Brain injury information for employers
Accommodations in the
workplace are simply adaptations that allow a person with a
disability to work effectively.
In many countries, employers are required by legislation to make
reasonable accommodations in the workplace for employees with a
A brain injury can result in a combination of disabilities which
may require accommodations, but these are typically low cost
and easy to implement.
The important questions
- What are the limitations caused by the brain injury?
- How much do they affect the person and their performance?
- What specific tasks will be affected?
- Has the person been asked about their accommodation needs?
- What accommodations are available?
- Will the person be asked about their effectiveness?
People who have brain injuries may develop some of the following
Physical limitations could
result in using ramps, handrails, and providing disabled parking
spaces. All pathways of travel can be cleared of any unnecessary
equipment and furniture.
Visual problems can be
accommodated by written information in large print, powerful
fluorescent lights, increased natural lighting and providing a
glare guard for computer monitors. Consult a vision specialist
particularly with someone who has lost part of or all of their
Maintaining stamina during the
workday is possible with flexible scheduling and
allowing longer or more frequent work breaks. Provide additional
time and a self-paced workload to learn new responsibilities.
Provide backup coverage for when the employee needs to take breaks
and allow time off for counselling. Make room for the use of
supportive employment and job coaches if required. Allow the
employee to work from home during part of the day and provide for
Maintaining concentration is
easier if distractions in the work area are reduced. Typical
accommodations include providing space enclosures, a private office
or allowing use of white noise or environmental sound machines.
Increase natural lighting and reduce clutter in the employee's work
environment. Let the employee play soothing music using
Plan for uninterrupted work time and divide large assignments into
smaller tasks and steps. Try restructuring the job to include only
Difficulty with organization &
deadlines can be reduced by encouraging the use of
daily 'to do' lists and checking items off as they are completed.
Use several calendars to mark meetings and deadlines and remind the
employee of important deadlines via memos, email or weekly
supervision. Use a watch or pager with timer capability or an
electronic organizer. Divide large assignments into smaller tasks
and steps and assign a mentor to assist the employee in determining
goals and providing daily guidance. Schedule weekly meetings with
the supervisor, manager or mentor to determine if goals are being
Memory deficits can be managed by
allowing the employee to tape record meetings or provide type
written minutes of each meeting. Use notebooks, calendars, or
sticky notes to record information for easy retrieval and provide
written as well as verbal instructions. Allow additional training
time and provide environmental cues to assist in memory for
locations of items, such as labels, colour coding, or bulletin
boards. Post instructions over all frequently used equipment.
Problem-solving deficits are common after
a brain injury but can be accommodated in various ways. Provide
picture diagrams of problem solving techniques such as flow charts.
Restructure the job to include only essential functions and assign
a supervisor, manager or mentor to be available when the employee
Working effectively with
supervisors can be accommodated by providing positive
praise and reinforcement. Written job instructions and clear
expectations of responsibilities and the consequences of not
meeting them are very helpful. Allow for open communication to
supervisors and establish written long term and short term goals.
Develop strategies to deal with problems before they arise and
develop a procedure to evaluate the strategies' effectiveness.
Difficulty handling stress and
emotions can occur after a brain injury. Provide praise
and positive reinforcement and refer to counselling and employee
assistance programs if required. Allow telephone calls during work
hours to doctors and others for needed support. Provide sensitivity
training to co-workers and allow the employee to take a break to
use stress management techniques to deal with frustration.
Attendance issues might arise
from regular medical appointments or due to managing fatigue.
Provide flexible leave for health problems. Provide a self-paced
work load and flexible hours. Allow employee to work from home or
provide part-time work schedule.
Issues of change
can arise after brain injury to due needing more time to adapt
to changes. Keep open channels of communication between the
employee and the new and old supervisor in order to ensure an
effective transition. Provide weekly or monthly meetings with the
employee to discuss workplace issues.
Examples of accommodation
A police officer returned to work following surgery for a brain
aneurysm. He had partial paralysis to the left side and could no
longer use both hands for word processing. He was transferred to a
vacant position that involved computer research, and was provided a
A professional returning to his job was unable to read past the
midline when reading from left to right on the computer screen.
Accommodation suggestions included: changing the margin settings of
his word processing program for 80 to 40 to limit right side
reading, or to purchase software that could split the computer
screen left to right and black out the right side; redesign his
workstation to place equipment on the left; and provide task
A therapist with short-term memory problems had difficulty
writing case notes from counselling sessions. Accommodation
suggestions included: allowing the therapist to tape record
sessions and replay them before dictating notes, to schedule 15
minutes at the end of each session to write up hand written notes
and to schedule fewer counselling session per day.
A labourer working in a noisy factory had difficulty
concentrating on job tasks. Accommodation suggestions included:
erecting sound absorbing barriers around his work station, moving
unnecessary equipment from the area to reduce traffic, and allowing
the employee to wear a headset or ear plugs.
References and further information
Many thanks to the Job Accommodation Network for their kind
permission to adapt an article from their website. The original
article written by Kendra M. Duckworth can be viewed at http://www.jan.wvu.edu/media/BrainInjury.html.