- Children, like adults, are affected emotionally when a close relative, especially a parent, is head injured.
- They need honest age-appropriate information to help them understand head injury, and an opportunity to express feelings and concerns. Sometimes counselling may be necessary.
- Children (of all ages) can feel that they are to blame for the injury and need to be reassured about this.
- There is a link between the ways that children and adults cope with stressful events. It helps if adults can model positive coping strategies for the younger members of the family.
- Head injury services do not routinely offer support to children, so adults need to be proactive about asking for help.
In this chapter we turn our attention to the issues faced by children who have a close relative, particularly a parent, with head injury. We discuss the ways in which children can be affected by family head injury and provide guidance for adults on how to explain head injury and support children.
We have written this as a separate chapter for the following reasons.
- Children have their own special needs at times of stress and cannot be regarded as ‘mini-adults’.
- Head injury services do not routinely offer help to children (because of lack of resources, lack of expertise, and lack of awareness of the issues facing them). However, without advice, it can be difficult for families to know how best to help children through this emotional experience. It is hoped that this chapter will address this gap and increase your confidence in supporting children and asking for help for them at this difficult time.
The information contained here is directed, in the main, towards helping children who have a head-injured parent. However, much of it is applicable to children with other relatives with head injury, such as a grandparent or a sibling. We provide guidance on children’s information and support needs at the different stages of their relative’s recovery, and as children’s needs also vary with age, we have tried to draw out the key issues for children at various ages. This might be helpful to families where there are children with different age ranges.
How are children affected by head injury in the family?
The challenges and tasks faced by children when a parent (or other close relative) is injured are, in the main, very similar to those experienced by the adults in the family (e.g. having to cope with the changed relative, managing role and relationship changes). However, the implications of these challenges for children, and how they are experienced and understood by them, are different from the implications for adults.
- Because of their age and lack of life experience, children may find it much harder than adults to comprehend or make sense of the changes observed in the parent. In particular, children (often secretly) worry that they might have caused their parent’s injury in some way.
- Witnessing such changes (especially cognitive and behavioural changes) can affect how children go on to develop emotionally. Infants and toddlers, especially, can be confused, unsettled, and afraid of the altered parent; this can affect the bond or attachment they had with that parent and can make them feel insecure. As a result, they may become very unsettled, and not recognize or know how to relate to the ‘new’ parent.
- Role changes within the family can also impact on children. Even very young children may be required to assume additional household duties to try to support the uninjured parent who may be caring for their spouse. Older children may be given extra responsibility, perhaps being asked to look after younger children in the family. They may be asked to ‘keep an eye’ on the injured person and this can gradually reverse roles, where children become almost parent-like towards the adult. This has been shown to have detrimental effects for both children and adults, even though most children will willingly take on the role of ‘young carer’. Very young children might have their place as ‘the baby’ in the family taken from them by a very needy injured parent, leaving them feeling neglected or ignored.
- Children may be ‘stigmatized’ for having a parent who is ‘different’ and may be teased or bullied at school. Teachers may be unaware of the potential impact of head injury on families, and may be oblivious to the issues facing children or how to help them. Again, children may not openly discuss these problems for fear of causing additional family stress. Instead, they may try to resolve these issues alone, or ‘act them out’ in the form of problematic behaviour or poor school performance.
- Children, like adults, also suffer the effects of the problems that can arise following head injury, such as financial difficulties, relationship breakdown, and house moves. However, unlike adults, they are often less emotionally equipped to cope with such issues and may worry only about how they will be personally affected. Older children may alter their own life plans in response to the changed family circumstances; for example, teenagers do not apply to universities far from home (as previously planned) as they feel that they must stay close to the family. However, this is often accompanied by feelings of resentment.
- Children’s ability to cope with the changed family life is also limited by the lack of information and support available to them (therefore we have provided some brief information that you might want to read with your children in Appendices 2 and 3).
- Children can also be affected further by the reduced physical and emotional availability of the non-injured parent, who is likely to be preoccupied with their partner’s needs, or who may be too distressed themselves to be able to acknowledge their children’s needs.
The small amount of research that has been carried out tells us that, when faced with these challenges, children can experience many of the problems that adults face, including anxiety, worry, depression, fear, and embarrassment. In addition, children of different ages tend to react in different ways (which might, if you have children of different ages in your family, explain why they could each be exhibiting different types of problems).
By permission of Oxford University Press, © Oxford University Press, 2009. THE FACTS: HEAD INJURY by Audrey Daisley, Rachel Tams, & Udo Kischka (2008) Ch. 10 "Helping Children Cope with Head Injury in the Family" pp.121-130. www.oup.com.