One of the common consequences of traumatic brain injury (TBI) is sexual dysfunction. Unfortunately addressing sexual issues as a component of rehabilitation is often overlooked for a variety of reasons.

“Sexuality is an integral part of the human experience” (Sander). We are all sexual beings and sexuality is part of our life experience. Social mores and cultural differences make sexuality a taboo issue in some societies. Many therapists and other direct care providers in hospital and rehabilitation settings are untrained about sexuality and persons with disabilities. Their personal values often interfere with their ability or comfort level discussing the topic. When sexuality is overlooked as part of rehabilitation, sexual dysfunction can become an issue that is very difficult for families to understand. Social isolation, common for persons after TBI, limits opportunities for developing meaningful relationships.

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Cognitive rehabilitation for children and youth with brain injuries (tbi) must address the developmental impact of brain trauma as the child matures. Children with traumatic brain injuries have unique needs for treatment and cognitive rehabilitation that are different from adults with brain injuries.

Children and youth with acquired brain injuries are less likely to receive inpatient rehabilitation than adults. School becomes the setting for cognitive rehabilitation for students with brain injuries. Consequently, families and educators become the long term providers of educational services and rehabilitation supports in local schools and the community.

The student with a brain injury will have changing educational needs as the latent effects of trauma to the brain emerge over time. So it is important for families and educators to work together as partners to identify and meet the needs of children and youth with brain injuries.

Identification and treatment of behavior challenges after acquired brain injury (ABI) have included behavioral modification programs, medications to control abnormal behaviors, token economies, and social reinforcement. Despite the widespread recognition of behavioral issues, today few resources exist for crisis hospitalization and treatment by mental health programs.

Concussion is the most common type of traumatic brain injury in adults. Concussion symptoms can include headaches, dizziness, trouble sleeping and difficulty concentrating. Mild traumatic brain injury is a “hidden” condition because too often it is not diagnosed by medical professionals. Many individuals are unaware that their brain has been injured and do not see a doctor or go to an emergency department. Most symptoms are temporary but some adults have long term effects with post concussion syndrome.

Blasts and explosions are major causes of brain injuries in soldiers injured in Iraq and Afghanistan. Concussion or mild brain injury is often not diagnosed since there is no loss of consciousness and soldiers return to duty. Post traumatic stress disorders (PTSD) have been diagnosed among soldiers and veterans exposed to combat stress who have returned home.

The severity of a brain injury ranges from very minor concussion to extremely severe brain trauma. Service members are exposed to additional damage from the blast’s impact. They can be thrown or propelled by the blast, be burned and inhale toxic substances.

Recovery from brain injury is a long process for families and schools. An injury to a child’s brain is a physical and emotional trauma. Changing symptoms – a neurocognitive stall – may appear over a year after the brain injury. Students have new cognitive challenges in school as the brain recovers and learning becomes more complex in school. Family training and education of teachers on TBI are essential to help children cope and learn at home and in school.

Treatment for traumatic brain injury can be costly for the child or adult who has been injured as well as the family. Hospital care, rehabilitation, therapies, medication, home care, equipment – all can be costly. These expenses are added to lost income of family members. The costs of care for traumatic brain injury, insurance limits, and limited community resources add to the stress of families.

Survivors of traumatic brain injury worry about the effects of aging on cognition, depression, Alzheimer’s disease, and epilepsy. Aging is not a disease, but aging can compound the effects of brain trauma including memory, organization, and problem solving. Ten rules are given to help adults with TBI with the aging process.

Reservists and National Guard have long deployments in Iraq and Afghanistan which are stressful for families and children. War changes soldiers. Many veterans come home with blast injuries, undiagnosed concussions, post traumatic stress disorders (PTSD), burns and amputated limbs. Adjusting to civilian life, going to college, returning to work, and living with family can be stressful for veterans and family members.