Identity change in children with an acquired brain injury (ABI)
Date: 28/07/2015 Host: @deblants
Tonight’s chat will be hosted by @DebLants who has written the following post to introduce tonight’s topic
What makes your identity?
Our identity is who we are, our past experiences, our memories, our confidence, our friends, our family, our home, our hobbies, what we look like, our sense of humour, our strength’s and challenges… our identity is how we understand, perceive and experience the world around us – interconnections between our neurology, environment and spirituality.
Children that have an ABI have experienced a vast change in who they are. One moment they are who they have always have known themselves to be, the next they are different and face lots of challenges. This causes a change in their identity, they are no longer the person that they have always known themselves to be.
Memory may have been affected meaning that they have difficulty remembering the past or creating memories. They may no longer be able to participate in their hobbies – they may not even be interested in these hobbies anymore. They may lose old friends, and gain new friends with difficulties too. They may not be able to live in the home they were in prior to their ABI as they are now a wheelchair user. They may look different because of the injury or medications. Their role within their family may have changed and their parent may also have the extra role as a carer. The list goes on and on.
The added difficulty for children is that they were already growing and changing, learning new skills and knowledge everyday – which was part of their identity. Also, depending on their age, the child may have difficulty to understand the obscure concept of identity, meaning that they portray and explain this in different ways – ways that therapists have to learn to adapt to.
“The value of identity of course is that so often with it comes purpose.” Richard grant – American author.
A simplified and multi sensory approach of brain injury training can aid a child to understand and gain insight into their illness without overloading them with jargon and scary thoughts. This can lead to an acceptance of the changes and a willingness to face the challenges ahead – something that Occupational Therapists (OT) can support and encourage. Also, by learning what a child used to identify themselves with OT’s can then plan therapeutic sessions around this with the hope to increase motivation. For example, a child may have loved to play football but now can’t in the same way. An OT could plan sessions around the rules of the game, planning the tactics of the game, working on gross motor skills of throwing and kicking etc.
The majority of the models of practice used to guide our interventions as Occupational Therapist’s (OT) highlight the importance of the self. Such as – Reed and Sanderson’s Human Occupation Model, the Model of Human Occupation and the Canadian Model of Occupational Performance and Engagement. Illuminating that as Occupational Therapists we work with a person as a whole, including all parts of themselves and therefore their sense of self.
These children may have an acquired brain injury, but, our role as OT’s is to support the children to ensure their brain injury does not become their identity. Instead their new found courage, resilience and endurance does, along with all their new and re-learned skills and knowledge. Something they and their families will be extremely proud of.
Here are three tips on how to talk to a child with an ABI:
An interesting and relevant read:
How an Occupational Therapist should conceptualise self-awareness following traumatic brain injury in childhood – a literature review by Lorna Wales 2013 in the British Journal of Occupational Therapy.
Questions to consider:
- What can you do as an OT to help a child build their new identity positively?
- What has the biggest impact on identity change for children after an ABI?
- How can we help parents/family understand the child’s new identity?
- How can we communicate with a child about the change in their identity?
- Is identity the same as occupational identity? And which one are OT’s concerned with?