by Diana Davis, OT
Member, American Occupational Therapy Association
Fiona experienced a traumatic brain injury (TBI) after a car crash on her 16th birthday. Fortunately, she recovered quickly and returned home and to school within two months.
Although things were different in ways that she could not describe, Fiona completed high school. At college, though, she struggled to meet academic demands, make friends, and succeed in her part-time job.
An occupational therapist (OT) working with her identified that Fiona was still experiencing complications from her brain injury. The OT evaluated Fiona’s high-level thinking skills, recommended accommodations for learning, and referred Fiona to the campus disability services office to implement the accommodations. The OT worked with Fiona to structure her daily routines to avoid cognitive fatigue and recommended a decrease in her work hours. Fiona and her OT identified strategies she could use to improve her memory for due dates and work responsibilities. The OT also helped Fiona make changes in her environment to decrease distractions when she studied. Group treatment helped Fiona improve her social and communication skills. Because even a mild concussion can have significant affects for individuals who have experienced traumatic brain injury, Fiona and the OT also discussed prevention of future TBIs.
Six months later, Fiona was able to manage her own symptoms and completed her first year of college. This was a great triumph for this promising young woman, and occupational therapy was a big contributor.
Preventing Teen Brain Injury
As an OT, I work with individuals to help them maintain or improve their health and wellness by participating in the simple daily and major life activities that they want and need to be able to do. OTs work in a variety of settings with clients of all ages, but I currently work with individuals who have experienced brain injuries.
For me, the prevention of brain injury in adolescents is of particular concern. And it’s an important topic to discuss during Brain Injury Awareness Month. Too often I have observed the life of teens and their families changed forever by brain injury, so I know how critical it is to decrease the incidence of this life altering injury.
A key part of preventing brain injuries is understanding what causes them. Among teenagers, motor vehicle crashes, assaults, and the head being struck by an object or another person are the leading causes of brain injuries resulting in emergency room visits, hospitalizations, and death.
Recently, sports and recreation–related TBIs have received a lot of attention due to awareness campaigns such as the from the Centers for Disease Control and Prevention (CDC). This increased awareness has resulted in an approximately 50% increase in emergency room visits for suspected brain injuries.
We also know that focusing on safe driving is crucial to preventing traumatic brain injuries. What does that include? Wearing seat belts, following graduated driver licensing rules that limit passengers and hours of driving, and limiting distractions while driving. Use of technology (including apps that block text-messaging), cars with advanced collision avoidance systems, and airbags can also be helpful. The use of helmets while operating other motor vehicles such as ATVS and while participating in recreational activities such as skiing, skate/snow boarding, and bicycling also lower TBI risk.
OT’s Role in Recovery
Despite best efforts at prevention, TBIs still occur, and they may be mild, moderate, or severe. Concussions are a mild brain injury and are the most common type of injury experienced by children and adolescents, accounting for 75% of brain injuries. Teens often recover quickly from concussion and are rarely hospitalized. However, discharge home doesn’t mean readiness to resume normal activities. Recent research has found that adolescents benefit from a controlled re-introduction to their normal activities, including school, sports, and socialization.
This is where occupational therapists play a vital role. OTs are specialists at analyzing activity and determining the level of demand it places on the recovering teen. OTs can assist parents in identifying when it’s time to resume activities. Controlled re–introduction to activities can assist in healing and prevent worsening of concussion symptoms that may occur when demanding activities are resumed too soon.
Brain injuries can cause disruptions in learning, memory, behavior, problem solving, risk awareness, and social skills. In adolescents, these skills are still developing, as the brain doesn’t fully develop until at least age 21. Recent research indicates that a brain injury can interrupt and/or disrupt normal development of the brain. This results in some difficulties persisting for years or not emerging until the individual is unable to meet the increasing complexities of adulthood. Fiona’s story is one of thousands that demonstrates the problem and how OT can help.
What You Can Do
Practitioners, parents, coaches, and youth can all be part of the prevention and treatment solution. Learn more about the , and about occupational therapy from NOYS member .