Links updated,July 2015
- En español | In Spanish
- See fact sheets on other disabilities
In This Publication:
- Susan’s story
- What is traumatic brain injury?
- How is TBI defined?
- How common is TBI?
- What are the signs?
- Is there help available?
- What about school?
- Tips for parents
- Tips for teachers
- Resources of more information
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Susan’s Story
Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She also hit her head very hard. The doctors say she sustained a traumatic brain injury. When she came home from the hospital, she needed lots of help, but now she looks fine.
In fact, that’s part of the problem, especially at school. Her friends and teachers think her brain has healed because her broken bones have. But there are changes in Susan that are hard to understand. It takes Susan longer to do things. She has trouble remembering things. She can’t always find the words she wants to use. Reading is hard for her now. It’s going to take time before people really understand the changes they see in her.
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What is Traumatic Brain Injury?
A traumatic brain injury (TBI) is an injury to the brain caused by the head being hit by something or shaken violently. (The exact definition of TBI, according to special education law, is given below.) This injury can change how the person acts, moves, and thinks. A traumatic brain injury can also change how a student learns and acts in school. The term TBI is used for head injuries that can cause changes in one or more areas, such as:
- thinking and reasoning,
- understanding words,
- remembering things,
- paying attention,
- solving problems,
- thinking abstractly,
- talking,
- behaving,
- walking and other physical activities,
- seeing and/or hearing, and
- learning.
The term TBI is not used for a person who is born with a brain injury. It also is not used for brain injuries that happen during birth.
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How is TBI Defined?
The definition of TBI below comes from the Individuals with Disabilities Education Act (IDEA). The IDEA is the federal law that guides how schools provide special education and related services to children and youth with disabilities.
IDEA’s Definition of “Traumatic Brain Injury”
Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines traumatic brain injury as…
“…an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.” [34 Code of Federal Regulations §300.8(c)(12)]
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How Common is Traumatic Brain Injury?
Approximately 1.7 million people receive traumatic brain injuries every year. (1) Ofchildren 0-19 years old, TBIresults in 631,146 trips to theemergency room annually,35,994 hospitalizations, andnearly 6,169 deaths. (2)
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What Are the Signs of Traumatic Brain Injury?
The signs of brain injury can be very different depending on where the brain is injured and how severely. Children with TBI may have one or more difficulties, including:
Physical disabilities: Individuals with TBI may have problems speaking, seeing, hearing, and using their other senses. They may have headaches and feel tired a lot. They may also have trouble with skills such as writing or drawing. Their muscles may suddenly contract or tighten (this is called spasticity). They may also have seizures. Their balance and walking may also be affected. They may be partly or completely paralyzed on one side of the body, or both sides.
Difficulties with thinking: Because the brain has been injured, it is common that the person’s ability to use the brain changes. For example, children with TBI may have trouble with short-term memory (being able to remember something from one minute to the next, like what the teacher just said). They may also have trouble with their long-term memory (being able to remember information from a while ago, like facts learned last month). People with TBI may have trouble concentrating and only be able to focus their attention for a short time. They may think slowly. They may have trouble talking and listening to others. They may also have difficulty with reading and writing, planning, understanding the order in which events happen (called sequencing), and judgment.
Social, behavioral, or emotional problems: These difficulties may include sudden changes in mood, anxiety, and depression. Children with TBI may have trouble relating to others. They may be restless and may laugh or cry a lot. They may not have much motivation or much control over their emotions.
A child with TBI may not have all of the above difficulties. Brain injuries can range from mild to severe, and so can the changes that result from the injury. This means that it’s hard to predict how an individual will recover from the injury. Early and ongoing help can make a big difference in how the child recovers. This help can include physical or occupational therapy, counseling, and special education.
It’s also important to know that, as the child grows and develops, parents and teachers may notice new problems. This is because, as students grow, they are expected to use their brain in new and different ways. The damage to the brain from the earlier injury can make it hard for the student to learn new skills that come with getting older. Sometimes parents and educators may not even realize that the student’s difficulty comes from the earlier injury.
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Is There Help Available?
