Encyclopedia of Clinical Neuropsychology

2018 Edition
| Editors: Jeffrey S. Kreutzer, John DeLuca, Bruce Caplan


  • Benjamin Grover-MantheyEmail author
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-57111-9_249


Initiation refers to an individual’s intrinsic ability to begin a series of goal-directed behaviors. Impaired initiation is a diminished ability to take the first steps toward beginning an action, despite an often intact ability to describe a comprehensive plan.

Current Knowledge

Initiation exists within the larger context of general executive functioning, which refers to the ability to plan, initiate, direct, and monitor one’s activities. Deficits in initiation may result in a person having difficulty starting and completing tasks without repeatedly being prompted. In mild forms, an individual may be able to engage in normal activities, particularly if these activities are structured or familiar to the person, yet may fail to start complicated or unfamiliar activities. In more severely affected individuals, self-care and productivity can become impaired, and patients may appear lazy, apathetic, or unmotivated. Initiation is often worse when individuals experience stress,...

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References and Readings

  1. McDonald, B. C., Flashman, L. A., & Saykin, A. J. (2002). Executive dysfunction following traumatic brain injury: Neural substrates and treatment strategies. NeuroRehabilitation, 17, 333–344.PubMedGoogle Scholar
  2. Wagner, A.K., Arenth, P.M., Kwasnica, C., McCullough, E.H. (2016). Traumatic brain injury. In David X. Cifu (Ed.), Braddom’s physical medicine and rehabilitation (pp. 961–998.e13). Philadelphia: Elsevier. Chapter 43.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Physical Medicine and RehabilitationIndiana UniversityIndianapolisUSA