In This Section: What is an Acquired Brain Injury? Common difficulties following an Acquired Brain Injury Myths and realities of Acquired Brain Injury (ABI) Positive interactions and workplace adjustments Techniques for supporting people with memory deficits Techniques for making adjustments related to lack of initiative Techniques for managing distractibility Techniques for supporting those who experience difficulties learning new tasks Techniques related to language deficits

What is an Acquired Brain Injury?

This term refers to damage to the brain that has occurred as a result of disease or injury. This term is often used when damage has occurred following a period of otherwise normal development.

Like any other living tissue, brain tissue dies when something interferes with the delicate balance of temperature, pressure and chemicals necessary to keep it healthy. There are a number of ways this can happen, the most common being:

• trauma resulting from motor vehicle accidents, assault, serious sporting accidents etc.
• cerebrovascular accident (CVA) or stroke resulting from a blockage of blood vessels or from a brain haemorrhage
• brain tumours
• degenerative disease such as Alzheimer's disease
• infection; e.g. meningitis, encephalitis
• lack of oxygen; e.g. near drowning accident, severe asthma attack
• poisoning; e.g. substance abuse, petrol sniffing.

Common Difficulties Following an Acquired Brain Injury

The effects of brain injury can vary from minor temporary problems to severe, long-term changes in some bodily or mental functions. The difficulties experienced can be categorised in four groups.

Physical and sensory impairments:

• loss of function and coordination, changes to posture and balance
• difficulties with vision: blurred vision, visual field loss
• changes with hearing: tinnitus or Ôringing' in the ears
• heightened or reduced sensation and sensory awareness
• headaches
• epilepsy.

Cognitive impairments that can affect:

• memory
• attention and concentration
• planning and organising
• reason and abstract thinking
• problem solving
• information processing
• language
• perception
• insight.

Psychosocial issues

Problems can include:

• emotional changes: increased anxiety, depression, anger, irritability, silliness
• social perception: lack of insight, self-centredness, decreased tact, over-familiarity, inappropriate behaviour
• self control: impulsivity, impatience
• dependency: lack of initiative or motivation, indecisiveness, impaired judgement and planning skills
• rigidity: inflexibility in thoughts and actions, inability to learn from mistakes, repetition of words, actions and ideas.

Communication impairments can include:

• dysphasia - difficulty staying on the topic; reduced volume of speech; slow response time
• pragmatics - poor eye contact; inability to take turns in a conversation; inability to initiate topics; interrupting; talking too much; lack of expression; standing too close; using too much gesture.

Myths and Realities of Acquired Brain Injury (ABI)

	Myth Reality People who have mobility or coordination impairments due to ABI probably don't have any other impairment. No. If the physical impairment is the result of ABI it is very likely that there are other impairments as well. People with ABI have ongoing medical needs. No. Ongoing medical problems are not frequent. Epilepsy would be the most common ongoing condition which is usually controllable with medication.

Positive Interactions and Workplace Adjustments

Interacting with a person with a disability, including a person with an acquired brain injury, should be characterised by respect for their rights to dignity, confidentiality and equity.

Techniques for supporting employee's with memory deficits

• Have an understanding of the employee's need for strategies to handle memory problems; e.g. notebook, calendar and tape recorder.
• Provide requests in writing as well as verbally.
• Provide environmental aids to assist the employee with locating materials, appointments and schedules; e.g. pin boards, diary, labelled items.
• Promote learning techniques such as mind mapping, colour highlighting, regular review, step by step notes.
• Encourage the use of a work diary to make clear entries with specific information torefer back to later.

Techniques for Making Adjustments Related to Lack of Initiative

• Establish timelines for the completion of work.
• Provide clear steps or small work goals rather than one big project or goal.
• If the employee is bogged down in a task, assist them in sequencing activities.
• Make job expectations and expected outcomes explicit at the beginning of the task.

Techniques for Managing Distractibility

• To lessen distractions, assist the employee to create an uncluttered work environment.
• Position the work space to have minimal visual and noise distractions.

Techniques for Supporting Those who Experience Difficulties Learning New Tasks

• Before introducing the employee to a new job or task, make sure they are comfortable with existing tasks and skills.
• Introduce new tasks in small steps.
• Introduce new tasks only when the previous skill has been mastered.
• Where possible, present abstract thoughts in a more concrete manner, such as physically demonstrating concepts rather than verbalising them.

Techniques Related to Language Deficits

Over time, people do become familiar with an individual's language deficits. Time and patience is required.

• Allow the person time to express themselves, without interrupting or trying to finish their sentences.
• Ask the person to repeat or re-phrase a statement if you don't understand it. If you are still unable to understand the person's communication, ask them to write the information down.
• Avoid speaking artificially slowly or simply unless they require this.
• Resist the temptation to speak for the person if they are experiencing difficulties in expressing themselves.

< Back to Types of Disabilities