Head Injuries – Acquired ADD?

Head Injuries Affect Attention & Focus
whether the injury was mild or severe

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
from the Brain-based Coaching Series

Boing-oing-oing-oing . . . OUCH!

As long as there have been humans, there have been hits to the head. Some of them were a actually caused by those humans!

Much attention has been paid to sports-concussions and severe forms of traumatic brain injury (TBI), especially those resulting in concussions and coma.

The milder impacts, such as those from falling off a bicycle or a ladder, the jolt from a low-speed car accident or taking a weak punch in a fistfight are far more common.

These milder injuries may not entail losing consciousness — more likely to result in a slightly dazed feeling or a brief lack in responsiveness before recovering — have gotten the attention they deserve only relatively recently

They ALL damage the brain, however.

“New data suggests blows to the head are on the rise among U.S. adults and kids, but definitive diagnosis remains elusive.” ~ Scientific American Mind

Questions remain as to how long it takes to recover, to what degree and how quickly each piece of the cognitive puzzle comes back on line reliably, as well as how to identify which brain injuries are likely to recover and why some never do.

Part of the challenge in understanding these injuries is how varied they can be.  But it is no small problem.

Making things worse still, suffering even one concussion elevates the risk of suffering another and may make it all the more challenging to recover from future damage.

Here’s a scary statistic: According to an article found on the Scientific American blogsite, the average a 10-year old can experience as many as 240 hits to the head in a single football season.

Related Post: How Do Brains Get Damaged?  Is YOURS?

Troubles Often Persist

Even when a brain-scan cannot pinpoint specific areas of damage, months after a concussion patients may still have lingering symptoms, including an inability to concentrate as well as headaches — even when initial brain scans reveal nothing amiss.

Dr. Jennifer Marin, a Pediatric emergency physician at Children’s Hospital of Pittsburgh says, “Explaining the concept of cognitive rest [for recovering from injury] is difficult when you can’t show an image of how the brain has been injured.”

At the hospital, she says, “we stabilize patients but then they go home and a lot of them will experience complications down the line.”

What KIND of “complications?”

Attentional deficits and reduced speed of information processing have been found consistently, in even mild head injuries, despite lack of gross deficits in intelligence or memory (Bohnen, Jolles, Twijnstra, Mellink, & Wijnen, 1995).

These deficits are frequently the most persisting cognitive complaints (Chan, 2001).

From an article on ScienceDirect from the Archives of Clinical Neuropsychology (Volume 21, Issue 4, May 2006, Pages 293-296):

Head injury typically results in diffuse damage (not in one specific spot) that produces a reduction in information processing capacity.

This processing capacity has been broadly described as the number of operations the brain can carry out at the same time.

Individuals with mild head injury demonstrate problems when they are required to analyze or process more information than they can handle simultaneously (Gronwall, 1989).

Decreased information processing has been posited to be primarily due to problems with attention (Kay, Newman, Cavallo, Ezrachi, & Resnick, 1992; Szymanski & Linn, 1992)

In addition, fatigue and/or stress, common following head injuries, have been shown to further compromise the processing speed of those who have incurred even a mild head injury (Ewing, McCarthy, Gronwall, & Wrightson, 1980; Wood, Novack, & Long, 1984).

Related Post: ABOUT Processing Speed

Or perhaps it’s because of slowed processing speed?

Research conducted by Ponsford and Kinsella (1992) demonstrated that the difficulty in performing a sustained attention task experienced by individuals who have suffered even a mild head injury may result more from a slowed speed of processing than from attentional deficits.

Fortunately, even though the speed of performance is reduced for head-injured participants, no significant reduction exists in terms of accuracy of performance (Stuss et al., 1985).

Related Posts:
Processing slower or more to think about?
Processing Efficiency is all about Juggling

REGARDLESS of the underlying problem, the effects on behavior are very much the same as the struggles of those with a particular Executive Functioning Disorder known as Attention Deficit Disorder.

Let’s take a look at what that means.

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Brain Damage from Head Injury

Resulting Attentional Problems

As I began in an earlier article, Attentional struggles? Not ME! (wanna’ bet?)

