Explaining Brain Injury, Blast Injury and PTSD to Children and Teens

Explaining Brain Injury, Blast Injury and PTSD to Children and Teens

Marilyn Lash, M.S.W., Janelle Breese Biagioni and Tonya Hellard

When a parent is injured, sons and daughters often feel confused, scared, anxious and even angry. This guide helps parents explain the physical, cognitive, behavioral, social and communicative changes that can follow a brain injury, blast injury or PTSD. Using examples from children of all ages, it helps them understand their emotional reactions to a parent’s injury or PTSD. Each chapter has an exercise for children and practical tips for children, parents and professionals.

Read an interview with Marilyn Lash on why she wrote this book.

Explaining Brain Injury is also available as an eBook click here .

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Full Description

This guide addresses the emotional impact of a parent’s injury upon children in the family. It discusses the complex and conflicting emotions expressed by many sons and daughters as they recount the impact of a mother or father’s brain injury on their lives and their family. A special chapter on PTSD is especially relevant for military families and returning veterans.

Based on extensive interviews with children and teens, this guide tells their story through their personal experiences as they grew up with a parent with a brain injury or PTSD. Their comments and insights will resonate with many families. By understanding the anxieties and fears of children, parents learn how to provide emotional support, communicate with children, and help children cope. This guide is very helpful for families at any stage post injury or recovery as it covers children’s perspectives from early hospital care to adjusting to life at home after a parent’s injury.

ISBN# 9781931117531
Pages 80 pages, 7 x 8½, perfect bound
Year 2009


Marilyn Lash, M.S.W.

Ms Lash has over 35 years of experience working with persons with disabilities and their families in medical, rehabilitation, educational and vocational settings. Currently, she President at Lash and Associates Publishing/Training, Inc. in Wake Forest, NC. Author of many publications on the psychosocial impact of brain injury, her writing and training emphasize coping strategies for families and practical interventions by professionals and educators in hospitals, rehabilitation, schools and community programs. Trained as a social worker at Boston University School of Social work, she has done clinical work as well as program development. While at Tufts-New England Medical Center in Boston, she was Training Director at the Rehabilitation Research and Training Center on Childhood Trauma. She continues to be an Assistant Clinical Professor in the Department of Physical Medicine and Rehabilitation at Tufts University School of Medicine. Active on many national committees, she formerly co-chaired the National Task Force on Children and Adolescents of the Brain Injury Association of America. She is on various national task forces on brain injury and editorial boards of rehabilitation journals. She is the Past Chair of the Brain Injury Association of North Carolina and current Chair of the North Carolina Statewide Advisory Council on Traumatic Brain Injury.

Janelle Breese Biagioni

Janelle is an author, international speaker and a long-standing advocate for families and survivors of brain injury. Her book, A Change of Mind published by Lash and Associates Publishing/Training, chronicles the changes in her marriage when her husband, Gerry Breese, had a severe brain injury from a motorcycle crash while on duty as a Mounted Policeman in Canada. She knows first hand the stress and challenges of trying to be a parent to two children while simultaneously being a wife and primary caregiver to a husband with significant cognitive, behavioral and emotional challenges following a traumatic brain injury. Her personal experience led her to earn a Certificate in Death and Grief Studies at the Center for Loss and Life Transition in conjunction with Colorado State University. She speaks and writes frequently on bereavement and coping strategies for families affected by catastrophic injury with workshops and presentations on grief and loss at conferences and on television and radio. Her next book, Extraordinary Mourning: Understanding Grief after Brain Injury, will be published soon. Janelle resides with her family in Victoria, British Columbia. She is editor of Headline a quarterly publication serving the brain injury community. To learn more, please visit her website at www.soulwriter.com .

Tonya Hellard

Tonya was particularly helpful in researching and identifying issues on parenting and the effects of PTSD.



Single Parent Families

Military Families

How to Use This Guide

Chapter 1 Helping Children when a Parent is in Coma and the Hospital

EXERCISE for Children

Giving Information to Children

Delivering Bad News “What is a Coma?”

How can Children Help?

