I was recently told that the minor head injury I sustained 24 years ago in a bicycle accident may be the cause of several of my current problems. At the time of the accident, I was in the hospital for about 2 weeks. I was in a coma for 3 days. There are no physical effects, but I am slow at everything. For example, I experience comprehension/reading problems. In the past 4 years I have struggled with mood swings and severe depression. I just started college and I am having a difficult time. Could my problems be related to this childhood brain injury, and how can I get help?
Your situation is common among people with minor brain injuries. Often these injuries are overlooked or minimized because the period of unconsciousness is minimal, the CT scan is negative, and/or the person "looks fine." Twenty-four years ago, no one even heard of brain injury anyway. (They were still using exorcists to cure epilepsy.) A person in need of accurate diagnosis and specific recommendations should see a neuropsychologist, which is a psychologist specially trained in evaluating brain-behavior relationships. In Pat's educated opinion, a neuropsychologist is the best person for you to consult at this point. Then you will have specific suggestions for yourself and your school to help you be academically successful.
I am currently attending a 2-year college for individuals with learning disabilities. I am learning a lot here, but I am looking for a school or program that deals specifically with students who have brain injuries. Do you know of any?
To anyone with a brain injury (or other disability) considering college, Pat has the following advice: (1) You will need to think about the same things everyone does, such as educational and career goals, financial needs and assets, living on-campus or off, taking classes full-time or part- time, etc. (2) In addition, you will need to think about your special needs, such as classroom accommodations, course load alterations, personal assistance using the campus, etc. (3) In resolving these issues, seek advice from someone like a school counselor or teacher at your high school or at one of the colleges you are considering. (4) To decide which college is right for you, talk with as many people as possible, such as your high school teachers and advisors, as well as college graduates whom you know. Get college catalogues and pamphlets, and look for colleges which meet your academic needs. The pamphlets also will give you a general idea of the accessibility of the campus layout, the transportation system, and the surrounding town. When you contact the colleges and visit, you will get a better idea of how your special needs will be addressed. (5) Visit prospective colleges and while you are there, meet with the person in charge of making special arrangements and accommodations for students with disabilities. There should be an office of "student services" or "student support" or something similarly titled. The person in this office who handles disability issues will take care of arranging untimed tests, books on tape, interpreters, personal assistance on campus, and other accommodations. You want to feel confident that this person will be on your side and help you get your college education. Without a strong on-campus advocate, you could face a continuous series of roadblocks. (6) Once you choose a college, be prepared to provide the college documentation regarding your disability (e.g., intellectual test results) in order for you to receive accommodations. You must be prepared far ahead of each semester's registration period to identify and secure the appropriate accommodations (e.g., interpreters must be recruited and hired months ahead of time).
People with disabilities who would like information about post-secondary education options and issues (including financing college) may contact the HEATH Resource Center. HEATH provides answers to individual questions and a variety of helpful publications, including guides to choosing and financing college.
HEATH Resource Center, National Clearinghouse on Post-secondary Education for Individuals with Disabilities, American Council on Education, One Dupont Circle, Suite 800, Washington, D.C. 20036-1193. Telephone: (800) 544-3284 or (202) 939-9320
I suffered a severe brain injury this past August and according to my neurologist I am between 85-90% back to normal. However, I have returned to work in a very busy environment and am still only part time building back up to my full-time position. We had an impromptu meeting last week and I was thoroughly upset. I was sure they were picking me apart even though they told me it was supposed to be constructive criticism. I wonder if that is a normal response and if there would be something that I can do to make this whole transition easier for myself as well as my co-worker.
There is virtually no one who has sustained a severe brain injury that does not experience some difficulties returning to work. Most jobs require a number of skills such as attention, memory, auditory and visual processing, reaction time, and good motor skills. Even relatively minor disruptions can cause problems on the job. Imagine a lawyer who has even slight difficulties remembering case law or a truck driver who can’t pay attention to the road. Even jobs such as working at a fast food restaurant can require people to work quickly in a high stress environment. Many people also find they have more difficulty coping with stress and are more easily frustrated.