MANY people – not just those diagnosed with ADD/EFD (or anything else) –
report ongoing, more frequent than “average” challenges with any or all of the following items.

How many of these do YOU experience?  How often?

  • procrastination and spotty follow-through
  • time, transition and energy management
  • recalling directions, names or what you said you would do
  • keeping the bills paid on time (or, for students, keeping on top of assignments)
  • beating back the clutter
  • keeping on top of the laundry or the filing or the mail, or
  • effectively handling any number of pile-ups of work, school,
    house, garage and lawn chores.

More than a few people with Attentional issues struggle to have much of a life beyond the all-too-familiar “mess it up, clean it up” cycle — in any one of a host of arenas.

DID YOU KNOW that fluctuations in the ability to manage the Attending system
are at the root of every single one of them?

Diagnostic ADDers have been struggling with several to many of these problems since childhood, and we ALL struggle with a few of them from time to time. However, many individuals find themselves really struggling for possibly the first time following a brain injury.

Symptoms and Manifestations of Attentional Struggles

• Easily overwhelmed by the tasks of daily living

  • Trouble maintaining an organized living and/or work space
  • Drowning in paperwork
  • Missing appointments (or chronically late for them)
  • Difficulty sequencing and/or prioritizing
  • Getting lost easily or frequently back-tracking

• Trouble directing focus and concentration

  • Easily dragged off the point
  • Losing the thread of your own conversation when speaking
  • Difficulty recapturing the moment after an interruption
  • Life as a protracted scavenger hunt (continually looking for misplaced objects due to lack of focus leading to impaired registration)
  • “Clumsy” – knocking things over, spilling, bumping into things
  • Difficulty completing projects

Activation struggles

• Apparent or actual slowed processing speed

  • Difficulties making decisions (especially when required “out of the blue,”
    or when a sudden need for a rapid response follows a waiting period)
  • Lengthy deliberation (agonizing over detail)
  • Procrastinating to avoid decision anxiety

• Uneven performance

  • Work performance inconsistent
  • Waivering attention to details and fine points
    (lack of attention at some times, excessive attention at others)
  • Intolerance for some mundane tasks, captured by others
  • Frequently falling behind and scrambling to catch up

• Easily stuck in hyperfocus

• Seemingly altered response to social reinforcement

  • Overlooking rules and regulations – misreading expectations
  • Appearing oblivious to consequences
    (likelihood of punishment or fines has no direct effect on actions)
  • Immediate & consistent positive reinforcement needed to overcome attentional difficulties
  • Tendency to lose interest or motivation with negative reinforcement
    (including “helpful suggestions” as well as correction or criticism)

• Delay intolerance

  • Motor anxiety (pacing, squirming, etc.)
  • Road rage — especially with slow moving traffic
  • Depressed moods during periods of inactivity

• Difficulties reading

  • Problematic attentiveness – losing concentration, missing key modifiers,
    skipping sentences or paragraphs,
  • Words “jump” out of context
  • Retention struggles (by the time you come to the end of a long sentence or a paragraph
    you’ve lost the beginning )

Looking through The ADD Lens™

For anyone who is struggling with any or all of the characteristics above, I have found the idea of looking at things through The ADD Lens™ extremely helpful.

In other words, look at your functional challenges as if they were a result of bona-fide, diagnostic Attention Deficit Disorder.

If Challenges like any of those above (or their kissing cousins) keep you from getting things done, pretend you actually do have ADD/EFD and start to utilize a few of the techniques that I initially developed to work with people who have been diagnosed with ADD.

I’d like to invite anyone who is struggling — as the result of a mild head injury or a more pervasive TBI, PTSD, garden-variety age-related cognitive decline, or anything else — to allow yourselves to learn about and use the principles and coping techniques that have empowered ADD/EFD and “vanilla” communities for the past 25+ years.

