myself and others to use to improve gist reasoning. I mean, how hard can it be? It seems really fundamental to me — it’s just been hidden behind all the Wizard Of Oz machinery of the medical establishment. Hidden in plain view, all this time.
How can I improve my gist reasoning? How can I strengthen my ability to screen out what doesn’t matter, in favor of what does — and move forward?
Figuring this out — I believe — will help me prioritize my activities better, help me determine the things that matter and the things that don’t, and help me stop wasting so much time on chasing distractions for the sake of distraction. I have a handful of projects I need to finish, and I’m hoping this will help me do just that.
This is going to be interesting.