Social Communication and Rehabilitation of Adolescents with Traumatic Brain Injury
Introduction Adolescence, the time between puberty and adulthood, is marked by a shift toward greater reliance on the peer group that the family, resulting in a greater need for more complex social communication. It is also the age group which reports the highest incidents of traumatic brain injury (Turkstra, 2004). One could surmise the many reasons for this – increased risk taking or increased participation in contact and/or extreme sports, for example. Because the adolescent brain is still developing cognitive skills which support later-developing communication skills such as figurative language, complex pragmatic functions , and receptive and
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297). Those cognitive processes include executive functions such as initiation, problem solving, inhibition of behaviors, and planning as well as encoding and retrieval of semantic memory (Siddiqui, 2008). It therefore stands to reason that “behavioral studies on tasks including inhibitory control, processing speed, working memory and decision-making continues to develop during adolescence… [and] developments in performance are linked to the pruning and myelination processes occurring … in the frontal cortex (Blakemore, 2006, p. 301). The prefrontal cortex, which covers the anterior portion of the frontal lobe, has been associated with both awareness and theory of mind, which are two very important functions that are necessary for effective social communication (Blakemore, 2006). Additionally, the surge of hormones during adolescence, the increased time spent with peers and the continued development of emotion processing contribute to the rapid development and proliferation of social communication at that age.
Assessment Just as with adults, the impact that a traumatic brain injury has on the communication skills and their underlying cognitive processes of an adolescent depends greatly on the nature, specifically location, and severity of the insult. Closed brain injuries in adolescents tend to damage the prefrontal regions. As a result,
During brain development, beginning in the womb into adulthood, all of these cells must be grouped and organized into specific networks, which create the architecture of the brain (Perry & Szalavitz, 2006). The brainstem, the diencephalon, the cortex and the limbic system are the four major parts of the brain. The brain is organized from the inside out, thus, “the lower and most central regions of the brainstem and diencephalon are the simplest” (Perry & Szalavitz, 2006, p. 21) and are also the first to form, therefore, developing first as the child grows and develops (Perry & Szalavitz, 2006). As the brain develops upward and outward, the limbic system becomes more complex and the cortex is the crowning achievement of the brain structure (Perry & Szalavitz, 2006). These four areas of the brain are organized from top to bottom and inside to outside, although these four areas are interconnected, each one controls different functions such as the brainstem controls body temperature, heart rate and blood pressure, as well as respiration. The limbic system and diencephalon control emotional responses that help to guide one’s behavior such as fear, love, joy and anger. The cortex, the top part of the brain, regulates the complex and high functions such as speech, critical thinking, and decision-making (Perry & Szalavitz, 2006). The
The article “Dude, Where’s My Frontal Cortex?” by Robert Sapolsky talks about the delayed maturation of the frontal cortex in teenagers and how the underdeveloped frontal cortex is the cause of erratic behavior of teenagers. Sapolsky explains to the reader how the frontal cortex does not fully develop until the age of twenty for a person and how that part of the brain is important for extensive reasoning, impulse control, and emotional regulation. He shows the reader how particularly emotional situations affect both a teenager and an adult differently due to either having or not having a matured frontal cortex. This example that he uses allows for the reader to see how a teenager responds to situations with extreme thoughts and behavior which
The author of the article states that there is no better time than now to review how we are raising teenagers for many reasons. First and foremost there have been many strides taken recently to understand how the adolescent brain develops, strengthening ones understanding, and in turn, shedding light on errors made in the way adolescents are being raised in relation to their neuro-development. This means that because scientists have learned substantial information about the brain recently, it is important to reevaluate how parents are raising teenagers now more than ever. Second, according to the article it is a good time to review how we are raising teenagers because children are becoming adolescents earlier based on their physical maturation increasing faster each year, therefore it is important to examine why this is occurring. Finally, the author states that there is no better time to review how we are raising teenagers because of the recent discovery that the brain is malleable during adolescence due to neuroplasticity, meaning that the brain is able to be transformed during this time period solely based on the environment in which these individuals are exposed to, as per the article (Steinberg, 2014).
Researchers can look at the brain of a teen to examine their behavioral decisions.Teenage brains these years are more active and dynamic which means it’s still developing.Processing in the Limbic system is a result of risky behavior.The construction of a teenage thinking brain is not cable of fully processing necessary to make responsible decisions.At this stage the brain is still developing.The brain changes depending on interactions, helpimg the teen make changes. At this time the brain will need focused and support for a healthy connection.Surrounding impacts the child faces such as challenging situations is an effective technique.Parents need to consider the teens emotional
During adolescence the teenagers become more risky (take more risks), the frontal lobe (the brakes) are not fully developed so it can’t cope with the temporal lobe (accelerator) which can’t control itself, energetic, adventurous, independent, they will become more independent because of peer influence and just because it’s a sort of natural thing, more rebellious, again peer influenced, intellectual, the older you get the wiser you become, self-conscious, once again peers influence this e.g. fashion appearance, better at making decisions, as the frontal lobe (the brakes) is developing it become easier to make decisions on your own, and either social or unsocial, social= you have a strong relationship with your friends, unsocial= you have a strong internet connection with your friends.