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About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

68 Responses to Head Injuries – Acquired ADD?

  1. Thank you for this well researched post.

    Liked by 1 person

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  3. Christy B says:

    That statistic on the number of hits to the brain for the average 10 year old during a single football season IS scary. It’s no wonder many parents don’t want their kids in that particular sport. You provide a wealth of information here, Madelyn, and do so in a way that is easy to read. I’m going to include a link to this one in my Friday roundup post. Hugs!

    Liked by 1 person

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  5. I was finally able to dedicate time to this article that It deserves. I completely agree with you, Madelyn, that processing deficiencies and attentional deficits resulting from head traumas should be approached in the same way as bona fide ADD/ADHD. I’ve long had a theory (not supported by any research that I know of, but if you have seen any, please share references!) that rather than causing a kind of “collateral damage,” head traumas might actually trigger genetic predisposition to certain emotional, behavioral, developmental, etc. disorders that would otherwise lie dormant in one’s genetic code.
    What do you think?

    Liked by 1 person

  6. I remember an item of news recently where a famous footballer was suffering in his middle age from after effects of heading a hard ball hundreds of times. Also boxers can suffer in this way too from too many blows to the head.

    Liked by 1 person

    • MOST boxers have cognitive problems according to what I’ve read – and so many football players (both types) that the American NFL has been sued by the players. While my heart breaks for them, at least pro-athletes have usually been payed enough that they can afford the best of care.

      Not true for the kids, so the lawsuits are bringing an important issue to light – prevention!

      Liked by 1 person

  7. Jodie says:

    It’s amazing how these occurrences can affect us in the future. And even more amazing that there are some that think they don’t affect us!!
    Great information!

    Liked by 2 people

    • Thanks Jodi.

      I think many Do know about the long-term affects – at least in the pro-sports field now – but there’s so much potential $money$ involved that coaches, managers and owners take the short-term shortcut and allow the players back on the field WAAAY too soon.

      IMHO, that encourages the public at large to take head injury far less seriously than warranted.


  8. MindBody says:

    It has been known for some time that “head injuries” can produce a pattern clinically indistinguishable from ADHD. In his book “Total Concentration” the psychiatrist Harold Levinson discusses this and cites some very clear case histories. The medical profession has been slow to catch up on this- but we are now seeing some talk about head injuries and subsequent ADHD symptoms.

    What is usually neglected is that head injuries are usually accompanied by injuries to the upper neck and that the upper neck houses the lower brainstem- important for vital functions and also for orienting reflexes. Equally brain injuries are often torsional and mostly involving axonal rupture in the midline structures- so not what we thought.

    Upper neck injuries tend to be difficult to resolve because they scramble the proprioceptive (body position) information coming from the neck- causing each side to differ and neither side to match the other senses.

    About 80% of that body position information comes from the small muscles innervated by the second cervical vertebra. The basic set of information our brain needs to construct even a crude map of the outside world is proprioception +vestibular+ vision ( you might remember my blog post titled “Upper Cervical Subluxation and the Reality Hologram).

    What complicates matters further is that the scrambled proprioceptive information makes it harder to co-ordinate eye movements, and once they are a little out of sync, you get what the behavioural optometrists call “convergence insuficiency”.

    The lack of convergence then creates a situation where the images from each eye do not match and that means that the brain has to suppress one for vision, and the other for balance. This maintains the loop by maintaining the eye muscle co-ordination problem.

    Eventually that leads to all sorts of knock on effects in activation of other brain areas- but usually ends up with a lack of drive to the L prefrontal cortex.

    Now the symptoms of convergence insufficiency and of ADHD are virtually inseparable.

    We now have a significant literature that shows that oculomotor problems are usual in ADHD, and also literature that this symptom is responsive to stimulants.

    That fits with reports I have had from ADHD individuals that they note an improvement in visual acuity after starting stimulants.

    Now the bottom line of this is that serious brain tissue damage is relatively uncommon.
    Most of these problems are what is called “functional brain disorders”- which means that they are effectively self maintaining loops of unhelpful activation patterns.