There are a couple of things you need to consider. The first is whether or not your employer is supportive of you and willing to show tolerance as you re-integrate into the workplace. A supportive employer is extremely important for people returning to work after a brain injury. If you believe your employer and co-worker are supportive, talk to them about your situation and ask for feedback. If you don’t think they are supportive, find out about your rights in the work place. You may have rights under the Americans with Disabilities Act or other legislation.
The second is whether or not you’re ready to come back to work. Many people simply come back too early before they are ready.
If you haven’t already, consider having a neuropsychological assessment. This can help you identify your strengths and weaknesses. Think about consulting with a psychologist or other therapist that specializes in rehabilitation. They may be able to offer you good ideas, suggestions for compensatory strategies, stress management techniques, and provide a neutral perspective that you can’t get from friends or family members.
If you want more help, a new book titled "The Brain Injury Work Book: A Guide to Living and Working Productively" is available from the National Resource Center for Traumatic Brain Injury. This book is written for persons with a brain injury and provides a number of useful ideas related to working (or not) after injury. Ordering information is available on this website.
I’m a 27-year-old brain injury survivor. I’m going to college, but I’m having problems with math. I’m working with disability services. Otherwise I’m doing fine in school. Should I keep going or give up? Math is the only subject I have real problems with. I was treated in the emergency room and released. I didn’t even spend one night under observation! Is this weird?
A college student having trouble in math? Shocking! Unless you’re writing from MIT, I doubt you’re rare. I’m quite sure graduation rates across the country would plummet if every student who is doing well in all other subjects "gave up" because of math.
Most people are able to overcome math-related learning disabilities or other deficits to make it through an undergraduate math or statistics course. If you just need to get through one course, you might consider auditing it before you take it for credit. Sometimes exposing yourself to the material without the "pressure" of having to make a grade helps. If your school offers math in large classes with little individual attention, find out if you can take the course at a smaller school and transfer the credit. Also, many students need tutoring. In most cases, it’s worth your investment of time and money because you get individual help tailored to your needs. Discuss your needs with your instructors. Request untimed testing to take pressure off. If you have anxiety related to math or testing, consider seeing a counselor to help develop strategies for coping. Most schools offer free counseling services to students.
If you’re taking math because it’s a required part of liberal arts curriculum, your school may be willing to waive or substitute the requirement for a student with a documented disability. (For example if Calculus is required, and you’re a History major). On the other hand, if you’re trying to enter a field that demands the use of math as part of the profession, you may need to consider if that profession is right for you. Consider another field that better suits your strengths and abilities. You can’t be an engineer without calculus, a psychologist or economist without statistics, or an accountant or pharmacist if you make frequent calculation errors. Find a field of work that plays to your strengths.
There’s nothing weird about having a brain injury that resulted in math problems. Math is a complex cognitive task requiring sustained attention, symbolic processing, abstract reasoning, good memory, and the ability to process multiple steps. Even minor brain injuries that disrupt any of these abilities can lead to problems in math skills.
I am a graduate student in speech language pathology and want to do a thesis on "teachers knowledge of educational and behavioral concerns of children that have suffered traumatic brain injury." I have searched the web and can't seem to find any such study. Would you know of one? Or would you have any information on this topic.
Graduate student? Glutton for punishment huh? Well, welcome to the club. I would say that your first problem is searching the web. The old fashioned search for library books may be the best starting place. If you really want to search for studies, you are better served searching scientific databases such as PsycInfo or Medline. Your university librarian should be able to help you. These databases usually contain studies conducted in peer reviewed journals. If you’re just using a search engine (like Yahoo, Lycos, or Hotbot) to search webpages, you’ll always be at a disadvantage. For example, many peer-reviewed journals (This means other scientists have looked at the paper to be sure it meets scientific standards) do not publish the results on the web (or else why would libraries need to buy the journals?). You will also have a very difficult time verifying the source or quality of any study that just appears on a website. In fact, someone could just completely make up a study and how would you know? Although the web contains lots of websites that provide good, balanced information (like this one!), there are others that are not as good and it’s sometimes hard to tell the difference – especially if you’re researching a topic you’re just beginning to learn about.
