Changes in Self Awareness Among Students with Brain Injuries

Changes in Self Awareness Among Students with Brain Injuries

McKay Moore Sohlberg, Ph.D., Bonnie Todis, Ph.D., and Ann Glang, Ph.D.

A student with a traumatic brain injury or TBI may have limited awareness of cognitive, social and behavioral difficulties. This can be challenging for educators as the student may resist supports and accommodations. This manual explains how brain trauma can affect self awareness and shows educators how to use awareness activities to help students with brain injuries in middle and high schools.

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Full Description

This manual explains five factors that contribute to a student's unawareness after acquired brain injury. It shows how to work with the student by using awareness activities consistently over time. Awareness exercises show how to:

  • build studentís awareness of how things are going at school
  • understand effects of brain injury on school work and peers
  • develop adaptive strategies with teachers.

This manual explains the causes of unawareness and gives practical suggestions and worksheets for working with students in middle, junior high and high school.

ISBN# 1-931117-09-8
Pages 32 pages, 7 x 8Ĺ softcover
Year 2016 (2nd edition)


McKay Moore Sohlberg, Ph.D.

As Professor in the Communication Disorders Program at the University of Oregon, Dr. Sohlberg conducts clinical research aimed at developing and evaluating methods to help adolescents and adults manage cognitive changes after brain injury.

Together with Drs. Glang and Todis, she worked on this project to learn how schools could help their students with brain injury be more successful. She is grateful for the insights of the many students and staff in secondary schools throughout Oregon who contributed to the development of these materials.

Bonnie Todis, Ph.D.

As Associate Research Professor at Teaching Research, a division of Western Oregon University, and University of Oregon, Dr. Todis has used qualitative methodology to explore a number of issues in special education, including assistive technology, resilience factors for youth with disabilities in incarcerated settings, and self-determination for adolescents with disabilities. Her current work focuses on studying effective supports for individuals with brain injuries in schools and other service delivery organizations.

Ann Glang, Ph.D.

As an Associate Research Professor at Teaching Research, a division of Western Oregon University, and a research scientist at Oregon Center for Applied Sciences, Inc. (ORCAS), Dr. Glang has worked as a special education teacher and as an educational and behavioral consultant in a rehabilitation unit specializing in treating adolescents and adults with traumatic brain injury. Since 1987, her research interests have focused on developing effective support services for children with brain injuries, their families, and the schools who serve them. In her work at ORCAS, Dr. Glang is developing multimedia programs to teach pedestrian and bicycle safety skills to prevent brain injuries in children.


About the Authors
Introduction to Changes in Awareness
Sources of Unawareness
What to do... and not to do
Program to Increase Awareness
Awareness Exercise 1
Awareness Exercise 2
Awareness Exercise 3
Awareness Exercise 4


Introduction to Changes in Awareness

He doesnít think anything has changed.

She gets angry when I point out how she has changed since her brain injury.

I just donít know how to get through to him.

No matter what I say or do, she just doesnít seem to get it.

These comments describe the frustrations so often experienced by parents and educators when a student has a brain injury. Some students may not recognize that the brain injury has resulted in changed abilities and created new needs for assistance. It is hard for parents and educators to help if the student believes that nothing is wrong.

Adolescence is rarely easy for anyone, including parents and educators. The major goal of adolescence is the development of an individual identity independent of parents. This is even more challenging for students who have brain injuries and are in middle, junior high or high school. They may become more dependent at a time when they are trying to establish their autonomy.

When students with brain injuries are unaware, or have inaccurate perceptions of changes in cognitive, physical, and sensory abilities, educators are challenged to help them. It may mean that a student is not willing to accept special accommodations or adopt compensatory learning aids. Decreased awareness of needs and difficulties may also prevent a student from setting realistic academic or vocational goals. Awareness can be especially problematic for students who are injured in middle or high school, since these students are already dealing with the many challenges of adolescence.

The good news is that accommodations and/or interventions can help build awareness. The first step is understanding the origins of altered awareness. The next step is to select the most appropriate strategy to facilitate increased insight or awareness. This manual describes the most common causes of changes in awareness and explains how educators can help the student with a brain injury, who is not fully aware of changes in abilities and functioning.

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