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Parents and teachers are often puzzled and frustrated by changes in a child’s behavior after an acquired brain injury. Methods previously used to manage or change behavior at home and in the school are no longer effective. This article explains why an antecedent approach with these children is more effective than traditional behavior management methods.

Why is our child’s behavior so different now?

Changes in a child’s behavior may be a direct result of an injury to the brain. Common changes in behavior include:

  • mood swings
  • withdrawal
  • emotional lability
  • temper outbursts
  • impulsivity
  • irritability
  • disinhibitions.

Why is this behavior so much harder to manage since the brain injury?

The frontal and temporal lobes are specific areas in the brain that monitor and direct behaviors. When either or both are damaged, a child may find it hard to control his temper, actions and feelings. Even the child’s personality may seem different. The child may now be restless, hit others, swear, be impulsive, and find it hard to follow directions. This can be very upsetting for parents to observe, for teachers to understand, and for siblings to adjust.

It can also be upsetting for the child, who may remember how he acted before the traumatic injury to the brain. This may lead to emotional reactions that also contribute to changes in behaviors as children try to form a new sense of self.

Will traditional behavior management techniques work for a child with a brain injury?

Antecedent, behavior and consequence is the traditional approach to managing behavior. Step 1 is the antecedent which is what happens before the behavior occurs. Step 2 is the behavior or the action that takes place. Step 3 is the consequence or what happens as a result of the behavior.

Most children quickly learn to change their behavior to avoid punishment. This consequential management style often does not work for children with brain injuries because the child may not remember the rules. If the child’s insight has been affected by the injury, it can be difficult for this child to learn from the consequences of his behaviors. Punishing children after the behavior has occurred may not help the child learn how to self monitor behavior or to recognize the warning signs of becoming overwhelmed or confused.

What will work for  children brain injuries ?

Managing what goes on before the behavior occurs is a much more successful method for children with brain injuries. The first step is to identify the antecedents. Then they can be changed to prevent the behavior from occurring. For example, distractions from other students or hallway activity may make it hard for a student to follow instructions or pay attention in class. This distractibility and difficulty focusing can be the direct result of damage to the brain. It will not improve by giving the student detention or reprimands. It is more effective to decrease distractions and improve attention by moving the child to sit in the front row.

Children Brain Injuries Conclusion

Changes in behavior that are caused by trauma to the brain can be positively managed by focusing on the antecedents or the child’s environment before the behavior occurs. This approach can be readily learned and used by teachers as well as parents and will improve the child’s abililty to function at home and in school.

Marilyn Lash is a founding partner of Lash and Associates leading resource on brain injury, blast injury and concussion.