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Pamela Targett and Dr. Katherine Inge, Virginia Commonwealth University (page 1 of 4) Page 1 of 4
INTRODUCTION
The Brain Injury Association of America (BIAA) reports that annually 1.5 million people will sustain a traumatic brain injury (TBI) with 80,000 people experiencing the onset of long-term disabilities. Currently, an estimated 5.3 million Americans live with disabilities resulting from a TBI. Every 23 seconds one person in America will sustain a traumatic brain injury (BIAA, 2007).
Traumatic brain injury is caused by trauma to the brain, which might occur when the head strikes a hard surface such as a windshield during an automobile during an automobile accident. This type of "closed" head injury typically results in damage to the entire brain. Trauma also may result from a penetrating injury such as a gunshot wound. This type of injury is called an "open" head injury and may only damage a specific area of the brain. After an injury, the person may be in a prolonged period of unconsciousness or coma, which may result in severe damage to the brain.
Not very long ago, many people who sustained a TBI died. Today, due to advances in medical care, the vast majority of individuals live. Because some degree of healing does occur to the brain post injury, a person may recover various skills and abilities during the first six months to two years post injury. However, many individuals with TBI will experience life-long difficulties as noted in the statistics from the BIAA.
How well the person does post injury will depend on a number of factors. Some of these factors are related to the individual's skills, abilities, and age before the injury. Other factors are related to the severity of the injury; personal, emotional, and social adjustment after the injury; and the level of support received from family members and others.
KEY POINTS
Supported employment has been shown to be an effective approach to assisting individuals with TBI in gaining and maintaining employment. Community rehabilitation providers (CRPs), offering supported employment services, can play an important role in helping individuals enter or re-enter the workforce post trauma. As always, it is important to remember that everyone is unique. The following key points are offered to assist employment specialists in developing support programs for individuals with TBI.
- Each individual with a TBI will have unique mental and physical abilities and challenges based on the type and severity of the injury.
- The type and intensity of support will vary from person to person depending upon the individual’s pre- and post injury skills and abilities, as well as the job tasks, work environment, and existing supports in the workplace.
- The individual's interests, abilities, and support needs should guide the employment process and not the person's disabilities.
- Compensatory strategies can minimize the challenges caused by the TBI.
- Individuals must be involved in the design and implementation of training and support strategies for finding and maintaining employment.
- The natural workplace supports must be identified and facilitated to promote success in the workplace.
CHARACTERISTICS
Some of the more common characteristics associated with TBI are described in this fact sheet. For each characteristic, workplace support examples are provided. Although the characteristics are presented individually, a person may have difficulties in more than one area. Furthermore, a combination of strategies may be needed to promote success in the workplace. Please keep this in mind when developing a support plan for someone with a TBI that is receiving services from your agency.
1. Physical Disabilities: After an injury, a person may experience some physical or motor changes such as difficulty walking, maintaining balance, coordination, and stamina. The individual's hand use may be affected including a decrease in speed, strength, and accuracy. A person's physical ability to speak also can be impacted by a TBI such as slurred speech patterns. Other communication difficulties associated with the area of the brain that was injured will be presented under the communication category.
Strategies: The person who has physical and motor challenges will need workplace accommodations particularly for jobs that require extended periods of standing or hand use. If the person has problems with endurance and maintaining stamina, it may be helpful to initially work part-time or ask for breaks to be broken down into smaller increments. Examples of supports include but are not limited to the following:
- Divide a 30-minute break into three, 10-minute breaks that are spread out over a block of time.
- Fabricate a stand to help the person maintain balance.
- Arrange opportunities to alternate sitting and standing while performing the task.
- Negotiate completion of a task from a seated rather than standing position.
From Virginia Commonwealth University Rehabilitation Research and Training Center on Workplace Supports and Job Retention, Region III CRP-RCEP, Rehabilitation Services Administration. Used with permission. www.crp-rcep.org