    We have not had effective treatments for these problems until recently, but there is now a field growing called “functional neurology” or applied “neuroscience”. It has been pioneered by a chiropractor called Ted Carrick in the US. His major interest focus around serious head injuries, but his team are working with a wide range of disorders, getting substantial improvements in functioning in conditions clinically intractable.

    This work has been gradually improving me over several years– but my situation has been complicated by decades of neglect – leading to significant spinal issues- widespread osteoarthritis and instability; severe clumsiness and oculomotor problems, episodic and unpredictable severe fatigue and a chronic pain syndrome involving my right upper back.

    Now 2 weeks ago I was taught (as a practitioner) an attentional gating exercise for chronic pain. That worked so well that I was able to largely unlock my back and adopt a straighter posture, then within a week able to re-stabilise my neck, with massive improvement in visual clarity, and in co-ordination and spatial perception.– all due to that improved proprioceptive input. Strength at the gym improved enormously because of the better muscle co-ordination.

    There are still a few kinks to be ironed out- but they are now manageable.

    It has taken 7 years from the initial neck treatment, and a great deal of patience to source the right sort of treatment.

    However, I am now juggling with a model of ADHD as a functional problem involving a series of self maintaining feedback loops- some of them operating across a number of levels:
    ie neurological-musculoskeletal behavioural-interpersonal autonomic- behavioural etc.

    Liked by 2 people

    • GREAT to “see” you again! Welcome back, and thanks for taking the time to leave this fascinating addendum.

      I was aware that you had been struggling for some years, so I’m delighted that you are FINALLY getting some traction on it (no pun intended). Seven years is forever in ADD time!

      Levinson? Wow – that is going back quite a few years, as well. You are certainly doing your research! ‘Total Concentration’ is in my personal library, but I must admit that it’s been quite a while since I read it. My biggest Levinson take-away was his inner-ear/childhood ear infection theories – which certainly would lead one to proprioception.

      The timing of your vision/proprioception info is, shall we say, “coincidental”, since my intro to Irlen/scotopic sensitivity article *just* posted early this morning. [Why you might have problems reading longer articles] Its another in sensory sensitivities explorations and I believe dovetails nicely with some of the areas you are exploring (with a different theory at base, of course).

      I’m on board with your functional model of attentional struggles and especially love the context of “self maintaining loops of unhelpful activation patterns” (which fits with the latest research on habit creation and maintenance.

      I have put Carrick on my list of research to investigate – thanks so much for that.

      Again, thanks so much for stopping by, saying hello, and adding to the conversation in such a meaningful manner.


  9. John Fioravanti says:

    Sorry, I’m a bit late to this party – crazy weekend. Interesting and helpful post!

    Liked by 1 person

  10. paulandruss says:

    Wow Madelyn what a sobering article. We are so careless with ourselves, when you think of what we do in terms of sports, motorbikes, driving etc. We wouldn’t deliberately put our mobile phone or laptop at the same level of risk. Yet you can always get another mobile device.. but just try getting another head!

    Liked by 1 person

    • We can be foolish indeed, Paul. Your comment reminds me of one made to me many years ago now, following a skiing accident that resulted in a badly broken leg and an entire year away from my sho-biz career at the time. “If you were a violinist, would you strap your Stradivarius on your back and ski down a hill just for fun?” Perspective.

      And yet, life wouldn’t be very exciting if we wrapped ourselves in cotton. What I wanted to do was to spread awareness of the need to take it easier than they believe is “enough” and for longer than most think AFTER even a “minor” head injury – and to give my TBI readers a bit of information that might make them feel less alone in their struggles to recover. And maybe to encourage a few more Mom’s to keep an watchful eye out for appropriate procedures in the kid sports arena – and the courage to take on any coaches who don’t follow them.

      Thanks ALWAYS for ringing in, Paul.


  11. John Fioravanti says:

    Reblogged this on Words To Captivate ~ by John Fioravanti and commented:
    Madelyn Griffith-Haynie gifts us with a very interesting article about new research into head injuries – both severe and mild. Please, read on…

    Liked by 2 people

  12. Thanks for this article, Madelyn. Thankfully no-one in my immediate family has suffered from a head injury or whiplash but one of my assistance at work fell and hit her head very badly about three weeks ago. She also had whiplash as a result of this accident. I have noticed that she is very tearful and anxious subsequently.

