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Helping Children Cope with Head Injury in the Family

Comments [8]

Audrey Daisley, Rachel Tams, and Udo Kischka, Oxford University Press

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Helping Children Cope with Head Injury in the Family

Key points

  • 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.

Comments [8]

To the person, 44, dealing with mother's challenging behavior who had scarlet fever aged 4: Time..time helps us adapt our position in relation to it continually, your position changed when you discovered your mother's unfortunate brain injury secondary to the illness she had, it must have demystified things? hopefully empowered you a little further, and may you continually be empowered to reclaim full emotional health, coz by God those kinds of heart aches can hurt, its much more personal when its those closest to us... Its also amazing how different & varied our lived experiences are. My own mother has brain injury but is severely disabled can't communicate, though my memories of her are an unconditionally loving mother, so the heartbreak is different to yours. Its the relatives who treated me appallingly growing up - I just cut them out my life - easy as they are utterly neglectful anyway, the shit they inflicted stays with me though. Time is definitely helping, a decade, two decades later now and (I'm now 30) and I trust as time goes on it'll get easier for me to face it step by step, but its a slow process for me.

Jan 15th, 2017 8:03am

I'm 44 and not till age 40 was I told that my mother at age 4 almost died from Scarlet fever and had brain damage as a child. As if it was a big family secret... My brother and I are very scarred from her emotional and, at times as a child, very physical abuse. We have always felt our mother was just crazy really. In the last few years I have learned to not internalize the inappropriate horribly hurtful things she says to us and now I really need some guidance on how to really understand and cope as she ages.

Jan 2nd, 2017 2:49pm

My father had a closed head injury he sustained after being struck by a train crossing tracks. He was comatose for two months. He did not reach base line for six years. My four siblings and I were aged 2-10. My Mother was 31.  My mother was tough and loving. What a great women. The injury changed my father completely. Memory, personality, everything. The stories I tell people think I'm making up. My oldest brother ended up hating him as an adult and taught his children to hate and fear him. I named my son after him and took care of him in his last years. My oldest brother thinks his life would be different if not for the tragedy. I agree. Tragic events shape us.

Sep 6th, 2016 6:45pm

Children need to truth. It's hard, but it's a better foundation to go from than anything else. Truth--albeit more sad and difficult at times--was what helped me most and no matter what the situation calls for us to grow up faster and stronger than we had planned on. Check out He Never Liked Cake, a memoir about growing up w a parent w TBI. http://www.amazon.com/Never-Liked-Cake-Janna-Leyde/dp/1452568286

Nov 26th, 2014 10:00pm

I suffered a bleed on the brain from a ruptured aneurysm at of 47, l left hospital unable to speak or write. I am a mother of three children.  I to am working to improve communication between family members by writing an illustrated book which aims to address this very point. See www.storypath.co.uk for more information. Wish me well as I have my funding meeting on Friday!

Nov 25th, 2014 1:18pm

A book that could help parents affected with 'invisible wounds' begin to explain PTSD and TBI to small children is "Daddy's Home" by Carolina Nadel. A sample of the book can be found at www.carolinanadel.com and it can be purchased there or on Amazon. Thanks and Good luck!

Oct 27th, 2013 12:09pm

I would love to get a hold of that book you are talking about that your O. T. read to your kids. Looking for something like that to read our 9 year old daughter to help explain more about her Dad. Let me know if it is available anywhere. Thanks.

Nov 6th, 2012 8:28am

I asked my Occupational Therapist at the time to explain as best she could to my kids why I had changed in alot of ways after my head injury. She brought a folder with all the info she had written out herself in storybook form and sat with the kids and read it out then listened to and answered their questions.

Sep 21st, 2012 9:02am

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