Allowing for delayed responses to questions or directions or commands
Providing clear and direct feedback regarding behavior
Responding to undesirable behaviors with a clear and specific statement of the behaviors you do and do not want; you cannot count on a person with a brain injury to
understand what’s implied—it must be explicit
Avoiding sarcasm, innuendo, literal expressions and random comments; because of concrete thinking, they may take your comments literally or miss the meaning of your statement or request
Repeating your questions or instructions in exactly the same way to allow for slowed processing; if problems complying with direction appear to be related to comprehension, phrase it another way
Remembering that talking louder will not help understanding, and repeating is not the same as understanding
Modeling calm body language, move and breathe slowly, keep hands down, and use low vocal pitch and congruent facial expression. The behavior of the messenger can affect the behavior of
others; rapid movement and increased voice tone convey an escalation of emotion
Looking and waiting for response and/or eye contact; when comfortable ask to "look at me", don't interpret limited or lack of eye contact as deceit or disrespect
Recognizing and being aware of a person's protective responses to even usual lights, sound, odors, touch, orders, and animals
Following performance of a requested/desired behavior with reinforcement immediately
Reinforcing successive approximations and avoid back-handed compliments (e.g., “It’s about time you…..”)
Remembering that positive feedback changes behavior; punishment only stops behavior, and only temporarily eliminating or reducing the things that may trigger an outburst
Making sure that when demands are made, the person is in a state where he or she is able to comprehend them
Providing environmental compensations to reduce stress and minimize the effects of learning differences; take into account the “why” of behaviors
Designating one person for interactions
Redirecting rather than confront perseverative and organically based behaviors
Utilize people who know the person well, who have worked with them before, and know what their behavior may result from and how to handle it
“Mirroring” can be an effective strategy to reflect back another person’s feelings and statements, it can be used when negative emotions are verbalized or when someone makes
confused and/or disoriented declarations.
It is done without agreement or disagreement,
without frustration or emotional reaction,
without insinuation of judgment,
and without attempt at logic or correction.
The approach utilizes a slow, respectful, non judgmental and patient look at the other person’s statements and feelings.
It can prevent escalation of emotions, aid in de escalation, and allows you to control your emotions by underreacting and staying cool enough
to try other approaches. It prevents engagement in a power struggle
and allows the person to hear and evaluate what they are saying or feeling without the need to be defensive and argumentative.
Don’t take inappropriate behavior personally; remember that it’s not about you
At any given time, a person is doing the best they are capable of given their unique skills, personality, environment, and circumstances
The very nature of brain injury creates disordered thinking
Almost anyone would prefer to be viewed as BAD rather than DUMB
There are two main functions of behavior: to obtain or escape something
There is no single treatment or approach for intervention relative to the behavioral problems commonly associated with brain injury
To manage behavior effectively, one must first seek to understand the motivation of the person and then design a specific, individualized, comprehensive approach
This article is provided courtesy of the Brain Injury Association of Virginia (BIAV) for informational and educational purposes only.
The information is not intended as a substitute for professional medical or psychological advice, diagnosis or treatment, and you should
not use the information in place of the advice of your physician or other healthcare provider. For more information about brain injury or
services and resources in Virginia, please contact BIAV at 800-444-6443, by email (email@example.com), or through our website (www.biav.net)
Traumatic Brain Injury Resources and Information
Traumatic brain injury (TBI) occurs when an external force injures the brain.
Logbook for brain injury survivors and caregivers, who need to keep track of important factors that can affect recovery. Spaces designed to record your symptoms, medication adjustments, environmental factors and reactions, especially effective for identifying and managing emotional seizures.