A person with a brain injury may experience changes in behavior, including self-control, self-awareness and response to social situations. The following are common behavioral problems for a person with a brain injury, what you may see and suggested ways to help.
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PROBLEM & SIGNS
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WHAT TO DO
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Problem: Difficulty with self-control
Signs:
- Acts or speaks without all the information or without considering the consequences Impulsiveness or poor judgment
- Lack of inhibition Inappropriate comments to or about others
- Gets stuck on one idea or activity (perseveration)
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What to do:
- Limit the person’s choice of options.
- Suggest alternatives for behavior.
- Explain the reasons for tasks.
- Be fair in your expectations.
- Respond immediately to inappropriate ideas but
- maintain the original focus of the discussion. Encourage the person to slow down and think
- through tasks or responses.
- Provide supportive verbal and non-verbal feedback for reassurance.
- If undesired behavior occurs, calmly and confidently discuss the consequences in private. Praise and reward desired behavior.
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Problem: Impaired self- awareness
Signs:
- Lack of awareness of deficits and limitations (this is not typically intentional, but rather a common phenomenon following traumatic brain injury in particular)
- Overestimates abilities; underestimates problems
- Inaccurate self- image/self-perception
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What to do:
- Anticipate lack of insight.
- Prompt accurate self-statements.
- Use feedback generously and supportively.
- Give realistic feedback as you observe behavior
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Problem: Difficulty participating in or being part of social situations
Signs:
- Acts or speaks without all the information or without considering the consequences
- Difficulty taking turns
- Impulsiveness
- Socially inappropriate behavior or comments
- Not always sensitive to social boundaries
- Acting out of place in unfamiliar social or public settings
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What to do — before the event
- Provide clear expectations for desirable behavior in social settings or in special circumstances such as job interviews, attending a funeral, or going to church.
- Plan and rehearse social interactions so that they will be familiar, predictable and consistent.
- Establish verbal and non-verbal cues to signal the person to “stop and think.”
What to do —during the event
- Treat the person appropriately, according to
- age.
- Encourage the person to slow down and think through responses.
- Prompt the person to consider consequences of
- behavior.
- Provide positive feedback for appropriate behavior.
- Encourage a break in activity when frustration or fatigue are evident.
- Respond immediately to inappropriate ideas but
- maintain the original focus of the discussion.
- If undesired behavior occurs, calmly and confidently address the behavior in private. Be
- objective and explain that the behavior, not the person, is inappropriate
- Reassure and be fair in your expectations.
What to do — after the event
- Review the behavior, the effectiveness of verbal and nonverbal uses, and the overall success of the outing.
- Praise appropriate behavior and responses to cues and redirection.
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