Yes, there’s a lot of help available, beginning with the free evaluation of the child. The nation’s special education law, IDEA, requires that all children suspected of having a disability be evaluated without cost to their parents to determine if they do have a disability and, because of the disability, need special services under IDEA. Those special services are:
Early intervention | A system of services to support infants and toddlers with disabilities (before their 3rd birthday) and their families.
Special education and related services | Services available through the public school system for school-aged children, including preschoolers (ages 3-21).
To access early intervention:To identify the EI program in your neighborhood, ask your child’s pediatrician for a referral. You can also call the local hospital’s maternity ward or pediatric ward, and ask for the contact information of the local early intervention program.There, you can have your child evaluated free of charge and, if found eligible, your child can begin receiving early intervention services.
To access special education and related services: We recommend that you get in touch with your local public school system. Calling the elementary school in your neighborhood is an excellent place to start. The school should be able to tell you the next steps to having your child evaluated free of charge.If found eligible, he or she can begin receiving services specially designed to address your child’s needs.
In the fall of 2011, nearly 26,000 school-aged children (ages 3-21) received special education and related services in our public schools under the category of “traumatic brain injury.” (3)
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What About School?
Although TBI is very common, many medical and education professionals may not realize that some difficulties can be caused by a childhood brain injury. Often, students with TBI are thought to have a learning disability, emotional disturbance, or an intellectual disability. As a result, they don’t receive the type of educational help and support they really need.
When children with TBI return to school, their educational and emotional needs are often very different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes. The child’s family, friends, and teachers also recall what the child was like before the injury. These other people in the child’s life may have trouble changing or adjusting their expectations of the child.
Therefore, it is extremely important to plan carefully for the child’s return to school. Parents will want to find out ahead of time about special education services at the school. This information is usually available from the school’s principal or special education teacher. The school will need to evaluate the child thoroughly. This evaluation will let the school and parents know what the student’s educational needs are. The school and parents will then develop an Individualized Education Program (IEP) that addresses those educational needs.
It’s important to remember that the IEP is a flexible plan. It can be changed as the parents, the school, and the student learn more about what the student needs at school.
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Tips for Parents
Learn about TBI. The more you know, the more you can help yourself and your child. The resources and organizations listed below will connect you with a great deal of information about TBI.
Work with the medical team to understand your child’s injury and treatment plan. Don’t be shy about asking questions. Tell them what you know or think. Make suggestions.
Keep track of your child’s treatment. A 3-ring binder or a box can help you store this history. As your child recovers, you may meet with many doctors, nurses, and others. Write down what they say. Put any paperwork they give you in the notebook or throw it in the box. You can’t remember all this! Also, if you need to share any of this paperwork with someone else, make a copy. Don’t give away your original!
Talk to other parents whose children have TBI. There are parent groups all over the U.S. Parents can share practical advice and emotional support. Tolocate parent groups near you, including your Parent Training and Information Center, have a look at our short brief, Parent Groups.
If your child was in school before the injury, plan for his or her return to school. Get in touch with the school. Ask the principal about special education services. Have the medical team share information with the school.
When your child returns to school, ask the school to test your child as soon as possible to identify his or her special education needs. Meet with the school and help develop a plan for your child called an Individualized Education Program (IEP).
Keep in touch with your child’s teacher. Tell the teacher about how your child is doing at home. Ask how your child is doing in school.
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Tips for Teachers
Find out as much as you can about the child’s injury and his or her present needs. Find out more about TBI through the resources and organizations listed below. These can help you identify specific techniques and strategies to support the student educationally.
Give the student more time to finish schoolwork and tests.
Give directions one step at a time. For tasks with many steps, it helps to give the student written directions.
Show the student how to perform new tasks. Give examples to go with new ideas and concepts.
Have consistent routines. This helps the student know what to expect. If the routine is going to change, let the student know ahead of time.
Check to make sure that the student has actually learned the new skill. Give the student lots of opportunities to practice the new skill.
Show the student how to use an assignment book and a daily schedule. This helps the student get organized.
Realize that the student may get tired quickly. Let the student rest as needed.Reduce distractions.
Keep in touch with the student’s parents. Share information about how the student is doing at home and at school.
Be flexible about expectations. Be patient. Maximize the student’s chances for success.
