Acquired Brain Damage
Acquired Brain Damage or Injury (ABI) is exactly as it sounds – damage to the human brain as a result of trauma rather than through birth defects or genetic faults. It is usually caused by a sudden, external physical force damaging the brain, often as the result of a car accident or blunt force trauma to the head. It is still one of the most common causes of disability and death in adults. ABI is the generic term used to describe a vast array of injuries that can occur to the brain. Damage can be categorised as either focal (localised to one particular region of the brain) or diffuse, affecting various regions of the brain to differing degrees.
There are two principle types of ABI:
- Closed brain injury – occurs when there is a non-penetrating cause to the injury with no break or fracture in the skull. A closed brain injury is caused by a rapid forward or backward movement, shaking the brain inside the cranial cavity. This results in bruising and tearing of brain tissue and blood vessels. These types of injuries are often caused in car accidents or as the result of a fall.
- Penetrating brain injury – again, these are exactly as they sound: injury to the brain is caused by an object penetrating the hard, outer layer of the skull and causing direct damage to an area of the brain.
One of the most common forms of ABI in young children is as a result of oxygen starvation at birth. Non-traumatic causes of acquired brain injury include strokes, tumours, haemorrhage, aneurysm asphyxiation and the effects of toxic substances. The effect of these processes is to starve the brain of oxygen causing irreparable brain cell damage (this is also known as hypoxia or hypoxic brain injury).
The affect of ABI on communication skills
Because the effects of any form of acquired brain injury is going to have a profound effect on both physical and psychological functioning, language and communication skills are often impaired by ABI. Memory difficulties are probably the most common characteristic of patients with acquired brain injury, and present the greatest challenge for the development of learning and communication skills. The primary problem is a decreased ability to store information and recall it at a later time. Poor attention and concentration, often caused by poor filtering or processing of sensory information, may reduce the ability to focus long enough for learning to take place, often leading to frustration as the patient faces a ‘two steps forward, one step back’ learning process. This is particularly apparent when faced with the problem of re-establishing formerly normal levels of communicative ability, with new information taking longer to process effectively. Conceptualisation deficits may reduce the ability to categorise, sequence, abstract, prioritise and generalise information.
Language functions such as writing, reading, speaking, listening, and ‘pragmatics’ may be impaired. Communication pragmatics problems are interrupting, talking out of turn, dominating discussions, speaking too loudly or rudely, or standing too closely to the listener. Those with ABI may also lose the ability to recognise shapes of objects, judge distances accurately, visualise images, comprehend mechanical functions, or recognise position in space. This may include the shapes of letters or even words that were previously familiar and well understood by the patient.
How can Verbal Behaviour help?
Because of the complicated nature of all acquired brain injuries, a bespoke and carefully tailored combination of therapy is required to tackle all the issues that the condition can cause. VB can play a pivotal role in helping learners to re-acquire language skills that the accident has diminished. It can also help to motivate our patients and teach other important life and social skills. Although not every case results in complete recovery due to the nature of traumatic brain injury, careful and specifically designed therapy can achieve remarkable results, allowing many patients to recover a substantial part of their communications skills. At VBC, we have extensive experience of dealing with a wide range of ABI issues and in helping both learners and their families make the first steps back to recovery.
The use of Verbal Behaviour with stroke and brain damaged patients is an upcoming and exciting application of the science. Here at VBC, we have a particular passion for assisting these patients and learners. We are committed to contributing to the field and look forward to discussing our results with anyone who is interested.
If you would like to know more about how our therapy, network of support and counselling can help,
contact us now in confidence for further information.