Unit III- Intervention for Adult Lang. Flashcards
TBI
traumatic brain injury- blow from an external force
closed head injury
skull is NOT penetrated
open-head injury
skull IS penetrated
Nontraumatic Brain Injury
caused by strokes, encephalopathies, toxins, or tumors
characteristics of nonTBI
very similar to injuries from a TBI
who’s more likely to sustain a TBI?
males are 2X more likely than females
50% of pop is over 18 yrs old & 50% are under 18 yrs old
Causes of TBI
largest single injury comes from falls in children & falls in adults 65 yrs old & over
vehicle accidents combined are 46% of injuries (largest when added together) [MVA- motor vehicle accident]
drugs & alcohol play a factor
weight of the brain
2-3 lbs (jello-like consistency)
Focal Injuries
Primary Impact- head hits skull & skull is thrown front to back
Shearing/Twisting
biggest concern!
results in diffuse damage at the cellular level (diffuse axonal injury- DAI)
Many times MRI/CT scans DON’T show potential damage
Minor (mild) TBI
- mild blow to head
- no unconsciousness (for less than 30 min. if so)
- 10% have lifelong problems
- nausea, headaches, confusion, learning problems
- problems with employment and social interaction
Moderate TBI
- period of unconsciousness (>30 min– 1-24 hrs)
- 33% have lifelong problems
- motor problems
- difficulty with cognitive communicative impairments
Severe TBI
- severe motor problems
- 75% have lifelong problems
- stay in a coma for an extended period of time
Medical Problems with TBI
Seizures, bowel/bladder control, orthopedic, sensory problems: hearing, vision, any sensory area
Physical Problems with TBI
can be mild paresis to serious paralyzed (plegia); watch for balance, strength, and coordination problems
Perceptual-Motor Problems with TBI
- visual neglect- left neglect is very common (damage to right side of brain)
- motor apraxia- motor planning problem (brain has trouble telling body what to do)
Cognitive-Communication Problems with TBI
- Dysarthria: one weak or paralyzed side of mouth causes “slurred speech”
- apraxia of speech
- tangenital speech- can’t stay on topic
- confabulations- make up info and lie, but not on purpose and don’t realize it
- hyperverbosity- keep talking and don’t know when to stop
- problems with writing, lang, artic, abstraction, reading comp.
- anomia- word finding problems
- memory/attention/concentration- residual: problem happens AFTER the fact
- egocentric- all about them
- executive functioning problems
Behavior Problems with TBI
- overlaps with problems with ADHD
- impulsivity, emotional lability (bouts of crying or laughing excessively), disinhibition, anger outbursts, poor judgement/motivation, apathy, lethargy
Social Problems with TBI
typically the family’s biggest concern
- withdraw (recluse/hermit), easily distracted/influenced, bossy/argumentative, misperceive social actions and events, poor responsibility/dependency, loneliness/stubborness, mood changes (bipolarism?), perseveration (“1,2,1,1,2” or actions), sexually inappropriate behavior (flashing nurses), reluctance to seek assistance
Proactive Intervention for TBI
Look at what’s ahead, determine obstacles, plan viable solutions, exercise creativity, ingenuity, and flexibility, involve key people, use many strategies learned for ADHD and LLD!
