Topic: Social-Emotional - Socialization and Helping Students with Brain Injury

Question:

I teach in a high school where we have a student with Traumatic Brain Injury. The area of his brain which is affected is that which aids him in socialization skills. Because of this injury, he is unable to establish social relationships with his peer group. He does, however, remember a time when those relationships were made, and he misses them.

We are looking for support for this student. At your web site, I found a list of support groups. Do you know whether any particular group in the St. Louis area would more helpful than another for this student? Any information you can give us would be wonderful.

Jo Ellen

Dear Jo Ellen,

Socialization is an important issue following a brain injury. I’m very curious about what you (and others) see as the primary “effects” of his brain injury, though. Is it only socialization skills? The way your question is worded, it might appear that the most pressing issue (to you and others) is socialization and social skills. If so, does this mean he gives the appearance of being OK in most other cognitive areas (short-term memory, decision-making, problem-solving, etc.)? Also, was his injury diagnosed as “mild,” by any chance? If so, this could explain why the most pressing issue would seem to be “higher level” issues related to socialization, when it may be the case that cognitive issues affecting his ability to make and keep friends, are being downplayed because they are considered more “minor” issues.

In my experience, so-called “typical” strategies for improving socialization skills may or may not work well with a person with brain injury, in part, because memory and other cognitive abilities are usually affected following a brain injury. When cognition is involved, the person with the injury needs to understand how cognition affects his or her social behavior. They also benefit from knowing how to use basic compensatory strategies to improve their skills in this area.

Resources

An excellent resource is a book entitiled, An Educator’s Manual: What educators need to now about students with brain injury. It is edited by Ronald C. Savage, Ed.D. and Gary F. Wolcott, M.Ed., and is published by the Brain Injury Association, Inc. (www.biausa.org).

Other resources include internet support groups and even a legal site dedicated to issues related to so-called “mild” brain injury (a better term, in my view, is “permanent brain injury without coma.” See www.waiting.com.

Simultaneous to the student’s involvement in support groups (whether local or on the internet), his “helpers” (parents, teachers and counselors) may want to join one or more e-mail support and discussion lists so they can get the perspective they will need to help the student. This site lists several at: http://tbimo.org/groups.asp#internet

In particular, I would encourage your and the student’s other helpers to join ASSIST-TBI, TBI-SPRT and BRAIN-EDU (two of which I facilitate).

Brain Injury is Misunderstood

Brain injury is often misunderstood. In my experience, the best resources for teaching a person with brain injury how to learn social skills is by networking with persons with brain injury and their families. After all, when formal “rehab” is completed, the social aspect of recovery is generally left to the person with the injury and his or her family. Learning skills to cope and compensate can take many years, and families are often left with the challenge (and burden) of helping the person in this area.

Some of the issues many of us face are related to the following brain injury-related problems:

• communication (from difficulty finding “the right word” to “mis-hearing”)
• appropriate behavior and conversation (including impulsivity, “dyscontrol” and possibly “disinhibition"
• frustration
• agitation (and possibly anger)
• lowered self esteem and loss of self confidence
• apparent lack of patience
• difficulty with noise and crowds, including restaurants (visual and auditory over-load due to over-stimulation)
• poor decision-making and problem-solving skills
• . . . Others

Support

Both the student and his family will benefit from on-going support. Local support groups may or may not be the answer. Many of us find the specialized support we need by networking internationally on the internet.

Hope this helps,
Kathy M.

University of Missouri - Columbia
School of Health Professions
Great Plains RCEP