TBI Consumer Report: Parenting Post TBI Mount Sinai Medical Center Page 2 of 2

This study does not suggest that every person with a TBI (or, for that matter, with no disability) will be a good parent. But it does say that when we looked at parents with TBI, who had largely long-term injuries of varying severity, most have met the challenge of parenting to a degree similar to parents like them but without a brain injury.

The study suggests that depression is a problem and a challenge for many of the parents and children in families that are contending with TBI. In terms of enhancing the quality of daily life in these families, parents and children need to seek help in dealing with their feelings, which may include sadness, anger, hopelessness, and/or helplessness. This may mean challenging the depression through increased involvement in community life, seeking the help of a mental health professional, reaching out to others (such as a minister or a local brain injury self-help group), or considering the use of medications or exercise to reduce depressive symptoms. These approaches have all been found effective in dealing with mood difficulties. Such actions are important for all members of the family, not just the individual with TBI, particularly since all too often the spouse and children assume that the person with the TBI is the only one whose needs merit attention.

The children in the families with parental TBI seem to be saying that both their parents are more lax than other parents. This suggests that parents and children each face a challenge. The parents may, when stressed by the realities of living with TBI, have less time and energy to pay attention to establishing structure, routines, and expectations for their children. Their distraction with other important matters may communicate to the children that their parents do not care. For the kids, this slippage in communication may translate into behavioral problems later in life. This is certainly an area of challenge that families need to look at carefully. In such families, parents need to exert more consistent discipline. Family meetings may help — at which guidelines and rules regarding children's behavior are made explicit, including the consequences if rules are broken. Such rules might cover areas such as sharing household chores, doing homework, use of the telephone and TV, letting parents know of afterschool plans, and the like. The parents' taking the time to communicate clear expectations about their children's behavior also communicates their caring, love and commitment to their children.

Finally, we need to look at the limitations of this study. This research was done with a small sample of parents and children, at only one point in time. Because this limits our view of parents with TBI and their children, the need for future research to answer more of our questions is clear.

Despite these limitations, this study suggests three things to parents with TBI (including those who are considering becoming parents): First, you can do it. Others have with the right support (which every parent needs). Second, depression is a possible element of living with TBI of which the family members need to be aware. If depression exists in any family member, help of many kinds is available. Third, be sure that structure, expectations, and rules for children are made explicitly. The rules and consequences for breaking rules should be ones that each family member can live with and ones children know (through their parents' consistent actions) must be followed. Misperceptions that parents don't care enough to set out their values and expectations can thus be avoided.

To Find Out More

This study was published in December 1998:

Uysal, S., Hibbard, M.R., Robillard, D., Pappadopulous, E., and Jaffe, M. (1998). The impact of parental traumatic brain injury on parenting and child behavior. Journal of Head Trauma Rehabilitation, 13 (6), 57-71.

TBI Consumer Report is a publication of the Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury, supported between 1993 and 2004 by Grant Nos. H133B30038 and H133B980013, to the Department of Rehabilitation Medicine, The Mount Sinai Medical Center, New York City, from the National Institute on Disability and Rehabilitation Research, United States Department of Education.

From Mount Sinai Medical Center. www.mssm.edu.

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