Social intervention after brain injury

Social Intervention After Brain Injury

A lovely, awesome, sweet child that I know has a brain tumor.  When I began an intervention, I expected to find poor grammar, vocabulary, and retelling skills. I began our first session using one of my favorite dynamic assessments. To my surprise, his pre-test score was nearly perfect. Although he needed prompts to continue his story retelling, he remembered everything and in great detail. Vocabulary, syntax, and retelling were not areas of need for this student. And yet, I knew something was off. He hugs every adult in the school. He compliments everyone’s shoes. He wanders.

The information is this post was summarized from a presentation by Roberta DePompei, Ph.D.

Children who experience a brain injury may experience many different long term language outcomes, including:

  • Spared pre-injury language (such as picture naming and grammar), however…
  • Impairments in learning new vocabulary and world knowledge
  • Underdevelopment of ambiguous/figurative language understanding
  • Difficulties with non-literal meaning
  • Lower scores than peers on tests of emotion (eye gaze/facial expressions)

A brain injury often impacts social and pragmatic language, which directly relate to difficulty within the school setting. In fact, most interactions in school are social, rather than academic (think of all the people we interact with in a school that have nothing to do with our lessons). Therefore, social communication treatment and goals should be a part of every intervention plan.

We should begin social skills interventions early and long before the child reaches the crucial pre-teen years. In early years at school, many children are inclusive, can be taught to be kind, and may name everyone as a friend. Beginning in the pre-teens, however, children are far less inclusive. They ostracize, cyber-bully, and ignore. It is extremely important to teach children with brain injury the social skills they will need before they start losing friends because of their differences.

Social skills to focus on may include:

  • Using expected language
  • Self-awareness and calming skills
  • Flexible thinking when unexpected things happen
  • Social problem solving skills
  • Turn-taking
  • Repairing conversational break downs
  • Paralinguistic skills: facial expressions, body language, personal space

These are tough skills to teach! I have been working on them for years with a variety of students with social communication difficulties. One thing that I’ve found is that is often takes a variety of resources and techniques to really help a child with social skills. Below I have listed some resources (created by myself and others). I hope that you find these useful and that you start working on these skills immediately with any student with a history of  brain injury.

Click on the images below to learn more about each lesson/curriculum.

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brain tumors

This post is part of a series on brain injuries. Read all the posts in this series here.


Comment below with your experiences with brain injury.

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One Comment

  1. My oldest had a TBI when he was 10 and the social/emotional effects have continued to ripple out over the past ten years. As a SLP, I understand how the frontal lobe was impacted, but it is difficult for others to understand how the injured brain functions with emotional regulation and executive function skills, and are changed for a lifetime. Thanks for a great post!

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