My daughter was in a car accident when she was 12 and was in a coma for three nights. I was told it could take years for her brain to make new connection, if it did at all. She has had some rehabilitation therapy. Later, she had other problems including running away and a pregnancy. She had problems staying in school and after she had a child she calmed down considerably. She has lived with me most of her adult life and can't seem to keep a job for longer than a month.
My daughter is in her 30's now and has not worked in five years. Her daughter is in elementary school and I am getting old. I did not see the problem; I thought she would find her niche. She needs help .... Now, I realize that her inappropriate behavior is probably due to the accident. I don’t have many resources and she doesn’t have health insurance. I don’t know what to do.
One of the long-term complications for children who sustain brain injury is the frequent need for ongoing rehabilitation and support as the brain continues to develop and grow. When a child has a brain injury before adolescence, it may appear as though interventions such as cognitive rehabilitation and psychotherapy have restored function. But as the child moves into the teen years, the effects of brain injury, especially if the frontal lobes are involved, begin to emerge. These symptoms can be easily misconstrued as teenage rebellion, when in fact they are deficits in the development of the control and self-monitoring functions of the frontal lobes.
It sounds as though your now-adult daughter would benefit from some education, cognitive rehabilitation, and environmental supports to compensate for her lack of executive functions. She may be able to get assistance from your state department of vocational rehabilitation, which will generally support an assessment and some intervention, as well as employment services. She may also be eligible for your state or county developmental services, since her injury occurred while she was a minor. In either instance, I would recommend she have a comprehensive neuropsychological assessment — either one of the aforementioned services may fund that as part of their assessment. She should thus be able to obtain the supports she needs in terms of cognitive rehabilitation, job supports, life skills, and parenting skills. I would also recommend you reach out to your local chapter of the Brain Injury Association to learn what other resources are available in your area to support you and your daughter in this situation, particularly if there are brain-injury specific services.
Dr. Celeste Campbell is a neuropsychologist in the Polytrauma Program at the Washington, DC Veterans Administration Medical Center. She has a long history of providing cognitive psychotherapy and developing residential behavioral management programs for children and adults.