Acquired brain injury
disability; brain; damage; trauma; acquired; injury; head; fall; meningitis; encephalitis; epilepsy; handicap; traumatic; injuries ;
An acquired brain injury refers to any damage to the brain that occurs after birth. Trauma to the head is the most common cause of acquired brain injury in children.
Injuries often occur in childhood. Usually, these injuries heal with time and do not cause lasting problems. However, some injuries to the brain may alter a child's thinking and behaviour.
Health professionals and educators can help families of a child with an acquired brain injury. There are also support groups and specialist agencies who understand the effects of acquired brain injury. There is more information about these in South Australia and Australia in the topic 'Acquired brain injury - resources'.
If a child has a hard blow to the head, seems dazed or loses consciousness (even briefly), see your doctor. Also consult your doctor if your child seems unwell or begins to vomit after a hard blow to the head. Call an ambulance if your child is unconscious and do not leave the child alone.
What is an acquired brain injury?
- An acquired brain injury refers to any damage to the brain that occurs after birth.
- It can change the way the person acts, thinks or behaves.
- Certain types of acquired brain injury may cause intellectual disability and/or physical disability.
- Acquired brain injury can also cause communication problems and mood changes.
Causes of acquired brain injury
There are a number of causes of acquired brain injury.
- Trauma to the head is the most common cause of acquired brain injury in children.
- Trauma means that an injury to the brain has been caused by a blow to the head, such as falling, motor vehicle accident, bicycle accident or being hit on the head, or by being shaken (have a look at the topic 'Never shake a baby').
- Children may be unconscious for a short time, or if the injury is more severe they may be in a coma for hours, or days, or longer.
- The type and amount of brain injury will depend upon the severity and location of the blow.
- A stroke (a clot in a blood vessel in the brain or cerebral haemorrhage (bleeding in the brain)) is the most common cause of acquired brain injury in adults.
- Anoxic injuries happen when the brain does not get enough oxygen. This can happen as a result of near-drowning, suffocation, electrocution or heart failure.
- Tumours (including cancers) that grow in the brain are another cause of acquired brain injury. The type of injury to the brain depends on the size of the tumour, what part of the brain is affected, the age of the child and the treatment needed. Treatment for brain tumours such as chemotherapy, radiotherapy or surgery, can also cause brain injury.
- Treatment needed for problems in other parts of the body (such as for cancers) may injure the brain.
- The injury may happen as a result of infections (such as meningitis and encephalitis).
- Drug abuse (such as alcohol abuse) or poisoning (such as lead poisoning) can cause brain injury.
Effects of acquired brain injury
An acquired brain injury may affect a child's development.
- The effects of an acquired brain injury will depend on how bad the injury was, the part of the brain that has been affected and how old the child was at the time of the injury.
- Brain injuries can be mild, moderate or severe.
- Usually there is some improvement in how the brain works after an injury, but the person may not fully recover.
- In some cases, acquired brain injuries will have a small (subtle) effect on a child's learning and behaviour. In others, the effects will be more wide ranging and there may be a physical disability.
The age of children at the time of the injury will affect their future development. There are important factors to consider for any child who has a brain injury.
- A brain injury in children under two years may permanently affect the development of speech, language and control of movement (eg causing cerebral palsy).
- A brain injury in young children may affect the development of other important processes that are part of thinking, learning and social skills.
- Problems with the development of important foundation skills (skills that are needed before a child can learn other skills) may lead to general and specific learning difficulties later in life.
- Older children often lose skills in some areas but not all areas (eg they may lose the control of one leg or arm but not all limbs as in cerebral palsy in a younger child).
- Older children will be more aware of the effects of their injury and will know that they have 'lost' skills. Social and emotional problems may happen because of this and because of the length of time spent in hospital away from their friends.
- In children between the ages of nine and fifteen, brain injury may interrupt the development of complex thinking. This may make it difficult for these children to learn to organise and plan ahead or to understand how ideas relate to each other.
- Older children may be more willing to do whatever is necessary to help their recovery.