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Resources of More Information
Basic Readings
American Academy of Family Physicians. (2010). Traumatic brain injury. Online at:http://familydoctor.org/familydoctor/en/diseases-conditions/traumatic-brain-injury.html
CDC | Centers for Disease Control and Prevention. (2010). Traumatic brain injury. Online at: www.cdc.gov/TraumaticBrainInjury/
Center on Brain Injury Research and Training. (n.d.). Traumatic brain injury: An overview (interactive learning module). Online at: http://www.cbirt.org/resources/interactive-learning-modules/
National Institute of Neurological Disorders and Stroke. (2014, July). NINDS traumatic brain injury information page. Online at: http://www.ninds.nih.gov/disorders/tbi/tbi.htm
Organizations
Brain Injury Association of America
Main website: http://www.biausa.org/
Find your state BIA affiliate:http://www.biausa.org/state-affiliates.htm
National Brain Injury Information Center: 1.800.444.6443 (brain injury information only)
National Resource Center for Traumatic Brain Injury (NRCTBI)
http://www.tbinrc.com/
TBI Educators
http://cbirt.org/resources/educators/
Brainline
Information available in English and Spanish.
info@BrainLine.org
http://www.brainline.org/
Center on Brain Injury Research and Training
http://cbirt.org/
Family Caregiver Alliance
Information in English, Spanish, Chinese, Korean, and Vietnamese.
https://caregiver.org/
TBI Recovery Center
http://www.tbirecoverycenter.org/
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References
1 | National Center for Injury Prevention and Control. (2012). Traumatic brain injury. Available online at the Centers for Disease Prevention and Control (CDC) website:http://www.cdc.gov/TraumaticBrainInjury/index.html
2 |CDC. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths, 2002–2006. Available online at: http://www.cdc.gov/traumaticbraininjury/pdf/blue_book.pdf
3 | Data Accountability Center. (2012). Data tables for OSEP state reported data.No longer available online.
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FAQs
What are the 4 types of traumatic brain injuries? ›
- Concussions. A concussion is a minor brain injury that is caused by an impact to the head, shaking, or a sudden change in movement, like whiplash. ...
- Brain Contusions. ...
- Penetrating Brain Injuries. ...
- Anoxic Brain Injuries.
Memory and reasoning impairment. Balance and sight changes. Difficulty with communication, expression, and understanding. Depression, aggression, anxiety, personality changes, and inappropriate behavior.
What are the five cognitive problems of TBI? ›Judgment, Reasoning, Problem-Solving, and Self-Awareness. Judgment, reasoning, problem-solving and self-monitoring are complex cognitive skills that are often affected after a TBI.
What qualifies as a traumatic brain injury? ›Definition. Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.
What are the long term effects of traumatic brain injury? ›Traumatic Injury Long-term Effects
“Trauma to the left side of your brain can cause problems with logic, speech difficulties, trouble understanding others or talking, versus right side injury, which can cause problems processing visual information, neglect, or apraxia - the ability to perform regular or familiar tasks.
Aggressive Behavior
Perhaps the most common personality change after a head injury is increased aggression. Studies have shown that around 30% of traumatic brain injury patients report struggles with anger and aggressive behavior.
An individual with TBI may have difficulty focusing, paying attention, or attending to more than one thing at a time. Difficulty concentrating may lead to restlessness and being easily distracted or they may have difficulty finishing a project or working on more than one task at a time.
Can a brain injury change who you are? ›“Any type of brain injury, regardless of severity, can cause personality changes — and some patients may not experience any personality changes at all,” said Dr. Thomas. For patients who do experience personality changes, common symptoms include: Becoming quick to anger or frustration.
Does TBI get worse with age? ›People with a moderate or severe traumatic brain injury can experience increased musculoskeletal deterioration with aging, more than occurs in the general non-traumatic brain injury population.
What is the best treatment for traumatic brain injury? ›Mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. However, a person with a mild traumatic brain injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms.
What is the most common traumatic brain injury? ›
Concussions are the most common type of TBI. You can take steps to lower your risk of accidents that cause TBIs.
What is the most common type of traumatic brain injury? ›Concussion is among the most common forms of TBI. A concussion can happen when the head or body is moved back and forth quickly, such as during a car crash or sports injury, or from a blow to the head. Concussions are often called “mild TBIs,” because they are usually not life-threatening.