[Pat now steps off the soapbox] OK. As for your question about studies… the study listed below seems to directly address your topic. (Pat just read the abstract and can’t comment on the quality or thoroughness of the study).
Title: Misconceptions about traumatic brain injury among educators and rehabilitation staff: A comparative study.
Authors: Farmer,Janet E.; Johnson Gerard,Mary
Journal:Rehabilitation-Psychology. 1997 Win; Vol 42(4): 273-286
Second, the book described below addresses your topic, as well.
TI: Students with acquired brain injury: The school's response.
AU: Glang,-Ann(Ed);Singer,-George-H.-S.(Ed);Todis,-Bonnie (Ed)
PB: Baltimore, MD, USA: Paul H. Brookes Publishing Co. (1997). xvii, 400 pp.
My daughter suffered a severe closed head injury and is 17 months post injury. Her short-term memory is impacted greatly. She has an IEP and is in the normal classroom with learning support. However 2 classes are very auditory and try as we may the instructors will not make the courses visual. Are there resources available to make subjects visual? How can we access them?
It would be helpful to know which two subjects you are concerned about. Some classes are easier to teach "visually" than others are. It would also be helpful to know if your daughter’s reading skills are impaired, or if her limitations only extend to information she hears. If your daughter’s difficulties are limited to problems learning from a lecture format, it will be important to supplement her learning with information presented in class with outside readings as well as information presented visually in the form of graphs, charts, or diagrams.
Your daughter may also benefit from tape recording lectures for later review at home (you may be able to help supplement these lectures with visual information). Hands-on learning, demonstrations or watching educational videos/documentaries may also be helpful. Finally, many subjects can be supplemented with educational software that provide multi-media learning opportunities.
I am a graduate student who suffered a mild TBI from a sports concussion 2.5 years ago. I have concentration deficits and experience problems reading and writing at the level of a graduate student. I am determined to finish my degree but I am behind schedule and meeting opposition from my advisor and graduate department. A neuropsychologist told me there is nothing I can do except spend extra time to get my work done. Are there rehab programs that address deficits in high functioning individuals? I would very much like to find solutions to my problems.
Most rehabilitation programs are more focused on helping people with more severe deficits. As a graduate student, you’re sort of doing the equivalent of professional sports for the brain. It requires very high level cognitive skills such as attention, communication, and memory. Knowing your strengths and weaknesses is very important. Attention problems can often be compensated for with a number of behavior interventions, which you have probably already discussed with your neuropsychologist. Reading and writing will depend on what the specific problems are. For example, if it takes you longer to write due to motor skills, you might consider voice recognition word processing software. On the other hand, if the issues are reading comprehension and/or organization of writing, your neuropsychologist may be right. It may just take more time and effort and/or some tutoring to compensate.
You may also qualify for some accommodations from your graduate school under the Americans with Disabilities Act. For example, you might get extended time for test taking, be able to test in isolation, or have a tutor provided. If you think something like this might be helpful, talk to your school’s student disabilities department about this.
There are also two very important questions you will need to ask yourself – and they’re very hard questions -
- Are going to be able to function at a high level in your chosen field? For example, if you are going into a field that requires a great deal of reading and writing at a high level, you need to ask yourself if you can compensate. Can you learn to compensate for your disability and function as well as your peers? Are compensations you receive in school (extra time, tutoring) reasonable for an employer to provide in the workplace? You also need to consider the cost of making a mistake due to inattention or misreading something. In some fields, the mistakes can be corrected with minimal cost (other than perhaps embarrassment) but in some fields (such as health care) mistakes can cause significant harm.