Changes to thinking and behaviour
Changes to a child's thinking and behaviour may be evident in many ways. Often parents and teachers will notice changes in a child's:
- memory (there may be gaps or lapses)
- ability to plan and complete tasks (concentration is poor)
- judgement (working things out)
- ability to think in complex ways
- balance and ability to move skilfully
- sense of time
- ability to think clearly
- personality (including mood swings, depression and anxiety)
- understanding of speech and language
- health (including the onset of epilepsy and changes to weight or growth rates).
The effects of some brain injuries may not be obvious at first, and they vary from child to child. This means parents, families and teachers will need to think about what changes have happened to each individual child. They may also need to change their expectations of the child because of the brain injury.
Can it be cured?
- People who have an acquired brain injury may recover fully, but for some there will be long term effects on what they can do, and how they behave and feel.
- Recovery from this type of injury may take a long time.
- For some children, recovery of individual cognitive (thinking) skills will be patchy and uneven. This may happen to your child's physical, communication, emotional or social skills as well.
What you can do
You will feel many different emotions as a result of your child's brain injury. Many parents feel shock and disbelief, anger, self-blame, despair, frustration and sorrow. It is quite normal to have any and all of these reactions and they may last for many years.
There are many things that you can do at different stages of your child's recovery. However, it is always important to take care of yourself as well as to look after the needs of your child, family and friends.
- Some families find it helpful to keep a diary of what happens during their child's recovery period. Older children with a brain injury can find it useful to read about their recovery at a later time.
- Your child may seem quite different after a brain injury. You may wish to speak to health professionals or other parents about your feelings about this.
- Often you will be asked to provide support and comfort to your recovering child, other children in the family and to friends. This may be at the same time that you are dealing with strong feelings of your own. Ask for help from health professionals. It is part of their job to support parents in your situation.
- Your child may spend a long time in hospital. You can help by bringing familiar toys and posters from home.
- Try to develop a routine between home time and hospital visits.
- Ask hospital staff for information about rehabilitation (the ongoing management of injuries and disabilities after the accident) and support services once your child leaves hospital.
- Be involved in the decisions made about your child.
- Remember that the pattern of recovery is different for each child. Professionals may not be able to give answers to all of your questions.
- Keep asking questions.
- Encourage friends to visit. However, in the early stages of your child's recovery, visits may need to be kept short. Visitors should be asked to follow some predictable routines and should avoid giving your child too much 'new' information to deal with.
Once your child is home
- Try to keep in regular contact with friends and family.
- Organise a roster with family members for hospital or therapy appointments.
- Look after your own health and well-being.
- Contact and join support organisations. A number of helpful support groups and specialist agencies in Australia and in South Australia have been listed in the topic Acquired brain injury - Resources.
- Remember that your child's recovery will take time.
Preschool and school
- Preschools and schools should make every effort to meet your child's support needs.
- Staff can be more helpful if you give them information about the injury and any other relevant medical information.
- Remember to give new teachers this information.
- Update the information every year or when there are important changes to your child's condition.
- The children in your child's class may need information about brain injury in order to understand what is happening.
- Disability Connect
diSAbility connect is for parents and carers of children and young people with disability living in South Australia. It provides a gateway to help you to find information about your child’s disability and to existing information on programs, services, benefits and payments that may help you to care for your child.
- Brain Injury Network of South Australia (BINSA)
Address: Torrens Building, 220 Victoria Square, Adelaide, 5000
Tel. 8217 7600
Country callers: 1300 733 049 (for the cost of a local call)
For a more comprehensive list of resources in South Australia, and books about head injuries, see the topic Acquired brain injury - Resources
References and further reading
Brain Injury Australia, 'Students with acquired brain injuries in primary and secondary schools', Canberra, 1994
Clare L & Wilson BA, 'Coping with memory problems', Thames Valley Test Company, Suffolk, United Kingdom, 1997.
Mira MP, Tucker BF & Tyler JS, 'Traumatic brain injury in children and adolescents: A source book for teachers and other school personnel', Pro-ed, Austin, Texas, USA, 1992.
Singer G, Glang A & Williams JM (eds), 'Children with acquired brain injury: Educating and supporting families', Paul H Brookes, Baltimore, USA, 1996.
Prepared in collaboration with:
Department of Education, Training and Employment
Ministerial Advisory Committee on Students with Disabilities
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your child's sex.