The Relationship Between Verbal Learning Patterns, Injury Severity, and Employability Following Traumatic Brain Injury

We examined the differences in verbal learning patterns in employed and unemployed individuals with traumatic brain injury (TBI). Existing records of individuals with mild or moderate-to-severe TBI ( n = 25) from a regional Community Re-Entry Program were reviewed. The California Verbal Learning Test (CVLT) was used to document verbal learning patterns and employment status and change in employment status following TBI were also documented. The results did not support a relationship between verbal learning patterns and change in employment status following the injury. The lack of group differences on CVLT subscale performance illustrates potential problems involving ecological validity of neuropsychological tests with respect to employment following TBI. In our study, individuals with moderate-to-severe TBIs were more likely to return to work than those with mild TBIs. While this finding was contrary to expectations, these results are not anomalous in a clinical setting, in that the severity of impairment may not always equate to the original injury severity. Individuals with moderate-to-severe TBI and greater subsequent impairment following TBI may be more accepting of their deficits, open to clinical interventions in the form of job coaching, and more willing to entering the work force at a reduced level. In contrast, individuals with mild TBI and more subtle subsequent impairment following TBI may be less accepting or aware of their deficits, which may ultimately thwart rehabilitative efforts. Implications for these findings may be that the individual’s reaction to their injury, and level of insight, rather than injury severity variables or neuropsychological testing, mediate employment following TBI.