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Acquired brain injury Disability Snapshot
This Disability Snapshot provides general information about acquired brain injury to assist you in communicating effectively and supporting the participant in developing their goals in a planning meeting. Each person is an individual and will have their own needs, preferences and experiences that will impact on the planning process. This information has been prepared for NDIA staff and partners and is not intended for external distribution.
Peak body consulted
In developing this resource we consulted with Brain Injury Australia.
What is acquired brain injury?
Acquired brain injury (ABI) is a term used to describe multiple disabilities caused by damage to the brain after birth. An ABI can result in deterioration in a person’s cognitive, physical, emotional or independent functioning.
An ABI can occur from:
an accident stroke brain tumour head trauma infection (such as encephalitis or meningitis) poisoning (alcohol or other drug abuse) lack of oxygen (referred to as hypoxia or anoxia) or degenerative neurological diseases1.
Some ABIs result in permanent physical disability, for example - paralysis, problems with balance and coordination, epilepsy, vision or hearing loss. Other significant impacts can be cognitive or behavioural, for example - challenging behaviour, poor short-term memory,
1 Australian Institute of Health and Welfare National Community Services Data Dictionary (2014)
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reduced attention and concentration, difficulties with learning, planning and solving problems. Challenging behaviours may include irritability, social (sometimes sexual) disinhibition and verbal (sometimes physical) aggression.
Misconceptions about acquired brain injury
Some misconceptions about ABI include:
ABI is an intellectual disability Recovery from an ABI doesn’t continue beyond two years.
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While the greatest improvement in function following an ABI occurs in the first two years, recovery can continue for at least five years following the injury. Everyone recovers from a mild traumatic brain injury.
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Approximately one in four people who have concussion/s or mild TBIs do not make a full recovery within the expected timeframes. They can experience
ongoing physical symptoms such as headaches and dizziness, impacts on
cognition, and behaviour and/or mental illness. For some people, the impairment
is permanent.
How is acquired brain injury diagnosed?
Participants who have a severe ABI will likely have one or more neuropsychological assessments. Assessments include an interview and standardised tests to determine the injury’s effects on cognition and behaviour. Recommendations are then made for therapies to improve function.
The period of time in which the participant is unable to have continuous day-to-day memory (duration of post-traumatic amnesia) is currently the best single predictor of severity for the disability.
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Language and terminology
Don’t say Instead say Here’s why
A participant “suffers from” A participant “sustained”, Many people with an ABI or is a “victim of” brain “has” or is “living with” a or other disabilities would injury. brain injury. prefer not to be defined or described by their disability.
A participant is “brain- A participant “has” or is Many people with an ABI injured”. “living with” a brain injury. or other disabilities would prefer not to be defined or described by their disability.
A participant is A participant “uses a Use person-first language. “wheelchair-bound” or wheelchair” or is a “confined to a wheelchair”. “wheelchair user”.
A participant has A participant has Use person-first language. “behaviours of concern”. “challenging behaviours”.
Enabling social and economic participation
The lived experience of a brain injury is usually very different from a lifelong developmental or intellectual disability. People with an ABI will likely remember what they were able to do before their injury. Their engagement with the NDIS may be affected by grief. Some participants may therefore have difficulty setting and achieving goals. They may also experience a breakdown in relationships with family and friends.
The circumstances of the participant’s injury may also be associated with embarrassment or shame, especially when the injury was, or is perceived to be, the participant’s fault. People with an ABI have a very high lifetime risk of mental illness, such as depression.
Help the participant adapt to their disability by reconnecting them to as much of their life before injury as possible. For example, exploring pre-injury employment, pursuits and pastimes.
It may be appropriate to explore ways for participants to go back to their previous career or profession with supports in place. For others, being supported through a vocational ‘discovery’ process to re-explore their strengths and interests in preparation for work could be useful. Volunteering to build confidence and connect with the community is another way to prepare for work.
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While employers are required to make reasonable adjustments to accommodate needs in the workplace – supports that are above and beyond this could be funded under the NDIS. Participants may require NDIS funding for specialist disability assessment services to access external employment retention and support initiatives, such as the Work Assist program provided by Disability Employment Services.
Peer support from other people with ABIs can also be helpful to improve social and economic participation.
How can I tailor a meeting to suit a participant with an acquired brain injury?
A person with ABI may recover well physically their cognitive and/or behavioural disability can be significant. Their disability may not be obvious to someone meeting them for the first time and that is why ABI is often referred to as an “invisible disability”.
Participants can also lack insight into their disability and be unaware of their limitations, or may have unrealistic expectations of their recovery and/or set unrealistic goals. It is recommended, with participant consent, to check unmet support needs with significant others, family members, clinicians or allied health professionals.
Many people with an ABI experience tiredness and difficulties with attention and/or concentration and reduced information-processing speed. You can tailor a meeting to suit the participant by:
asking their preferred meeting length and discussing any other adjustments that
might assist when scheduling a meeting securing a meeting location free of competing background noise or distractions scheduling short meetings or taking breaks during longer meetings checking how they are feeling during the meeting communicating in short, simple, sentences using plain English checking for understanding without questioning the participant’s intelligence, ask
“did that make sense?” rather than “do you understand what I’m saying?”.
Helpful links
Brain Injury Australia (peak body) Stroke Foundation (national charity) Synapse (service provider) Ontario Neurotrauma Foundation (Canadian research and prevention organisation)
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Version control
Version Amended Brief Description of Change Status Date by
1.1 KHM678 Annual review, feedback from Employment DRAFT 2020-01-14 team.
2.0 NAN927 Annual review of resource, additional APPROVED 2020-02-16 information provided on supporting employment goals for acquired brain injury.
Class one approved
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