Download Adolescents with TBI: Commonly Observed Behaviors and Possible

Adolescents with TBI:
Commonly Observed Behaviors and Possible Strategies
(Document provided courtesy of Courage Kenny Rehabilitation Institute)
Behavior
Impulsivity
Definition
-Acts on impulse
instead of thoughts
Difficult to filter
immediate reactions
-Little regard to
consequences of the
behavior
Lack of Initiation
-Difficulty starting
and/or completing
tasks
-Getting stuck are
starting a task
Distractibility
-Can appear to be
disorganized or
unmotivated
-Short attention span
-Difficulty sustaining
attentiveness
-Difficulty focusing on
one item at a time
-Inability to filter out
external stimuli
Difficulties with
Relationships
-Difficulty forming and
maintaining peer
relationships
-Difficulty with social
interactions, lack of
self awareness
Coping Skills
-Difficulty managing
and working through
emotions
-Reacting impulsively
on feelings
Independence &
Responsibility
Issues
-Assisting an
individual in being
realistic of challenges
-Working with an
individual to learn basic
steps towards being
independent
Examples of
Behavior
Strategies
-Verbal and physical
outbursts
-Poor boundaries with
others
-Socially inappropriate
reactions or comments
to others
-Difficulties with food
/beverage limits
-Difficulties following
financial budget
-Difficulties with tasks
such as: personal care
routines, ADL’s,
homework, household
tasks, etc.
-Difficulties with social
interactions /
communication skills
-Provide structure, modify environment
-Planning ahead for events, role-play situations
-Reviewing expectations
-Supervision
-Providing written or verbal cues
-Limiting options
-Setting short-term goals
-Timeouts
-Positive feedback for appropriate behavior
-Stop and Think cue
-Stopping conversation
in mid-sentence
-Modify environment to minimize sudden changes
-Limit possible external distractions
-Focusing on one task at a time
-Setting short-term goals / Break things into small
amounts of time
-Provide positive feedback
-Stop and Think cue
-Focusing on
background sounds
-Focusing on a
particular object/
item/person with
difficulty redirecting
-Establishing schedules, checklists, calendars,etc.
-Break tasks into small steps
-Establish and maintain consistent routine
-Attainable reinforcement programs
-Identifying and building off success
-Positive feedback
-Slowly increase accountability
-Provide triggers/cues to begin tasks
Personality traits and
difficulty interacting with
others who may have
personality traits that are
similar or completely
opposite.
-Poor social skills.
-Poor personal space.
-Difficulty knowing how to
interact with others in a
socially appropriate
manner
-Structured social group either within school or an
agency working on peer interaction and basic
social skills.
-School working to set up activities
-Involving young people in team athletics to
increase teamwork.
-Role playing general skills.
-Modeling social skills during activities.
-Anger/stress
management
-Time Management
-Emotional expression
-Understanding how to
react in a way that is
socially acceptable.
-Teaching relaxation techniques.
-Utilizing things around the individual’s space and
environment that can assist with being
overwhelmed or anxious.
-General body awareness (i.e. Engine level)
model.
-Use of feeling cards/pictures/and individual’s
cues.
-Difficulty grasping a full
-Working with parents and caregivers to support the
understanding of the
steps it takes to be
independent.
-Safety and vulnerability.
-Setting personal
priorities.
-Slow progress is okay
and typical of
transitioning.
individual however not do things for the individual.
-Working on understanding basic skills for
independent living.
-Setting up checklists and daily routines.
-Normalizing the struggle to be independent.
-Modeling and role playing skills.
-Clearly outline consequences that may accompany
the lack of routine