Returning to Studies - Fact Sheet
Survivors of a brain injury who have
done very well in their recovery still face a major hurdle in
returning to their studies.
A number of factors will make this difficult after a traumatic
brain injury or similar brain disorder. First of all, short-term
memory will make it very hard to learn new material. School is
nothing but learning new things. Second, school has a fair amount
of fatigue associated with it. With a brain injury, people have
limited energy and may be good in the morning, but fade early in
the afternoon. Third, returning to school involves a social
dimension-people very desperately want to fit it with their peers.
For some people, having some friends that you can hang out with is
their number one priority in college or high school.
An injured brain may never be restored to pre-injury
capabilities but performance can generally be improved.
Difficulties are often experienced in the areas of attention and
concentration. It will be necessary to gradually build up tolerance
for concentration daily but this is not as simple as it sounds.
Keep periods of concentration short by allowing regular breaks.
Start with ten minutes and build up gradually with a few extra
LACK OF INSIGHT
Many students with an acquired brain injury have a lack of
insight regarding their level of ability, unable to recognise that
their performance and capabilities are functioning at a reduced
level. They may respond to negative feedback by believing that
teachers are against them, or other ways that allow them to believe
their performance is still normal.
LACK OF PLANNING AND ORGANISATIONAL
Planning and organisational skills can be impaired to the extent
that the student knows what he or she wants to do, but has
difficulty getting started. This means that the person will need a
very clear plan of how to go about carrying out a task. The first
step will be to stop and think - he or she will need time and
support to work out a plan by identifying the task, keeping it
simple and addressing one task at a time:
- Write down all the steps required to complete the task
- Sort out the list of steps in the order they are to be
- Treat steps as a self-contained goals and tackle them one at a
- As each step is completed, reinforce it as an achievement of
- Create a distinct break between each step
- Review each preceding step before moving onto the next.
SHORT-TERM MEMORY PROBLEMS
Most brain injuries will result in impairment of short-term memory
and the ability to retain or process new information. Students will
lose books and equipment, forget appointments and arrangements, ask
the same questions again and again, or forget which classroom they
are supposed to be in. Fortunately, there are ways to assist memory
and it can be an exciting challenge to work out new avenues to
compensate for problems. However, it is important that the students
are aided but not rescued from their own failing memory.
Common memory aids include:
- A diary to note all class times, appointments and
- A notebook to list common times and protocols
- A map of the school showing classrooms, toilets, offices, bus
- Clearly marked exercise books and equipment
- Thong necklace for keys
- Wristwatch with an alarm.
Students with poor memory will need to become familiar with using
memory aids and will need constant reinforcement. Other helpful
aids are clocks, calendars, blackboards, whiteboards, signs,
notices, photos, post-it notes, or anything that provides a
compensation to memory deficits.
Normally, people use their planning and organising skills to work
their way through confusion. However, because acquired brain injury
often results in some loss of these skills, it may be difficult for
a student with an acquired brain injury to deal with confusion.
Confusion usually comes about through:
- Unrealistic self-expectations e.g. the student may have a
memory of achievement that is inconsistent with their impaired
- The student's inability to recognise that a disability
- Others having too high an expectation of the student
- The student attempting to achieve too much at once
- Interruptions, noise, clutter or visual distractions around the
- Too many instructions being given to the student at the one
- Students should make their teacher aware of these issues and
see what changes can be made to minimise confusion.
STRESS, FRUSTRATION AND ANGER
A common trigger to personal stress is the feeling of
helplessness or being trapped in a situation over which we have no
control. Disciplined or authoritarian environments can add to
students' beliefs that they are deprived of alternatives. The
student should be able to choose from a number of options in
dealing with these emotions.
The 'triggers' for these emotions should be identified, and
where possible, avoided. When this isn't possible, relaxation and
meditation can act as good insurance policies. When high levels of
anger or aggression are imminent, the student should be able to
take time-out, having planned for this already with teachers. This
needs to be seen as an opportunity to restore balance and
perspective, not punishment.
Students with an acquired brain injury often do things on impulse.
Behaviours displayed are often a genuine case of innocently doing
what seemed to be a good idea at the time. Strategies should be
discussed with teachers so that undesirable behaviour can be
replaced with an agreed alternative. It is also helpful to agree on
a signal that the teacher can give as a sign for the student to
stop and think about what they are doing. It could be a word, or a
sign (e.g. arm up in the air). In time it will become an automatic
All educational institutions now have policies that make
allowances for people with disabilities in terms of time given for
tests and assignments. These institutions are frequently unaware of
the multiple impacts on a student's abilities such as short term
memory difficulties, mental fatigue, lack of concentration,
susceptibility to stress and lowered organisational ability.
Students should contact their Disabilities Officer to make suitable
arrangements for tests and assignments.
Many schools and universities will help you learn new material
if you let them know that you have a disability or send emails
There is still little awareness of brain injury in many
organisations so you may need to present this information to them
to acquaint them with this particular disability. It may help if
your doctor or neuropsychologist writes a letter to document that
you have a valid disability.
You will need to explain the accommodations or special help you
require, such as:
- Extra time assignments and examinations
- Exams in a quiet room without distractions
- Copies of teacher's notes if your concentration and attention
SOME STUDY STRATEGIES
Organising yourself will be crucial. Some useful suggestions to
- Have a balanced diet, good sleep and regular exercise
- Avoiding alcohol, cigarettes and other drugs
- Structure your days and week with a daily planner, diary or
- Use memory prompts such as notepads, alarms, post-it notes, and
a large notice board
- Experiment on study times, most do better in mornings than
- Structure your study times and stick to them no matter how you
- Make use of study groups or a 'study buddy'.
PATIENCE AND ENDURANCE
There are many resources available on good study techniques
which will be useful to students. Students with a brain disorder
such as a traumatic brain injury may take longer to learn these
strategies but the same benefits are available as the skills are
acquired. Most survivors say that learning compensatory strategies
is one of the hardest challenges in their lives, but one that has
made them better people when they did not give up.