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Returning to Studies - Fact Sheet

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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.


IMPAIRED CONCENTRATION

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 minutes daily.

 
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 SKILLS

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 achieved
  • Treat steps as a self-contained goals and tackle them one at a time
  • As each step is completed, reinforce it as an achievement of success
  • 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 instructions
  • A notebook to list common times and protocols
  • A map of the school showing classrooms, toilets, offices, bus stop etc.
  • 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.

 
CONFUSION
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 ability
  • The student's inability to recognise that a disability exists
  • 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 student
  • Too many instructions being given to the student at the one time.
  • 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.

 
IMPULSIVE BEHAVIOUR
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 process.

 
ALLOWANCES
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 to info@synapse.org.au. 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 are affected.

 
SOME STUDY STRATEGIES
Organising yourself will be crucial. Some useful suggestions to try are:

  • 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 electronic organiser
  • 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 evenings
  • Structure your study times and stick to them no matter how you feel
  • 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.

 

 

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