Spotting the signs of acquired brain injury (ABI) in adults:

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Spotting the signs

The consequences of ABI span physical, sensory, cognitive, emotional, communication and behavioural domains, with damage to the frontal lobes in the brain causing altered behaviour, anxiety and irritability, among other problems. Social workers have a crucial role in identifying ABI in all these domains, otherwise, assessments will not reflect an accurate picture of the individual’s care and support needs which could let to treatment delay and inappropriate support. Below are key signs to spot:

Physical
– Disturbed sleep/wake cycle and fatigue
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Slurred or difficulty speaking (dysarthria) and uncoordinated movements (ataxia)
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Epilepsy
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Swallowing difficulties (dysphagia)

Sensory
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Sight damage, including difficulties with depth perception as well as sight impairment
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Impaired hearing or loss of hearing
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Tinnitus, which may also affect balance and cause nausea
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Loss of smell and taste
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Changes in tactile sense: becoming more or less sensitive to touch

Cognitive
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Poor memory, concentration and slower information processing
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Difficulty reading and writing
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Impaired understanding/ability to think logically

Emotional
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Loss and sadness
– Frustration and anger
– Easily altered emotions
– Reduced self-esteem and low confidence

Communication
– Difficulty reading emotional prosody (voice tone, pitch, volume and so on)
– Being unable to pick up on visual clues such as in facial expressions and body language
– Experiencing expressive or receptive aphasia (an inability to comprehend or formulate what they want to say)

Behavioural
– Aggression
– Perseveration (where the person repeats the same word, phrase or gesture)
– Apathy and lack of initiation
– Sexually inappropriate behaviour

It can be difficult to assess all the consequences of an ABI when looking at someone’s care and support needs, particularly if it is not diagnosed or even known about.