Lasting Psychosocial, Psychological and Emotional Effects of Brain Injury in Individuals Suffering From Traumatic and Nontraumatic Acquired Brain Injury
The prefrontal cortex, which is the anterior part of the frontal lobes, controls understanding consequences, impulse control, abstract thinking, long range planning, and mental flexibility (Ortiz 93-94). Researchers at UCLA, Harvard Medical School, and the National Institute of Health have been working together to understand brain development. Their research has shown that at a young age the brain overproduces gray matter, which is the overall thinking part of the brain. After this comes the pruning process in which gray matter is removed. Paul Thompson from UCLA describes this time as a "massive loss of brain tissue" (as quoted in Ortiz 94). The average amount of tissue lost per year is one to two percent (Ortiz 94). While this pruning process is taking place the myelination is occurring simultaneously. Myelination is when white matter, what insulates the brain, makes brain process more efficient. This process is also thought to shape brains neural connections for adulthood (Ortiz 95). With age, the brain becomes denser and more organized which makes it better at processing and understanding information. Changes in the brain also can happen late into the twenty's (Beckman 3). A member of the UCLA research team reported that "[The] frontal lobe undergoes the most change during adolescence-by far. It is also the last part of the brain development" (as quoted in Ortiz 94). For most, full brain development is reached during the ages
It impacts the maturation of specific brain areas at particular ages, the physiological and neuro-endocrinological responses as well as impacting the ability to coordinate cognitions, behaviours and emotional regulation. Therefore, the effect of trauma is different in different developmental stages. Ornitz (1996) has listed critical periods of major structural changes in brain development in accordance with Piaget’s stages of cognitive development. This includes the periods between early childhood (1.5-4 years), late childhood (6-10 years), puberty and mid-adolescence. This ensures that there are widespread implications of trauma in childhood especially in terms of the age at which exposure to trauma occurs as well as the areas of the brain affected. For example, the volume of the brain shows a rapid increase in first two years (Matsuzawa et al., 2001), a time when the development of attachment also takes place. Moreover, this growth is more experience- dependent (Schore, 2001). Children below the age of two also show a greater right brain than left brain
The above mentioned research study did not control for the age of traumatic brain injury patients in such a way that patients could be compared on this basis. Research on brain damage (due to traumatic brain injury, substance abuse, and other means of neurological harm) and the effects of age on the likelihood of extensive recovery has been conducted over the past several decades in the fields of both medicine and psychology, and conflicting evidence exists. Some studies suggest that young brains are more vulnerable to irreversible brain damage due to the underdevelopment of neurons and brain structures, while other studies indicate that the brains of older individuals are less “plastic” than in younger individuals, making them less resilient to damage. To study the outcomes of pediatric traumatic brain injury as opposed to traumatic brain injury in adulthood, Catroppa et al. conducted research on children that had suffered a TBI between the ages of one and seven years. Participants were recruited
1. During teenage years, the human brain is in a very delicate state of development, and when the brain is damaged during delicate stages, it is more difficult to repair. Damaging a brain in progress is like leaving bricks out of the foundation for a house that is in the process of being built. One cannot fix the foundation of an already built house, and if they try, they will only weaken or destroy its remaining integrity.
It was previously thought that children brains were less sensitive to injuries because the brain had a longer time to rewire or rewrite itself. Since a child’s skull is not as strong as an adult skull they are more susceptible to skull fractures which can puncture the brain and cause serve damage. Studies by Virji-Babul, Borich (ped neurology), showed that in a child’s brain the frontal and temporal lobes are more susceptible to damage. Damage to the frontal and temporal lobes of the brain are a major call for concern because those lobes are associated with learning, memory, and
According to the Center for Disease Control, every year approximately 1.4 million people are victims of a traumatic brain injury (Reeves and Panguluri, 2011). Furthermore, the World Health Organization estimates that traumatic brain injuries will be the leading cause of death by the year 2020 (Ganesalingam et al, 2006). Although this is pervasive societal issue, the vast majority of experiments on this issue focuses on adults, although fatalities are higher amongst adolescents. As a result of their injury, children with traumatic brain injuries experience cognitive deficits which hamper their academic, social and behavioral functionalities. The following literature review examines the causes of traumatic brain injuries in adolescents, behavioral
The short term effect of trauma on the brain development can be mental, emotional and behavioral problems as well as emotional instability and a need for support and comfort or a heightened state of fear. Some short term effects may be memory loss, mood swings, loss of consciousness impaired language skills, loss of balance, and impaired cognitive function. Children with severe brain injuries show greater problems than children with other injuries in the areas of mental processing, learning, memory, behavior, and academic. The children with the brain injury will first seem to be doing okay on cognitive tests and in the classroom but then develop significant behavior problems. An example of child with traumatic behavior would be the fear of
In children, the traumatic brain injury may be even harder to see—and more dangerous as their bodies are still forming. They may become depressed both physically and mentally, not moving around a lot or eating. Change in attitude may become apparent too as they are irritable, crying, and may be unable to sleep.
The purpose of this issue paper is to compare and contrast two different articles one written by L.E. Berk in 2010 that explores lifespan development. The other article was written by the staff and research team at Lucile Packard Children's Hospital at Stanford in 2012 that addresses what cognitive development is and the progress of adolescence cognitive development. Cognitive development begins from the moment of birth and continues throughout life. However, this student finds the cognitive abilities are more complex during the adolescent years. Therefore, the issue this paper will address is adolescence cognitive development.