Hydrocephalus – Strategies for Living Your Best Life

Improving Executive Functioning

The term executive function describes a set of cognitive abilities that control and regulate other abilities and behaviours. Executive functions are necessary for goal-directed behaviour. They include the ability to initiate and stop actions, to monitor and change behaviour as needed, and to plan future behaviour when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes and adapt to changing situations. The ability to form concepts and think abstractly are often considered components of executive function.

Executive functions are important for successful adaptation and performance in real-life situations. They allow people to initiate and complete tasks and to persevere in the face of challenges. Because the environment can be unpredictable, executive functions are vital to human ability to recognize the significance of unexpected situations and to make alternative plans quickly when unusual events arise and interfere with normal routines.

Tips which can help improve executive functioning

• STRUCTURE • Set goals, then break these down into small tasks. • Use checklists • Structure the day by writing a plan of tasks you need to do and the time frame. Include all activities

Managing Emotional and Behavioural Difficulties

Emotional or behavioural difficulties can impede or distort personal development and affect relationships, causing distress to the person with Hydrocephalus, their family or community.

Emotional or behavioural difficulties occur most commonly when the frontal and temporal lobes have distorted due to the Hydrocephalus. The frontal lobes or connected pathways in the teenage years may lead to irritability, anxiety, over sexualised behaviour, poor social responses, increased risk-taking behaviour, failure to inhibit responses, and poor self-monitoring.

Tips which can help improve emotional & behavioural difficulties

• Structure and Routine • Exercise • Diet • Medication (where appropriate) • Psychological Intervention/ therapy (where appropriate) • Encourage the person to seek support from family/friends when necessary • Support can also be sort from your SBHI Family Support Worker

Improve Information Processing

Information Processing is a person’s ability to take in information e.g. instructions or directions. When we deal with information, we do so in steps. One way to think of this is to picture the process of acquiring, retaining, and using information.

For example when checking into a hotel we are given a number of instructions, information and directions all in one go. “Your room is 201, it is on the second floor, the lifts are to the left of reception and breakfast is in our restaurant which is on the 4th floor. Have a lovely stay”. If you have difficulties processing information you may well be thinking, yes I will have a nice stay but since I can’t remember anything you said before “have a nice stay” it might not be that great. Now is what floor is my room on?

Tips which can help improve information processing

• Pacing – Ask people to slow down when giving instructions or during conversation or ask them to write it down • Timing - Develop awareness of the best times to complete more complex activities • Write lists or notes • Check and re-check your work • Use paper to break up information on a page so as to avoid overloading • Use index cards to summarise information • Underline key words or phrases in instructions • Work in periods of 20-30 minutes with short breaks in between

Improve Attention Span

Attention span is the amount of time a person can concentrate on a task without becoming distracted. The ability to focus one's attention on a task is crucial for the achievement of one's goals.

Tips which can help improve information processing

• Minimise distraction • Time management – plan a programme of activities ahead of time. • Where possible allow preparation time before making a transition to a different activity or place • Pacing – distribute the activity over a period of time, including frequent breaks • Rehearsal – Repeat what someone has said in your own words i.e. ‘ let me repeat this to you to see if I have it’ • Use cues and prompts – cue the person that what you are saying is important, colour code timetables • Write down anything you feel might confuse you or you might forget • Chunking – break complicated tasks into smaller, carefully arranged steps • Finish one activity before starting another • Sequencing – sequence tasks from simplest to most complex

Improve Personal Insight

Personal insight is the ability to clearly see and instinctively understand the nature of a person, situation, or subject. It is also the ability to be self-aware by seeing and understanding personal strengths and weaknesses and the ability to find solutions to these weaknesses.

Tips which can help improve information processing

• Ask for feedback from friends and family • Attend activities/groups where you can meet others with similar difficulties – learn from them • Read books, leaflets and other information about Hydrocephalus • Watch yourself on video • Make mistakes and fail, but learn from those mistakes and failures • Ask to be sent medical letters and reports • A neuropsychological assessment can be helpful in highlighting strengths and difficulties and in tailoring appropriate rehabilitation interventions.