Difficulties with multitasking on return to work after TBI: A critical case study

Authors: Boycott, N., Schneider, J., & McMurran, M.
Year Published 2010
Publication Work
Volume 36
Number 2
Pages 207-216
Publisher IOS Press

Cognitive functioning is a strong predictor of success at work. Every job requires a specific set of cognitive skills. Multitasking requires a person to switch between several concurrent tasks, requiring the application of a variety of cognitive strategies to succeed without errors. After a traumatic brain injury (TBI) a person may have problems processing cognitive information. This is one of the leading reasons for loss of work among individuals with mild TBI. People who return to work after injury have reported increased cognitive demand with associated stress. Occupational rehabilitation providers have noted organizational and planning of complex or multiple work tasks difficult for high functioning individuals post TBI. The difficulty seemed to not only stem from cognitive problems but also the ability to apply cognitive strategies on the spot or situations with increased cognitive load. While neuropsychological evaluations may prove useful in helping determine potential cognitive capacity to return to work, there are some limitations to its usefulness. Some believe that sampling work behaviors through observation or client and employer interview may be a much better way to obtain accurate evaluation of cognitive work demands for individuals who are attempting to return to work after TBI.


The study examines the use of the Perceive, Recall, Plan, Perform@WORK:Questionnaire/interview with category rating response format, by an employer to determine information processing strategy application difficulties.


The study took place at a telemarketing company.


A thirty year old man who sustained a TBI nine months earlier. His Glascow coma score was 9/15 and he experienced post traumatic amnesia for 21 days post injury.

Data Collection

The participant's employer was interviewed by an occupational therapist using the PRPP@work questionnaire/interview format. The participant's case manager was also present to provide background information, and to corroborate interview data from other assessment sources like client observation and interview.


There was no control or comparison condition.


The employer did not perceive that the employee with TBI, was adequately applying cognitive information strategies in any of the four areas (perceive, recall, perform, plan) to meet job requirements. The findings indicated specific areas of information processing strategy strengths and weaknesses during work performance as categorized by PRPP@WORK Employer Questionnaire/Interview.


More research is needed. A measure of mental effort should be included in future studies assessing a person's ability to apply cognitive information processing strategies in multitasking work environments. While it is not possible to generalize the findings to the broader population of individuals with TBI the findings contribute to targeting future research in the area of improving multitasking work behaviors. The PRPP@WORK may have potential to offer useful information about the capacity of a person to engage in complex information processing for multitasking work performance post TBI.

URL http://www.ncbi.nlm.nih.gov/pubmed/20634614
Disabilities Traumatic brain injury (TBI)
Populations Male | White / Caucasian
Outcomes Return to work
NIDILRR Funded Not Reported
Research Design Case reports
Peer Reviewed Yes