People who have suffered Acquired Brain Injury comprise a uniquely challenging group for agencies (both statutory and voluntary) who provide services for them. This results from both the nature and the range of impairments and disabilities which occur.
Physical deficits are visible and, although they can result in considerable handicap, eventually the affected individual adapts to the residual problems to a greater or lesser extent. Of proportionately more importance are the psychological deficits.
The person who has survived a serious head injury or other ABI may look remarkably unscathed but suffers profoundly from these psychological problems.
The lack of understanding of these factors by others may greatly aggravate the disadvantage faced by the victims and their families.
There are so many psychological damages that can occur that a short note like this cannot be comprehensive but a few commoner examples may help. For convenience these will be listed as Physical, Cognitive, Emotional and Behavioural Problems.
These can include obvious injuries, paralysis, inability to walk or stand, poor balance and co-ordination. There can also be problems with eyesight, speech and hearing.
This refers to intellectual or mental activities. Memory, attention and concentration are major examples although many other factors are relevant. Memory difficulties usually relate to recent memory which has significant implications for learning. The person may have good long term memory and be able to remember stored knowledge and skills laid down before the injury very well and so be able to speak fluently about these things.
In contrast they cannot grasp new concepts, learn new ways of doing things or even remember the name or faces of new acquaintances without considerable effort, if at all.
The ability to speak articulately about items from long-term memory may hide from the casual observer the profound acquired learning disability that may be present.
Impairment of attention and concentration may result in the brain injured person being unable to stick to any task, be it physical or mental. They may be easily distracted.
This is misconstrued as consciously-willed disruptive behaviour and there is the danger of that person being denied access to the very group activities they so desperately require to assist their recovery. These deficits are closely allied to the lack of motivation, poor initiative and apathy that they may exhibit.
The major abnormalities of mood are depression and anxiety, both of which are common. Depression is more than just the feeling of sadness that most people experience now and then.
It is often deeper, more persistent, associated with feelings of worthlessness and accompanied by disturbances of sleep, loss of appetite, constipation etc.
Anxiety may be equally disabling with the elements of fear, panic and groundless worrying that it includes.
After ABI, altered behaviour is sometimes categorised as positive or negative. Examples of abnormal positive behaviour are verbal or physical aggression, temper tantrums, social disinhibitions such as butting into other people’s conversations or proffering unwanted advice.
Negative behaviours are general apathy, disregard for personal appearance and unresponsiveness to the social cues of others. One should add to the list the communication difficulties commonly found in these people.
They may have impaired understanding of language and be unable to express themselves accurately. This clearly can compound the ‘bad impression’ they may give to others.
Brain injured people therefore, are often grossly misunderstood. Because they are not visibly disabled they may be denied the resources given for example to a wheelchair bound spinal injury person.
They often suffer from a ‘learning disability’ equally profound as that of children with learning disability but it is acquired. It also occurs on a background of previous knowledge.
Because they often have memories and insight into how they were before and how others treated them before it is necessary for those working with them to be sensitive and adaptable.
On the one hand they have to be a teacher who is aware of the training needs of their pupil but it is necessary to respect them as an adult who may not be aware of their need to be taught.
If you would like more information about any of these symptoms or practical issues following Brain Injury, please follow the link below to a range of printable factsheets and e-booklets.