Objective: The remarkable persistence of disablement in chronic traumatic brain injury and the dearth of accommodation define the condition as a disorder of adaptation. This construct is extended to explain exceptional recoveries after postacute treatment.
Method: Nine severely injured graduates of holistic cognitive rehabilitation were selected for their exceptional postmorbid academic, vocational, and social accomplishments.
Results: In interviews, they attributed their successes to continuing reliance on, and ongoing elaboration and modification of, cognitive compensation strategies. Unlike their disabled cohorts, they implement a deliberate procedure for self-corrective self-management that minimizes the functional impact of their permanent deficits.