Brain Injury - Planning, Problem-Solving & Adapting To Change

Brain Injury - Planning, Problem-Solving & Adapting To Change

Children often have difficulties with planning, problem-solving and adapting to change after they have had a brain injury or illness that affects the brain. Find out what you can do to help.

Key points to remember about brain injury and planning, problem-solving and adapting to change

This page is part of a whole section on brain injury.

  • children who have had a brain injury (or a medical condition that affects the brain) can have difficulties achieving goals on their own and adjusting their approach to tasks
  • they can also have difficulties coping with unexpected changes in situations or activities
  • there are several ways you can help
  • establish consistent/regular routines
  • help your child with planning and organising
  • prepare your child in advance for changes

What skills do young people need to set and achieve their goals?

As children get older and become teenagers, they develop higher-level thinking skills, which allow them to set and achieve goals independently. They can also be flexible and adjust their approach to tasks when needed or cope with unexpected changes in situations or activities.

These higher-level thinking skills are often affected in children who have had a brain injury or an illness that affects the brain (such as epilepsy).

What signs and symptoms might I notice if my child has difficulty setting and achieving their goals?

You may notice that your child has difficulties with planning, organisation, problem-solving, self-monitoring and thinking flexibly.

The kind of difficulties your child experiences will depend on their type of injury or illness and how serious it is.

You may only notice these difficulties when your child reaches their teenage years. At this stage, you would normally expect more independence with less structure and guidance from parents and teachers.

Difficulties with planning and organisation

You may notice that your child:

  • starts tasks impulsively rather than planning the steps needed before starting
  • becomes overwhelmed with complex, multistep tasks and can't work out where to begin
  • struggles to prioritise tasks and organise schoolwork or extracurricular commitments, particularly when there are multiple commitments or demands (for example, if they have several school assignments due at once)
  • is unable to manage their time effectively (for example, they start tasks at the last minute or underestimate the time needed to finish a task)
  • appears lazy, disorganised and careless with their belongings (such as forgetting to bring equipment they need for a task)

Difficulties with problem-solving and self-monitoring

You may notice that your child:

  • has difficulty monitoring or evaluating their performance (for example, they may make lots of careless errors and are unaware of them)
  • is unable to work out why something has gone wrong or to think ahead to see upcoming problems
  • has trouble thinking of another way of doing something when things are not working

Thinking flexibly or coping with change

You may notice that your child:

  • has trouble adjusting their approach to a task or trying something different when their first attempts aren't working
  • has difficulty changing from one activity to another (such as moving on to a new schoolwork task in the classroom)
  • struggles to cope with new situations or changes in their usual routine

How can I help my child with goal setting difficulties after brain injury?

Establish regular routines

A stopwatch and heartEstablish regular routines for everyday activities and provide your child with more support with structuring their day/week (as you would if they were younger). This means they have to do less independent planning and organisation.

Avoid sudden changes

Try to avoid sudden, unexpected changes in their usual routine where possible and prepare them in advance for changes when needed (for example discuss and provide lots of reminders of an out of routine activity or outing).

Use distractions

If you need to move your child off an activity, task or topic of conversation they are stuck on, use distraction rather than confrontation.

Reduce their thinking load

A person thinkingReducing your child's overall thinking/organisation load by cutting down the amount of daily/weekly activities they need to do, particularly on school days.

Use organisers

A DiaryEncourage and support your child to use a paper diary, wall calendar and/or digital organiser to help with organisation and time management. They may need prompting to enter information and check their organiser. Your child's teacher or school learning support coordinator can also use this organiser when arranging schoolwork tasks and activities. 

Prioritise tasks

A checklistSupport your child to prioritise tasks or activities, particularly when they are overwhelmed with multiple demands or commitments.

Help with decisions

2 speech bubblesHelp your child with making decisions or thinking of possible solutions to a problem (such as choosing subjects for the next school year).

What can school do to help my child with goal setting difficulties?

Establish good routines

A stopwatch and heart

Teachers can establish regular routines for the school day and provide more support with structuring your child's day/week, so they have to do less independent planning and organisation.

Prepare for change

Teachers can prepare your child in advance for changes in their usual school routine (such as discussing and providing plenty of reminders about a school outing). You can also ask teachers to let you know about changes in advance so you can remind your child.

One on one explanations

2 people talkingWhen teaching a new concept or skill, teachers can help by giving direct instructions, rather than expecting your child to work out what to do on their own. Teachers can also give your child time to practice the task or skill with supervision and prompts before leaving them to complete it by themselves.

Break down tasks

2 puzzle piecesTeachers can help your child to break down complex task or projects into smaller parts or steps and organise their approach (such as helping them work out where to start and what to do next or by helping them prepare a step-by-step written plan to follow).

Allow extra time

A clockWhen suggesting other ways of completing a task, teachers can allow your child time to consider, or take on board, a change in approach. Provide clear, calm feedback and praise and reinforce any attempts at trying a new way of doing things.

Use distractions

If your child gets stuck on an activity or in their approach to a task, teachers can use distraction rather than confrontation to move them off when needed.

Reduce workload

A stack of booksTeachers can help reduce your child's overall thinking/organisation load by cutting down the amount of schoolwork your child has to complete.

If your child is at primary/intermediate school, this can mean focusing the curriculum on core learning areas and removing homework or keeping homework loads light.

If your child is at high school, this can mean removing a subject or subjects from their timetable. They can then use free periods for extra planning and organisation (preferably with support).

Use organisers

A diaryTeachers can help your child in using a diary, daily planner or digital organiser to help with organisation and to create timelines for longer-term projects (particularly for teens). Teachers may need to prompt your child to enter information and check their organiser.

Helping with prioritising

A checklistTeachers can also provide support with prioritising, particularly when your child is overwhelmed with multiple schoolwork demands or commitments. This might include helping them to choose the most important schoolwork tasks and deciding which tasks they can leave.

The content on this page has been developed and approved by the Clinical Neuropsychology Team, Consult Liaison, Starship Child Health.

This page last reviewed 20 February 2020.
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