- Will it be worth the extra effort and energy needed to compensate for your injury related deficits? For example, if it takes you extra time to compensate for your deficits, you need to be prepared to spend that extra time to get the job done. In other words, what might take 40 hours per week for a non-injured person may take 50 hours for you. You might be able to do the exact same job, but if you have to read and write as part of your job, it may take you longer to do the same amount of work.
If you believe you can do it and you’re willing to put in the effort and energy, then the best thing you can do is to devote the time and energy needed to complete your degree. Continue working with your neuropsychologist and continue to explore options and compensatory strategies. If attention problems are significant concern, talk with your physician about the risks and benefits of a medication trial. Another option to talk to your neuropsychologist about is whether taking some time off might be helpful. Sometimes stress can limit recovery from an injury, and perhaps you would benefit from a year away from school to allow further recovery and to assess your options.
If you decide the answer to either of the two questions is "no", then you need to consider other career options. Talk with your neuropsychologist about your strengths and consider career counseling to assess job options that play to your strengths!
You sound like a hard-working and dedicated person and I’m sure there is a lot of success in your future!
I've read in your prior e-mails that you have been contacted by police officers that suffer from TBI. Do you still have their e-mail address so I may contact them? Unfortunately, I suffer from the same problem and I would like to talk with them about their return-to-work experience.
Pat believes privacy on the Internet is important. Therefore Pat does not release names, e-mail addresses, phone number or any other information. While Pat is convinced your request is genuine, there is no way to easily verify that you are who you say you are. Also, many people do not wish to have unsolicited e-mail from strangers (even if well meaning).
You might try contacting your local Brain Injury Association. Police departments sometimes have organizations to help injured officers. If there is one in your community, they may be able to help you find fellow officers with similar experiences.
My son's Social Security Disability was cancelled 3 years ago because they state he is able to work. However, he has not been able to secure a job on his own and what work he has had was through employment agencies. Even though these are supposed to be open to full time employment at the job sites, he is always told he is no longer needed. The longest he was kept was 10 days. He always works when told to report but I suppose he is inappropriate in someway. We need advise in securing SSI or other financial support. He wants and needs to be independent.
- Talk with his physician about his condition and prognosis. In order to qualify for SSDI, you will need a doctor to describe the patient's problems and state that he is unable to work.
- Talk to your son or his former employers. Finding out why he cannot hold a job is essential for determining if this is due to a disability, behavior problem, or some other reason.
- Investigate the possibility of having your son evaluated by a psychologist, psychiatrist, or neuropsychologist. Documenting behavior problems may help to qualify for SSDI - but more importantly may suggest some treatment options to help him improve his behavior and allow him to keep a job.
- Contact your state's Department of Rehabilitative Services. Most of these programs include return-to-work training and supportive employment services to help people successfully re-enter the work force. Perhaps they can suggest some programs that may be able to help your son.
- Contact your state's chapter of the Brain Injury Association and ask if they have any information to assist people in your son's situation. Also, you may find some useful advice in the FAQ section of this website.
My son had a car accident in Aug of 1994. He has a Traumatic Brain Injury with short-term memory loss and a speech deficit. We are trying to find him a job and the Department of Rehabilitative Services has been very helpful, but we are hitting brick walls right now. As soon as an employer finds out he has a deficit they say, "We'll call you!" We live in Chester, Virginia and I am trying to find a place where he can get out and see other people other than our family! Do you know of anyone available in the area or who I can ask in the area? Thank you for your help!
Pat has several ideas for you! A visit to a chapter of the Brain Injury Association of Virginia (in Richmond, 355-5748) can be a helpful source of support and education. There are also brain injury support groups in the Richmond, Virginia area. The Brain Injury Association will be able to provide you with contact information (I know there are groups that meet at Sheltering Arms Rehabilitation Hospital in Richmond). If you believe individual and/or family counseling might help, you could try contacting the Department of Physical Medicine and Rehabilitation at VCU at 828-9055 (They maintain this website). They offer counseling services on an outpatient basis and have experiencing in working with people struggling with return-to-work issues.