Parent's Guide: building social skills, brain injury & your child
Young people learn their social skills from their
day-to-day activities in the family, at school, at play, and in the
various groups and clubs they may be part of. Children and young
people with a brain injury may have difficulty with the social
skills that most of us take for granted.
A traumatic brain injury or similar brain disorder
can cause children to interact in ways that aren't
socially appropriate - being tactless, poor at 'reading' social
cues, talking too much, interrupting, or seeing the world only from
their own point of view. Other social skills may be lacking -
simple things such as using eye contact appropriately or they may
be excessively friendly and accepting, hugging near-strangers and
willing to trust and go with anybody.
They can be at risk of becoming socially isolated and cut off
from friends and the normal things kids do together. Bullying or
teasing can sometimes become a problem due to being impulsive and
less able to judge social situations. Don't hesitate to contact the
school if you suspect bullying.
Understand your child's strengths and weaknesses in social
skills, cognition and language. Be prepared to alter some of the
ways you do things.
Think about how you feel when your child behaves in ways that are
socially difficult. Becoming angry isn't helpful so recognize your
frustration, embarrassment, or anger. Set specific rules and
practice these skills many times, in a range of different
Don't draw attention to an inappropriate behaviour by reacting
strongly to it. Always praise or reward the behaviours and skills
you are trying to encourage.
Think about when the difficulties happen. Often you can improve
things substantially by adapting what you and your family do and
when you do it.
Try using 'problem solving' techniques (a simplified version if
necessary) with your child to find ways around difficulties.
Help your child to rebuild social networks and friendships by
asking other children to your house, and talking to the school
about building friendship networks.
One strategy that has proved helpful for some young people is
"stop, think, do". Use a traffic light image-red, amber, green-to
help the young person stop before reacting.
Help and encourage your child to get involved with other groups
in the community.
Professional help and advice can be very valuable. Look for a
professional who has expertise and experience in working
with brain injury - ideally a
neuropsychologist or clinical psychologist. If you can't find a
psychologist, talk with other health professionals and/or parents
to find out what might be available to you in your local area. Some
schools and community health centres offer young people group
training programs in social skills, and these programs can be of
benefit to some young people with a brain injury.
THINKING, FEELING, BEHAVING- OTHER STRATEGIES
Young people with a brain injury often
have difficulties that affect their thinking, their feelings, and
their behaviour. The best results come when parents, teachers and
health professionals understand these difficulties and work
together on a program.
Measures to help a young person overcome their difficulties
require lots of repetition, practice and reinforcement. The child
may find it very difficult to carry that skill into a different
situation - to 'generalize' it. It may have to be dealt with
A memory aid is anything that can be used as a reminder such as
a diary or notes.
A cue is a 'signal' like a hand gesture for someone to start or
stop doing something.
A prompt is a reminder to do something, such as a note in a
homework diary, a note on the fridge door - it can take many
Role playing is a bit like taking a part in a play - the person
gets a chance to practice how to behave in certain situations.
Behaviour management provides a system for 'rewarding'
behaviours we want to encourage and not rewarding (or ignoring)
those we want to discourage.
To generalize is to use appropriately, in a new situation,
something the person has already learned in a different
A PROBLEM SOLVING APPROACH
'Problem solving' is a positive approach to dealing with
difficulties; one that breaks the process into separate, manageable
steps. A problem solving approach can:
- Help you and your child decide which problems should be tackled
- Provide you with something concrete and positive to do, when
faced with a problem.
People who use problem solving regularly, for small, everyday
problems, find that it becomes a way of thinking. The approach is
detailed, and takes time and commitment from everyone involved.
There are six steps of problem solving:
1. Define the problem
Work with others to identify the main problem. If you can't agree
on the main problem, negotiate a compromise. Pick one problem.
Avoid being overwhelmed by trying to solve lots of related problems
at once. Be specific. Try to separate facts (the description of the
situation) from the issues these raise (why the situation feels
like a problem).
2. Brainstorm options
Search for anything that might offer a solution. List on paper as
many new options as possible, even silly ones - and don't make any
judgements yet. Just write them down. Get ideas from solutions that
have worked only in part, or not at all. Be specific about what a
particular solution involves and get options for different aspects
of the problem.
3. Select what might work
Eliminate options with less chance of working, and options that
some people don't agree with. Give everyone involved a chance to
comment. Try to pick the solution that will make the most
difference now, or 'take the pressure off'. Try to understand the
meaning of the behaviour. Be prepared to try an option for a while.
Don't give up on it too quickly.
4. Put a plan into action
Many plans fail because people don't carry out their part or
because there's no coordination. It's often easier if there's a
written summary and one person takes responsibility for checking
that everything is happening as agreed.
5. Review what happened
People often forget to reflect on how well a plan is going -
sometimes because the problem 'disappears' but usually because
everyone gets caught up in something else.
Get the opinion of everyone involved and be as objective as
possible about what's worked and what hasn't. Use this new
information in future attempts to solve the problem. Acknowledge
6. Keep going
Most problems aren't neatly resolved, and new ones can spring up.
Information from the first round of problem solving must be used to
fine-tune solutions and solve other problems. Remember that problem
solving skills must be learned and practiced.
KEEPING THE COMMUNICATION LINES OPEN
Good communication skills are one of the greatest assets you and
your family can have. Many aspects of communication can be
disrupted by a brain injury. These are things we learn
in all our interactions with other people, in the family, at school
and elsewhere. A person with a brain injury
may need special training to master some elements of these
- Difficulty talking about things in a general or abstract way so
use more concrete or descriptive terms
- Be prepared to ignore repetitions or wandering off the point,
and gently redirect the conversation if it seems to be 'getting off
- Respond positively and sound interested when you are talking
with the young person
- Stay calm - don't let yourself get angry or aggressive.
Speech pathologists, found in most public hospitals and community
health centres or through school support services, can assist
individuals with a brain injury and families
with the development of communication skills after a
Attention and listening
The first requirement is that you focus your attention on the
other person. This entails facing the other person from a
comfortable distance, using the right amount of eye contact, and
giving your time. Genuine interest in the other person is the best
Responding and encouraging
Your responses show that you are listening and interested. For
example, 'Uh huh', 'OK' or 'I see' all encourage the other person
to go on talking. 'Reflective listening' goes beyond this - it
involves repeating or rephrasing something the person has said, or
summarising the main point.
Open and closed questions
Open questions can encourage people to keep talking. Open
questions invite the other person to provide more information -
'What did you do today?'
Closed questions, by contrast, generally have a single response
- 'Do you like chocolate ice cream or vanilla?' They too have their
place-sometimes we only want a brief response.
Young people with a brain injury may
find closed questions easier to answer. If you are using closed
questions, try giving a choice between alternatives ('Do you want
tuna or cheese?') rather than asking a 'yes/no' question ('Do you
want to eat something?).
It is important to be able to state your own point of view,
without blaming or accusing the other person-particularly if you
are concerned about something they are doing. The 'I-statement'
tells others how you feel. For example: 'I get very worried when
you're late', 'I get angry whenever I try to talk to you about your
friends.' It gives the other person a chance to say 'I'm sorry' or
'I didn't realize you felt that way'.
In contrast, a 'you-statement' places responsibility on someone
else. For example: 'You're so irresponsible', 'You make me lose my
temper every time we talk.' A 'you-statement' often leaves the
other person feeling attacked and they may get defensive.
References and further information
Many thanks to Brain Foundation Victoria for permission to
adapt their material for this fact sheet.