Monitoring and insight

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is it?

There are a collection of cognitive, or thinking, skills that are often discussed as a group and often called `executive functions' or `higher level thinking skills'. These skills include monitoring and insight. These skills help people to reflect, evaluate and anticipate the consequences of their actions so that they can work effectively and interact appropriately with others. These skills can be affected by an acquired brain injury.

What do problems with monitoring and insight look like?

The following list outlines some of the common difficulties that may be seen on an everyday basis that could indicate problems in this area.

• Produce work that contains a number of mistakes, or that appears to have been completed in a careless manner
• Monopolise conversations
• Keep talking when others are no longer interested
• Exhibit unawareness of limitations or difficulties that they are experiencing, physical or cognitive
• Have unrealistic goals, plans or expectations

What strategies might help?

• Encourage regular work checks and make this a routine step when undertaking tasks
• Agree upon a signal which indicates that it is time to stop talking
• Encourage turn taking in conversations
• Have external aides which illustrate ongoing performance on different tasks
• Gently remind person of difficulties, limitations
• Explain effects of actions, both positive and negative
• Work through possible consequences which can occur in different types of situations

Who do I see and how is it diagnosed?

Difficulties with monitoring and insight, as well as other cognitive difficulties, are formally identified by having a neuropsychological assessment and a neuropsychologist can help devise compensatory and management strategies that are suitable for each individual child and their cognitive profile. A clinical psychologist may also be able to provide individual strategies to cope with monitoring and insight problems.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/