What are the two most common brain injuries? ›Depending on the cause, there are two types of brain injuries: Traumatic Brain Injuries (TBI) and Non-Traumatic Acquired Brain Injuries (ABI).
What are the two types of traumatic brain injury? ›A closed brain injury is caused by a rapid forward or backward movement and shaking of the brain inside the bony skull that results in bruising and tearing of brain tissue and blood vessels. Closed brain injuries are usually caused by car accidents, falls, and increasingly, in sports.
Can you get disability for traumatic brain injury? ›Yes, you can receive long term disability benefits for a traumatic brain injury (“TBI”). A TBI is a serious and life-changing injury caused by a sudden blow to the head that damages the brain. Suffering a TBI can lead to physical and/or cognitive difficulties requiring intense rehabilitative care.
Can TBI cause problems years later? ›One thing we know for sure: people with moderate or severe TBI have multiple physical problems that can last for years. In fact, at least one-fifth of those with more severe injuries have reported difficulties with their physical health—in some cases decades later.
How long does it take to recover from traumatic brain injury? ›The majority of patients with mild TBI have these symptoms and recover completely in a week to three months. If you are older than 40, it may take a bit longer to return to normal. Symptoms often disappear without any special treatment.
How long do traumatic brain injuries last? ›In fact, depending on the severity of the injury, recovery time for a TBI may vary from a few weeks to six or more months. Each person reacts differently to injury and illness. Thus, recovery time will vary between individuals. However, the length of recovery time for TBI depends on how long a patient is unconscious.
Can TBI be treated years later? ›The effects of moderate to severe TBI can be long lasting or even permanent. While recovery and rehabilitation are possible, most people with moderate to severe TBI face life challenges that will require them to adapt and adjust to a new reality.
Can a traumatic brain injury cause mental illness? ›According to a study being presented at the 2018 American Academy of Pediatrics National Conference & Exhibition, these injuries have long-term consequences; researchers found children who experience traumatic brain injury are at higher risk of developing headache, depression, and mental or intellectual disorders up to ...
Can a brain injury cause narcissism? ›
The answer to the question: Can a brain injury cause narcissistic personality disorder? If yes; there are cases that show that narcissistic personality disorder is caused by head trauma.
What are the long term effects of frontal lobe damage? ›Changes in personality, emotion, mood, and social behavior control have frequently been associated with frontal lobe damage.
How do you love someone with brain injury? ›- Educate Yourself and Others. The effects of brain injuries are diverse and unpredictable. ...
- Stay Organized. ...
- Be Patient. ...
- Reduce Stress. ...
- Go Places. ...
- Keep the Environment Safe. ...
- Be Supportive.
Life after a brain injury may never be the same as before but adjusting and living a fulfilling life is possible.
How does brain injury affect personality? ›Many people suffer from social anxiety, irritability, anger, depression, feelings of overwhelm, general anxiety, mood swings, or emotional lability (teariness) after their injury. But make no mistake: While these symptoms can make it seem like you're a different person now, your personality is intact.
How does traumatic brain injury affect behavior? ›Brain injuries can have significant effects on behaviour, impacting impulse control and self awareness. These effects stem from damage to areas of the brain that regulate emotions and impulses and include anger, impulsive behaviour, self-centeredness, impaired awareness and even violence.
Why do brain injuries cause anger? ›A brain injury can damage areas of the brain involved in the control and regulation of emotions, particularly the frontal lobe and limbic system. Other effects of a brain injury can lead to irritability, agitation, lowered tolerance and impulsivity, which also increase the likelihood of angry outbursts.
How much disability do you get for TBI? ›If the Veteran's TBI residuals qualify as “total” severity in any of the facets, then the veteran is entitled to a 100 percent disability rating. If the highest level of severity is a 3, then the disability rating will be 70 percent. If the highest level of severity is a 2, then 40 percent will be assigned.
Can a TBI cause dementia? ›Another study conducted by researchers at Umeå University in Sweden also found that TBI is a risk factor for dementia and revealed that the risk of a dementia diagnosis was highest during the first year after the injury.
Is traumatic brain injury permanent? ›While damage to the brain following a traumatic brain injury is permanent because damaged brain cells cannot regenerate or repair themselves, there is hope for functional recovery. This is because functions affected by TBI may be rewired and improved by healthy brain cells.