    Liked by 1 person

    • Whiplash ALWAYS causes PFC damage, so he may well have troubles concentrating and following through for a while, since going back to work immediately is not really advisable. In a perfect world it wouldn’t be necessary, but we all know our world is far from perfect. The best thing you can do is to encourage them to go easy on the self-judgment and take it easy and get LOTS of sleep for a while, since their brain is still healing.

      I’m glad to read that none of your close loved-ones have had to deal with head injury along with life’s other struggles, however.

      Liked by 1 person

  13. dgkaye says:

    Such an important post M. So many aren’t aware of how being hit in the head can cause long-term injury and manifest itself in various ways. Recently banned NFL star who committed suicide in jail is a prime example. They analyzed his brain from years of NFL injuries and saw how much damage was actually left residual. Thanks for bringing this subject to light. And important reminder that any activity that cause involve falling should be required helmet wearing. 🙂 xxx

    Liked by 1 person

  14. Reblogged this on Smorgasbord – Variety is the spice of life and commented:
    Something for you to think about this morning with a post from Madelyn Griffith-Haynie on a subject that impacts millions of people around the world, sometimes without them being aware of the cause. A hit to the head in sport, by accident, in the boxing ring, whiplash or intentionally when hit by someone else, can result in a number of long-term mental deficits. Do you find yourself confused, losing objects, unable to carry through a simple task? Madelyn shares a very long list of symptoms that could identify that you are suffering from some form of mild to severe brain injury. Do head over to check it out.. and if I could add.. if you are cycling, skateboarding or any other activity where you might bang your head including being up a ladder… wear a helmet. #recommended

    Liked by 1 person

  15. Tina Frisco says:

    I haven’t thought about this in decades … When I was 6 years old, I fell off our back porch swing and hit the pavement head first. For a few minutes, I couldn’t see or move (but I could hear). Maybe that’s why I have 3 out of the 6 in your ‘How many of these do YOU experience?’ list. I also was a hyperactive child, but I think I was born that way! A lot of good info and food for thought in this post, Madelyn ♥

    Liked by 1 person

  16. Bernadette says:

    Madeline, almost three years ago I was out shopping for wine and got hit in the head by a flying case of whisky. I know it sounds funny but it is true. Your post is right on the money when you describe the results of a minor concussion. I struggled for two years with cognitive issues and with balance issues. I still have residuals today. The cognitive issues rear their ugly heads when I am over stressed and the balance issues are random and frightening. Thanks for such an erudite post outlining the dangers of what people would consider a “minor” head injury and a wonderful suggestion as to how to manage the side effects.

    Liked by 1 person

    • Thank you so much for sharing your own experience, Bernadette. It doesn’t make it easier to deal with to understand why we are experiencing certain struggles, but I believe it makes it easier to accept rather than beating ourselves up about it. As you know all too well, the stress only makes things MORE difficult.

      I’m sorry to read that your struggles came as a result of such a freakish accident, but I’m glad it didn’t result in a coma or worse. Have you seen a chiropractor to see if an adjustment or several might help with the balance issues?


  17. Excellent post, Madelyn! Sharing.

    Liked by 1 person

  18. That is scary. I am so happy my son never went out for football. Well, he loved karate (got his Black Belt) but that doesn’t concentrate on the head so much!

    Liked by 1 person

  19. Fascinating and informative post, Madelyn, and not surprising that injuries to the brain have all these subtle and not so subtle repercussions. As amazing as our brains are, they aren’t infallible. 240 hits to a 10-yr-old’s head. What are people thinking???

    Liked by 2 people

  20. foodzesty says:

    Great post Madelyn…thanks!

    Liked by 2 people

  21. A fantastic read and so much knowledge to get out of your well written post, Madelyn and I too agree that so many things can happen with head injuries whether mild or severe. Your presentation is great. Thanks for the awesome share.

    Liked by 1 person

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