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Positively Managing Behavior Concerns After a Brain Injury by Charles Watson


Posted on February 13, 2020

TBI and ABI patients usually present chronic or inappropriate changes in behavior such as aggression, lack of initiation, agitation, or lack of sexual inhibition. These behavior changes are particularly challenging for the sufferer as well as for the people who support and care for them. Social isolation, relationship breakdown and dislocation from accommodation can result due to behavior changes which can be quite stressful too.

The Traditional Approach

The most frequent and well-known approaches to behavioral intervention for brain injury victims are designed to reduce some well-defined problem behavior(s). With the help of well-trained practitioners who prescribe strategies with great reliability, a positive and successful impact can be achieved on the sufferers for the rest of their life. 

Sometimes, however, the problems facing brain injury victims require more than the elimination of the problem and focus on the enhancement of the quality of life.

Positive Behavior Support (PBS)

PBS comprises of interventions that are hopeful, non-disability focused and optimistic about life possibilities. To develop a person’s sense of positive personal identity, improvements in meaningful engagement in chosen life activities are encouraged. Intervention strategies include the development of competent, self-regulated and satisfying activities that should begin in inpatient settings. 

The strategies are developed keeping in mind the chaotic realities of life that make the implementation of traditional behavioral interventions almost impossible. The myriad problems faced by brain injury victims are uncontrollable as they navigate the demands of life. 

The PBS guiding assumption is relatively simple in that when individuals’ needs are effectively met when they are involved in competitive and meaningful activities over which they have adequate control and healthy social relationships, their quality of life is enhanced, and problem behaviors decrease substantially.

Using a variety of cognitive, behavioral, and social support procedures to ensure positive participation, PBS interventions help support independent living and manage activities of daily living. 

Emerging technologies for pain management: Recent studies to improve outcomes for people with persistent pain include four main approaches. These include medications, nerve stimulation or surgical procedures, physical therapy, and pain management programs. 

Neuro stimulation is a new strategy that employs gentle electrical currents to stimulate the nervous system. Research shows that this may be a new ray of hope for people with the injured spinal cord.

Research is being conducted towards a holistic home modification design process for people with acquired or traumatic brain injury who require a change in their home environment. 

Telehealth for carers’ communication skills: The whole support network and not just the person with the injury, requires support in managing the consequences of TBI. A study into the feasibility and efficiency of using telehealth especially in rural or regional areas that do not have specialist brain injury services, was conducted. Researchers concluded that video conferencing is a potential tool for increasing diagnostic evaluation and communication for people with TBI and their carers.  

Vehicle modifications for drivers with disabilities and powered lower limb exoskeletons for spinal cord injury are some other areas of study that can help brain injury sufferers increase mobility and provide freedom to individuals with paraplegia.