What is a level 3 brain injury? ›
Grade 3: A severe diffuse axonal injury with finding as Grade 2 and additional focal lesions in the brainstem.
What do occupational therapists do for TBI? ›A TBI can affect a variety of physical, cognitive, and psychological functions such as memory, emotional regulation, movement, and sensory processing. An occupational therapist will assess your functional abilities and create a personalized rehabilitation regimen to help you regain or compensate for these skills.
What is the most common type of traumatic brain injury? ›Concussion is among the most common forms of TBI. A concussion can happen when the head or body is moved back and forth quickly, such as during a car crash or sports injury, or from a blow to the head. Concussions are often called “mild TBIs,” because they are usually not life-threatening.
What is the most common traumatic brain injury? ›Concussions are the most common type of TBI. You can take steps to lower your risk of accidents that cause TBIs.
What are the 3 main categories of a head injury? ›- Concussion. A concussion is an injury to the head area that may cause instant loss of awareness or alertness for a few minutes up to a few hours after the traumatic event.
- Skull fracture. A skull fracture is a break in the skull bone. ...
- Intracranial hematoma (ICH).
Physical injuries are among the most prevalent individual traumas. Millions of emergency room (ER) visits each year relate directly to physical injuries.
What is the best treatment for traumatic brain injury? ›Mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. However, a person with a mild traumatic brain injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms.
Does TBI get worse with age? ›People with a moderate or severe traumatic brain injury can experience increased musculoskeletal deterioration with aging, more than occurs in the general non-traumatic brain injury population.
How long does a traumatic brain injury last? ›In fact, depending on the severity of the injury, recovery time for a TBI may vary from a few weeks to six or more months. Each person reacts differently to injury and illness. Thus, recovery time will vary between individuals. However, the length of recovery time for TBI depends on how long a patient is unconscious.
What are the two types of traumatic brain injury? ›A closed brain injury is caused by a rapid forward or backward movement and shaking of the brain inside the bony skull that results in bruising and tearing of brain tissue and blood vessels. Closed brain injuries are usually caused by car accidents, falls, and increasingly, in sports.
Can TBI cause problems years later? ›
One thing we know for sure: people with moderate or severe TBI have multiple physical problems that can last for years. In fact, at least one-fifth of those with more severe injuries have reported difficulties with their physical health—in some cases decades later.
Does traumatic brain injury qualify you for disability? ›Yes, you can receive long term disability benefits for a traumatic brain injury (“TBI”). A TBI is a serious and life-changing injury caused by a sudden blow to the head that damages the brain. Suffering a TBI can lead to physical and/or cognitive difficulties requiring intense rehabilitative care.
What is a level 3 brain injury? ›Grade 3: A severe diffuse axonal injury with finding as Grade 2 and additional focal lesions in the brainstem.
What type of brain injury causes memory loss? ›Head injuries that cause a concussion, whether from a car accident or sports, can lead to confusion and problems remembering new information. This is especially common in the early stages of recovery. Mild head injuries typically do not cause lasting amnesia, but more-severe head injuries may cause permanent amnesia.
Does a TBI reduce life expectancy? ›Even after surviving a moderate or severe TBI and receiving inpatient rehabilitation services, a person's life expectancy is 9 years shorter. TBI increases the risk of dying from several causes. Compared to people without TBI, people with TBI are more likely to die from: 57% are moderately or severely disabled.
How do you talk to a trauma victim? ›- Give them time. Let them talk at their own pace – it's important not to pressure or rush them.
- Focus on listening. ...
- Accept their feelings. ...
- Don't blame them or criticise their reactions. ...
- Use the same words they use. ...
- Don't dismiss their experiences. ...
- Only give advice if you're asked to.
According to Dr. Prewitt, some specific examples of trauma dumping include: A coworker sharing specific details of a difficult divorce while at a casual lunch with colleagues. A friend sharing details of a toxic relationship, without allowing the other person to talk about their day.
What can trauma lead to? ›Studies suggest that trauma could make you more vulnerable to developing physical health problems, including long-term or chronic illnesses. This might be because trauma can affect your body as well as your mind, which can have a long-term impact on your physical health.