Military Families

Helpful Tips

EXERCISE for Children

Chapter 2 Giving Emotional Support to Your Children

Life or Death


Helpful Tips

EXERCISE for Children

Chapter 3

Understanding a Parent’s Brain Injury

Military Families

Changes in Behavior

Changes in Thinking (Cognition)

Physical Changes Changes in Speech and Language

What is Independence?

EXERCISE for Children

Chapter 4 Having with a Parent with PTSD

What is PTSD?

How will the Child Feel?

Protection and Overprotection

What to Expect from Children when a Parent has PTSD

Children’s Behavior and Social Skills

How Can You Help Your Child When a Parent has PTSD?

Finding Treatment


Chapter 5 Helping Siblings Adjust at Home

New Routines

Emerge Bond Between Siblings

Teaching Parents

New Alliances

Helpful Tips

EXERCISE for Children

Chapter 6 Dealing with Friends and School

Who Knows What?

Fitting In at School

Getting Help at School

Helpful Tips

EXERCISE for Children

Chapter 7 Moving On

EXERCISE for Children

Recommendations for Reading and Resources



The bond between a parent and a child is very special and unlike any other relationship. Mother and daughter, father and son, mother and son, father and daughter – each relationship is special and unique to each family.

When a parent has a brain injury, the family is changed. Some changes are temporary; others last a lifetime. This can be a very confusing time – for parents and for their children. No matter what age children are, they will have questions. This guide was written to help families answer some of those questions including, “What do I tell my children? How can I help them understand?” and “What do we do now?”

Some children have a parent with a traumatic brain injury. Others have a parent who has had a stroke, aneurysm or anoxia. Others have a parent with a blast injury. Some have a parent with post traumatic stress syndrome (PTSD). Some parents have visible signs of an injury or disability. They look different, so it is obvious they have been hurt. Some have broken bones or need surgery. Other parents look the same, so it is harder for their children to understand what it means to have a brain injury. Children can readily understand why mom needs to use crutches because she broke her ankle or dad needs extra sleep because he had surgery. It’s harder to understand why mom is mad most of the time or dad jumps at loud noises and has nightmares.

The most frequent comment by children of all ages - youngsters, preteens and teenagers - is that, “No one else understood” what it was like for them when mom or dad was injured. Many children have said, “Our family was never the same. It changed our lives forever.” Much of the content for this guide is based on interviews with sons and daughters. Their courage to speak out and share their experiences, emotions, hopes and fears is applauded.

The crisis of brain injury forces many children to grow up quickly. They often become more independent and self-reliant at an early age. Caring for younger siblings, preparing meals, doing laundry, and going to school are often seen as reassuring signs of coping by relatives. Yet while children “do the things that need to be done,” they often feel confused, alone, angry, and sad. Too often, there is little time or opportunity for families to talk because they are struggling just to get through the day.

Children often feel lost or forgotten because they often do not receive the same and consistent level of parenting they had prior to a parent’s brain injury. Seeing the stress and worry among relatives and family members, children often hesitate to express their needs. Instead, they hold their fears and feelings inside and learn too late that not talking only makes them feel more cut off. Unfortunately, the adults (parents, family and friends) can mistake this silence as “coping” when in fact it isn’t coping at all.

Life may not be the same ever again. A parent’s return home from the hospital or rehabilitation program usually signals excitement and hope for the family that life will get better now. But it can also be mixed with sadness and uncertainty. Hope grows with signs of a parent’s progress toward recovery. Yet at the same time, there are daily reminders of how much a parent has changed. Coming home is the beginning of a new journey.

How to Use This Guide

Each chapter has a section with “tips” or practical strategies for children, parents and professionals. This guide can be used several ways…

§ Parents reading this guide will find insights into the needs of their children for support, information and guidance. This guide is not written for children, but each chapter has a section called “Tips for Children”. Parents can use these suggestions in conversations with their children.

§ Do the exercises with your children. These exercises are intended to open the lines of communication between the uninjured parent, the injured parent and the children. They will help increase your children’s awareness about how they feel.

§ Health care professionals and educators will learn methods for helping children of all ages cope with the changes in their families and lives.

§ Families of veterans and service members will find information to help their children when a parent has been injured or has post traumatic stress disorder (PTSD).

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