How TBI Affects Everyday Function

Functional Cognitive-Communication Consequences

Children, adolescents, and adults with a TBI often experience problems at home, at school, and/or at work. They may have difficulties when they are with people that they knew before their TBI and/or with people that they did not know before their injury. Difficulties may be most obvious in situations, activities, and/or tasks that are new to them since the TBI or that they did not do too often before the TBI versus those that they regularly did before the injury. For example, they may have difficulty:

  • Concentrating on tasks
  • Remembering new material
  • Thinking, speaking, and solving problems slowly
  • Reading for understanding quickly
  • When normal routines are changed or when they are over-stimulated
  • Moving on when encountering difficulties they cannot fix
  • Finishing things within a reasonable timeframe
  • Thinking outside the box, thinking abstractly, and using humor
  • Finding words and/or understanding what others are saying when trying to communicate (oral and written)

Depending on the damage to the brain, a person’s communication problems may be a cognitively-based (e.g., because of decreased attention, memory, reasoning) and result in confused language or be more specifically language-based and result in aphasia (the loss of the ability to express oneself and/or to understand language-  oral and written).

After a TBI, a person may also have pragmatic problems when interacting with others, such as:

  • Taking turns in conversation
  • Maintaining the topic of conversation
  • Using an appropriate tone of voice
  • Understanding and using sarcasm
  • Responding to body language and facial expressions
  • Keeping up with others in conversation

Speech (breathing, voicing, and talking) and swallowing may also be impaired.  After a TBI, a person’s speech may be unclear, or (s)he may not be able to talk.  (S)he may also not be able to eat and drink like before the injury.

Functional Psychosocial/Emotional Consequences

After a person suffers a TBI, there are common emotional stages that people go through (individuals who are injured and their families).  These include: confusion, denial, anger/depression, testing phase, and uneasy acceptance. The TBI Guide website goes into detail about these.

Functional Physical Consequences

With the help of therapy and time most people who suffer a TBI are able to walk and use their hands again.  In the long term a person with a TBI may have reduced coordination, balance and strength compared to what they had before the TBI.  For example a person with a TBI might not be able to play soccer as well as they used to before the injury, or now they may fatigue more quickly. Other physical problems after a TBI may include a hearing loss, decreased smell or taste.  People may suffer from headaches or develop seizures.  In most cases these difficulties do not prevent the return to independent living.