The Nature Of Head Injury is an article published in Traumatic Brain Injury and Vocational Rehabilitation, where Thomas Kay, Ph.D. and Muriel Lezak, Ph.D, attempt to debunk the most common myths surrounding brain injury.
In their article, Kay and Lezak discuss the validity of IQ testing as a measure of a patient’s progress — and why professionals and families alike should be careful about how much they read into these tests.
Often, upon request, naive psychologists will examine a head injured person on a traditional battery of intelligence tests, find that the IQ (the numerical average of the many subtest scores) is in the average range, and then pronounce the client “cognitively recovered”, or “capable of functioning intellectually in the average range.”
The danger here lies in that, upon receiving “normal” test results, professionals and families might set unrealistic expectations for just how much and how quickly things will improve — being told that the patient has a “normal” IQ can set the unrealistic expectation for a “full” recovery.
Also, it is important to note, IQ testing does not measure a person’s emotional state, ability to read social cues, and many other areas in which a brain injured person might now be facing challenges.
Head injured persons who can perform quite well on such tests may have such breakdowns in learning, memory, and especially executive functions (planning, organizing, self-monitoring) in the unstructured real world that they are totally unable to function. “Average range IQ” and even higher IQ scores should never be the basis for concluding that a client is cognitively intact, and therefore ready to handle mental stresses of the real world.
Believing that “normal” IQ test results mean the victim will “go back to normal” can set unrealistic expectations — especially when dealing with patients who were, previous to their accident, exceptionally bright.
Just as normal range IQ’s should not be mistaken for cognitive normalcy, a normal neurological evaluation -especially late after injury should not be mistaken as meaning that there is no brain dysfunction. As noted above, acute bleeding and contusion of brain tissue may clear up and disappear from brain scans over a period of months and years -even though nerve networks and biochemical balances may still be severely effected.
Similarly, “normal” brain scans and tests might not be an indicator that full recovery has taken place. Even when all of the physical damage to the brain has healed, the patient might still have cognitive and social hurdles to face.
It is important, when trying to help a loved one after an injury, that we tune in to their needs. The fallacy that normal tests results mean no more help is needed can cause unnecessary harm.