Helping Your Children Cope with TBI

The Defense Health Board, The Defense and Veterans Brain Injury Center and The Department of Veterans Affairs

Having a parent with TBI can be frightening for a child who looks to his or her parent to provide strength and safety. The parent with TBI may no longer act the same as he or she did before the injury.

Your family member/parent with TBI may be angry, depressed, or uncertain. As a result, the special parent-child bond that existed previously has changed.

Children may be confused and upset about what is going on. This could be due to worry about a parent’s condition or concerns about changes in their parents’ relationship. It could also be due to financial strains, or simply adjusting to the new “normal.”

It is important to recognize that your children are grieving, just as you are. They may withdraw from social activities with peers, have mood swings, become withdrawn or disruptive, do poorly in school, and show other behavioral problems.

Children also need time and space to be kids. Communicate with your child that he or she is not to blame for the TBI.

Some children may need to take on some caregiving tasks for the parent or for younger children in the family. Children who care for parents or other relatives experience considerable conflict over the reversal of roles between parent and child.

“Thankfully, they’re pretty adaptable, but still they’re kids, and that’s why we’ve had to seek counseling. My son is dealing with secondary post-traumatic stress disorder. He’s very terrified that every time my husband goes in the hospital, he’s not going to come home. So we deal with that. With my daughter, we’re kind of dealing with the teenage issues. Plus she’s pretty angry at my husband.

He’s not who he used to be. You know, I think the key is talking, keeping the lines of communication open, letting your kids express to you if they’re mad, angry, whatever it is. It’s okay. Emotions are okay. Do not hold it in because that’s going to make it worse in the long term.”
— Anonymous

Make sure any tasks that your child takes on — household chores, for example — are suitable for his or her age. Strive as much as possible to find other adults to help you, rather than relying on your children to play a major caregiving role.

You can help your children by explaining TBI in a way that they can understand (see below). Ask a health care provider to talk with your children.

Build new family routines, and keep an eye out for signs that your child is not coping well.

The table on page 34 offers some ways to explain TBI to children of different ages. If your child appears to be depressed for a long time or he or she begins taking on risky behaviors, seek professional help.

“When Tim was starting to read and do word finding, those games were fun activities for the kids to do with him. They took part in his recovery, and I think that involvement was probably the key factor that kept the children from getting resentful, from being isolated. The kids have told me since then that they had wanted to know about things sooner. They thought that we kept a lot of things from them.

I still think that there are some things kids at that age don’t really need to know and they learned things along the way that they were ready for. But they did want to know. They’re very intuitive. Sharing age-appropriate information meant that they still had a little control in their lives, too. They could then process why Mommy and Daddy had to be away and not go to the dark side of their imagination thinking their worlds were falling apart and not have a clue as to why. I think not discussing the issues is probably the worst thing you can do for your children. They don’t like being left in the dark.”
— Shannon M.

How Can I Tell My Child about TBI?

It is difficult to explain TBI to a child. Yet it is vital to tell your child what is going on. Some adults try to protect children from the truth because they think they are too young to understand.

Children of almost any age are aware that something is wrong and they want to know what is happening.

Communicate in an age-appropriate way what has happened to your family member with TBI. Protecting your children by withholding information may backfire. Children have active imaginations that may create a scenario worse than reality.

How you tell your child about TBI depends on the age of the child. The table on the next page offers strategies that you can use, depending on the age of your child.

“You know, it’s still a daily thing. TBI is definitely a hard thing to grasp. I think the hardest thing, especially for our teenage son, because maybe he is older, is that his Dad is 37 on the outside, but on the inside he’s younger. Our son is going to continue to get older and get more mature and grow up, and his Dad is kind of where he’s going to be.

I just think a lot of communication is the key. Ask them: Do you have questions? What are you struggling with today? What don’t you understand? We also go to therapy. I stressed to our son that this isn’t going to go away. This is a lifelong disability. We have to learn to deal with it and cope with it, and you can’t do it on your own. You cannot do it on your own.

Getting plugged in to support groups that are geared for TBI, seeking out counselors that know TBI and can give you strategies on how to deal with situations, those things are important. That’s what it’s about for us right now. It’s about getting the mental help and the feedback that we need and realizing that, really, we’re not alone.”
— Anonymous

What Are Specific Ways to Explain TBI to a Child?

Here are some suggestions for how to explain TBI to a child:

The brain is similar to the command station of a space ship. If a meteorite hit the command station, the crew would not be able to control what the space ship does. If the brain is hurt, it may send out the wrong signals to the body or no signals at all. A person with TBI may have a hard time walking, talking, hearing, or seeing.
The brain is the computer for the body. When injured, it doesn’t boot up properly, runs slower, has less memory, etc.
A broken bone will usually heal and be as good as new. A brain injury may not heal as completely. Even though the person with the injury may look the same, he or she may still be injured. These injuries might include having a hard time paying attention or remembering what you told him or her. He or she may get tired easily and need to sleep. He or she may say or do things that seem strange or embarrassing. He or she may get angry and shout a lot.
Many people develop anger as a direct effect of the damage to the brain. In other words, the parts of the brain that normally stop angry flare-ups and feelings have been damaged and do not do their jobs as well. The parent with TBI may be mad because he or she can’t do the things he or she used to do. His or her feelings may be hurt because others treat him or her differently than before the injury.
A cut may take a few days to heal, a broken bone a few weeks. Getting better after a brain injury can take months or even years. Sometimes, the person will not get 100 percent better.
Brain injury changes people. These changes can be confusing. Try to remember that the changes you see are caused by the brain injury. You can still love and care about the person.