Key points about brain injury and planning, problem-solving and adapting to change
- tamariki 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 have difficulties coping with unexpected changes
- there are several ways you can help
- establish consistent routines
- help your child with planning and organising
- prepare your child in advance for changes
This page is part of a whole section on brain injury. You might also find some of the other content helpful.
Skills that young people need to set and achieve goals
As tamariki 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. Their capacity to cope with unexpected changes in situations increases.
These higher-level thinking skills are often affected in tamariki who have had a brain injury or an illness that affects the brain (such as epilepsy).
Signs and symptoms of difficulty setting and achieving 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
Difficulties with flexible thinking and 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 to help your child with goal setting difficulties after brain injury
Establish 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.
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).
If you need to move your child off an activity, task or topic of conversation they are stuck on, use distraction rather than confrontation.
Reducing your child's overall thinking and organisation load by cutting down the amount of daily and weekly activities they need to do, particularly on school days.
Encourage and support your child to use a paper diary, wall calendar 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.
Support your child to prioritise tasks or activities, particularly when they are overwhelmed with multiple demands or commitments.
Help your child with making decisions or thinking of possible solutions to a problem (such as choosing subjects for the next school year).
How school can help your child with goal setting difficulties
You can talk with your child's teacher about your child's difficulties and show them this website with things they can do to help.
Teachers can establish regular routines for the school day and provide more support with structuring your child's day and week, so they have to do less independent planning and organisation.
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.
When 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.
Teachers can help your child to break down complex task or projects into smaller parts or steps. They can help your child to organise their approach to tasks (such as helping them work out where to start or by helping them prepare a step-by-step written plan to follow).
When 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.
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.
Teachers can help reduce your child's overall thinking and organisation load by cutting down the amount of schoolwork your child has to complete.
If your child is at primary or intermediate school, this can mean focusing the curriculum on core learning areas and removing or reducing homework.
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).
Teachers 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.
Teachers can also provide support with prioritising tasks, 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.
More information
The Ministry Of Education's Te Kete Ipurangi (TKI) site has a range of practical resources for teachers to help students returning to learning following a concussion or other acquired brain injury (ABI).
Topics include:
Changes to physical wellbeing
Changes to cognition and thinking processes
Effects of ABI on stages of development
Changes to emotions, social skills, behaviour, and wairua
Acknowledgements
The content on this page has been developed and approved by the Clinical Neuropsychology Team, Consult Liaison, Starship Child Health.
