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Traumatic & Acquired Brain Injuries


According to the United States Center for Disease Control, brain injury is a leading cause of death and disability in the United States. Each year an estimated 1.5 Million Americans sustain traumatic brain injuries (TBI). Add to this acquired brain injuries (ABI) such as strokes, aneurysms, and others, and the number increases to nearly 3.2 Million. As a consequence of the traumatic brain injuries alone, each year:

  • 230,000 people are hospitalized and survive
  • 50,000 people die
  • 80,000 to 90,000 people experience long-term disability

Cumulatively, an estimated 12.7 Million people are living with permanent disabilities in the United States today (5.3 Million are living with deficits from TBI). This does not refer to senior citizens. While senior citizens form a component of those who have survived a stroke or are suffering Alzheimer’s disease and are disabled, the number include children, young adults and adults ranging from nineteen to fifty-five years. The author of this work has suffered six brain injuries, three TBI and three ABI. Ernest Hemingway (1899-1961), one of our most prolific literary writers, suffered five brain injuries before his death and produced many of America’s most sublime poetry and literature. Brain injuries vary incredibly in region effected, duration and severity and it is not the quantity of brain injuries one suffers but the singular quality of each which produces mild to severe deficits. The USAF reported that now more than 60,000 servicemen and women have suffered one or more brain injuries.

In recent media exposure, brain injury and concussion related brain injury has received attention because highly paid professional football players and other sports personnel are laying claim to their brain injuries rather than pretending, for the sake of the sport or income, that none has occurred and thousands of military service personnel are returning from war with diagnosed and undiagnosed brain injuries. It is sad that it takes this sort of media attention to bring light to the mass casualties that occur annually from brain injuries. The CDC reported that:

"… the disabilities most often associated with TBI include cognitive, emotional, and – to a lesser extent – sensory and motor impairments. A [TBI] may permanently alter a person’s career or vocation aspirations and may also have profound effects on social and family relationships. In part, impairment of cognitive function may result in the loss of communication skills and memory, inability to organize tasks and solve problems, and decreased attention to detail. TBI may also cause emotional instability – especially impulsiveness – and changes in the ability to see, smell, and hear."

Notice that physical impairments are the lesser of the deficits that impact the survivor. For adults, who must look for accommodations to the ADA, this is disaster. The ADA accommodations, for the most part, time, focus on visual aids, physical information processing aids, time and access to places. The definition of learning disability includes brain injury and minimal brain dysfunction. When we turn to the assistance and accommodations available to brain injured adults seeking formal higher education, the ADA provides sufficient basic accommodations for someone who has pre-injury higher education and experience but those without previous education and experience in the nature of high functioning skills do not seem to fare as well. This has been demonstrated repeatedly and is yours for the reading in numerous post-recovery memoirs.

Writing and telling stories is an accepted rehabilitative therapy for we who have suffered a brain injury. We search for our new self as we recover. We know that thinking is hard work. We know that it is with thinking that we create self, access memories, and create stories.

As we access memories, we develop neural pathways. We connect with hidden parts of memories and the more we do so, the more we are able to develop stories. Writing can help us with many deficits, including memory, decision making, planning, organization, attention, processing, speed of thought processing, problem solving, new learning, perception of self and others and self esteem. Writing can help us heal emotionally, helping us improve our coping skills, behavior, reduce anxiety, relieve depression, frustration and irritability, and writing can improve our self motivation, sense of humor, and reduce stress. There are other ways it helps. For more on how writing heals, click on the Writing to Heal link.

Many of us reenter education before attempting to return to employment after a brain injury. For children, federal acts such as the IDEA and ADA provide for special needs. For adults, we have only the ADA. Within the ADA is a category known as intellectually disabled. This is when preparation is vital. A neuropsychologist's report that details the deficits affecting education and lists recommended accommodations is very important to your educational future. Most of these reports do not provide these details routinely and you must ask for them to be detailed and provide the expert with a list of suggestions that would be helpful. If the doctor approves your suggestions, they can be listed in the report. For more on this, click the Education link.