Impacts

Video: Cognitive Behavior Changes with TBI (4:22 minutes)

Physical and Cognitive Development

The effects of TBI on physical and cognitive development vary with individual cases. Cases may involve significant bodily injury that requires surgery and physical therapy for months or years beyond the traumatic incident. Other physical changes include headaches, seizures, fatigue, dizziness, tinnitus, and light sensitivity. Cognitive impairments resulting from the injury may range from a few months to the rest of one’s life. Most notable results include short-term memory issues, executive learning impairment, slow information processing, vision impairments, difficulty in problem-solving, flexibility, planning and organizing, reasoning, and the possible development of depression and posttraumatic stress disorder.

Social-emotional Development

The effects of TBI on social-emotional development include personality changes such as disinhibition, apathy, and aggression. People with TBI may also experience heightened anxiety and insomnia. Other affective changes include irritability, tension, and being easily frustrated. The affected person exhibits changes that may cause a change in friendships and impaired self-esteem. They may seem like a new person after the TBI, and expectations of who they were prior to the injury can be difficult for the person with the TBI and others around them to understand. These expectations can set the person with a TBI up for disappointment and confusion. A brain injury may change the personality and thought processes of the injured person. These changes may set them up for bullying, as seen in the below video:

Video: More Than My Brain Injury: Megan’s Story (7:20)

Here is another example of TBI as an Invisible injury:

Video: “You Look Fine!” —The Real-Life Struggle of an Invisible Injury — TBI Awareness (3:17)

Communication

Communication issues for people with TBI include:

• Cognitive communication, the ability to put one’s thoughts into words and interact with others
• Social communication, producing or regulating conversations with others in social situations
• Speech production, the ability to speak and/or form words
• Receptive language, understanding what is being said or asked of the person with TBI
• Expressive language, the ability to use words to express themself
• Hearing may also be affected by TBI

(Crook et al., 2023)

The effects of TBI on communication are complicated by the age of the child at the time (and extent) of the injury. Children under the age of four have the highest incidence of TBI, compared to other age groups (Ciccia et al., 2021). Children in this age group are still learning language production, expanding their vocabulary, and engaging in social communication. The result of TBI is more difficult to estimate and depends on their language ability prior to the injury. Teenagers experience more TBIs that stem from sports and recreational activities and automobile accidents. Resulting communication issues may impair their ability to socialize and continue in sports, and may make learning more difficult. A speech-language pathologist (SLP) will work with students to improve their communication ability.

Video: Communication Tools After Brain Injury (1:54)

Video: Deeper Dive on Communication and TBI  (1:22:33)

This is a webinar from the Brain Injury Association of North Carolina.

Motivation

Motivation is used to set and achieve goals. Adding TBI to a goal-setting session may add complications. TBI may affect short-term memory and cognitive functioning, and may hinder an individual’s motivation to advance in school and/or their career. The use of different goal-setting models has been found to be effective with certain people who have TBI. Goal-setting models include strategies that use the student’s input and a clinician’s supportive coaching. This model has been found to be effective; however, research has not shown it to be effective for every person.  A person’s limitations caused by TBI and the process of setting goals are challenging due to the complex cognitive, communication, and social-emotional demands of the task itself (Brown et al., 2021).