In the Classroom: Friendship and Peer Acceptance

The Center on Brain Injury Research and Training, University of Oregon
In the Classroom: Friendship and Peer Acceptance

Description of the Problem

Students with TBI have difficulty maintaining friendships. This is one of the most common and devastating consequences of significant brain injury. The resulting social isolation compounds feelings of loss, sadness, and depression in students with TBI.


Childhood and adolescence are challenging socialworlds to navigate in the best of times. TBI is scary;in a single moment a friend’s life has changedforever. Damage to the brain has potentially lefthim limited physically, mentally, and emotionally.Few children or adolescents have the mental oremotional resources to process the implicationsfor their own sense of stability and safety in theworld and struggle to maintain a friendship with theaffected person.

The complexity of the issue

Loss of old friends may be largely inevitable. Watching a friend recover from any significant loss,even without long-term disability — serious illness or injury, death of a parent or sibling — is beyondthe social and emotional capabilities of most adolescents and children. It’s important to help studentswith TBI understand that their old friends aren’t rejecting them as much as they’re running away fromideas too big and scary to handle. On the other side, many adolescents and children are capable ofdeveloping new reciprocal friendships with people of any ability.


Help students with TBI maintain what friendships they can and replace those that will inevitably end by providing structures of support.


  • Before the student with TBI returns to your classroom, prepare the rest of your class for what to expect.
    • Consult with the student’s parents about what to say and, if possible, have the family be part of the presentation.
    • Keep the details specific to the student and the accommodations the student will have (notetaker, rest periods, etc.).
    • If you know the student has significant challenges in social competence — impulse control, ability to read situations or the emotions of others, etc. — explain them as a result of the brain injury and suggest strategies peers can use to accommodate the injured student.
  • Use peer volunteers to help the student withTBI and also provide valuable social interaction.
    • Peer volunteer can help the student navigate busy corridors, carry books and materials, and complete assignments.
    • Peer volunteers should be selected from a social set acceptable to the student with brain injury.
    • True friendships are reciprocal; both volunteers and students with brain injury need to be prepared to both give and receive in their interactions.
  • Use schedules to promote social interaction. Sometimes students spend significant parts of the school day separated from their peers. As much as possible, keep students in situations that promote positive social interaction.
  • Help students build new friendships. Create opportunities for your student to interact with new people — students new to the school or just students from other social groups. For example, a former athlete can do speech therapy as part of choir practice and get to know a whole new group of friends.
Posted on BrainLine August 12, 2013.

In The Classroom, Copyright 2012, supported by Oregon Department of Education (ODE) and National Institute on Disability and Rehabilitation
Research (NIDRR) grant #H133B090010, is the sole responsibility of the authors and does not necessarily represent the official views of ODE or
NIDRR. Adapted from LEARNet, a program of the Brain Injury Association of New York State, and funded by the Developmental Disabilities Planning
Council. Copyright 2006, by the Brain Injury Association of New York State. Used with permission.

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