Initiation Issues & Strategies

The ability to start something is called initiation. For individuals who have had a frontal lobe injury, this skill can be impacted, often leading them to be mislabeled as “lazy” or “not caring enough”. However, it is important to recognize these judgements as inaccurate, because the person is not intentionally failing to start a task. In addition, the person may not be able to verbalize or understand why they lack this ability to get going, causing even greater confusion or even depression.

The challenges seen with initiation include:

  • Unsure of where to start on a task.
  • Difficulty switching attention to new activity.
  • Appears unmotivated.
  • Needs constant reminders to get going or keep going on a task.
  • May seem to avoid or withdraw from tasks.

Effective strategies include:

  • Encourage the person to work for 5 minutes, and then stop when timer goes off to take a break.
  • Provide a simple starting point to build success and confidence.
  • Write out a checklist that can be crossed off as each step is done.
  • Employ work-break-work sessions to avoid burnout.
  • Use music or movement for completing mundane tasks.


Initiation problems can also be attributed to other mental health issues. A team approach is best when deciding what is driving the person’s difficulty with starting and maintaining tasks.