Acquired Brain Injury (ABI)

Pending RCH approval

The Condition's Effects on the Child / Young Person

Effects on the individual

In general, most people will experience increased fatigue (mental and physical) and some slowing down in the speed with which they process information, plan and solve problems. They may experience changes to their behaviour and personality, physical and sensory abilities, thinking and learning. ABI can also cause difficulties with motivation, insight, problem-solving, body temperature control, and hypersensitivity to sound, light and movement.

The effects of a brain injury can be differentiated as primary effects (things that happen to the brain as a result of the trauma) and secondary effects (things that might happen afterwards).

Primary effects

A closed head injury will effect the brain of a child differently to how it effects the brain of an adult. The reasons are not fully understood. Often young children have a better capacity to survive a closed head injury because a child’s skull is soft and the bones are not fully fused. When the bones are not fused they can provide a greater cushion for the brain upon impact.

Sometimes when the head is hit from one direction the brain is pushed into the skull on the opposite side. This push of the brain against the skull is called contre-coup damage. Contre-coup damage is far less common in children than in adults.

When there is a specific point of injury to the brain the injury is described as focal damage. Focal damage may occur if there has been penetration of the brain, such as may occur in a depressed skull fracture. Focal damage is relatively uncommon in children as compared to adults because of the differences in the anatomy of the brain between adults and children.

Secondary effects

In children as well as in adults, bleeding may occur either in the brain itself or in the spaces surrounding the brain.

Secondary effects may develop following the initial injury caused by a trauma. One effect that is more common in children than adults is widespread swelling of the brain.

Bleeding in the brain is described as a haematoma. In children, because the injury is usually more diffuse, large haematomas within a particular part of the brain do not occur very often.

(For further information about Brain Injury (TBI) see the Headway Victoria Changed Lives kit module Understanding Traumatic Brain Injury) by logging on to www.headwayvictoria.org.au or by telephoning Headway Victoria. See contact details in 'ABI - Further Resources' section.

Effects on those close to the child / young person

The effects on a family

When a family member suffers a brain injury, people have to come to terms with the changes to the family caused by the injury, as well as the changes to the person.

A family member can be anyone who has a primary relationship with the person with the brain injury. A family member can be a mother or father, or a sibling or a very close friend or an aunt or a girlfriend or boyfriend. When a person is involved in a traumatic event, many people will be distressed. It is important they receive the respect they deserve – anyone who loves the injured child will be hurt as well, and their recovery is closely linked to the recovery of the child.

There is enormous stress on everyone who is close to an injured child. People feel pain, anger, confusion and grief, as well as regret about how and why the event occurred. Blame will neither change the situation nor help a person to adjust to the trauma and stress of the event.

Help for families

Some family members or friends or whole families may wish to seek the assistance of psychologists or social workers to enable them to adjust to the trauma and the radical changes that may need to be made. Talking to an outside person may give a fresh perspective to the situation and can be non-judgmental. Some people find this useful.

For information about how a brain injury can affect the other members of the family see the Headway Victoria Changed Lives Kit booklet: Personal Journeys. For information about getting assistance for difficulties that may occur call Headway Victoria on 9642 2411 or The Brain Foundation of Victoria on 9845 2950. The Bouverie Centre offers specialist counselling for families affected by acquired brain injury, they can be contacted on 9376 9844.

Taking care of friends and siblings

Some behaviour by the child with injury may disturb other children. They may already be distressed about what has happened and worried about the outcome. Often children feel enormous guilt when a sibling or friend has been injured. For no logical reason, they may even feel responsible. Some children will want to visit their sister or brother and some may withdraw. Either of these responses is fine. The best environment around the child with the injury is one that is stress free and as peaceful as possible.

There is no single right way to react to a traumatic event. People - adults and children, may not have a choice on how to react. Everyone is affected and everyone is on a path to recovery from that trauma. For further information about Coma and PTA see the Headway Victoria Changed Lives kit module Acute Care by logging on to www.headwayvictoria.org.au or by telephoning Headway Victoria.

"In their shoes" -
stories from children / young people with the condition,
or those close to them

Parent of a child with ABI

‘He used to do really well at school. Then his marks dropped, his friends changed and he started sneaking out at nights, drinking and goodness knows what else. Finally he was kicked out of school. We didn’t realise, for some time that all these problems were caused by his injury. He couldn’t keep up at school, kept getting lost, didn’t understand what the teacher was asking him to do. So he used to spit the dummy.

Now we have a plan. We get help from a psychologist and the school has been fantastic. He’s doing much better - not the same, but much better.’

Excerpt taken from the extensive resource provided by Brain Foundation Victoria:
Growing up with Acquired Brain Injury: A Guide for Parents - available online at http://www.brainfoundation.org.au/abi/home.html

Adolescent with ABI

" I got sick with meningitis.  I recovered from that but I have never got back to being the same.  I spend all my time at home and I no longer see my old friends.  Sometimes people ask when will I get better but I don't think I will ever get better. "

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