So, the thought occurred to me....

I recently realized that while I alluded to having social challenges, I didn't provide much info about the how and the why. Allow me to do so now...... Please.

In addition to, complementary to, whatever.... a brain injury, at least in my case, is Nonverbal Learning Disorder. Essentially what that means is difficulty learning skills, social and otherwise, unless they are specifically verbally taught. Brain injury disrupts the brain making normal brain connections. A typically developing brain can learn skills and unwritten rules and guidelines, simply by observing situations; however a brain that has disrupted develoment needs more specific teaching.

For example, you call someone, they are in a hurry and don't have much time to talk. They may specifically tell you that but it is more likely that will try to give "cues" such as short, direct answers and comments and/or a more frustrated, rushed tone of voice. Not necessarily rude, just trying to provide feedback that they can't talk for long. Unfortunately, if the person on the other end has had a brain injury, cues won't do the job. They need more specific, yet postive feedback such as, "Now is not a good time for me, when can we talk again?" They need to know that you can't talk now, that you are not mad/upset, you can/will continue the conversation later. (Or at least that has been true in my case.....)

A couple of other examples: unless there is specific teaching an individual with a brain injury is less likely to know what not to say/ask. Knowing when a question is too personal or when there is too much/unecessary information (like a clogged toilet. True story)

Finally, social situations are challenging for somone with a brain injury because there is so much brain negotiation required. For example, a preschooler who is trying to enter a playgroup. The act of choosing a group, making their way over there, deciding what to say/do to enter the playgroup, and how to adjust if their first entrance attempt fails. This can be overwhelming for inviduals aged children to adults!

So, whether you work, know or love someone with a brain injury, remember to do direct, specific, positve teaching and modeling to learn and develop social skills. It's needed and appreciated!

A Different Approach

Math was not my friend during elementary school years. In fact, a lot of times it was my enemy! Math just did not make a lot of sense to me and as the academic challenges increased so did my level of frustation. I believe the biggest reason for my math struggles was that I approached problems in a different way than what was being taught. When the approach made sense to me, I did OK.

For example, I did really well in addition but I did not have a traditional problem solving approach. The classroom approach was to count/add number by number. 7+8 would be solved by starting with 8 and counting, 9,10,11,12, etc. However, I discovered an approach that seemed easier and made a lot more sense to me! I already knew that if I added 10 to any number, the first digit would remain the same, the second would increase by one. So naturally if I added 10 to 7, it would be 17. Next, I knew that subtracting 10-8 would be 2. So once I had 17 in my mind, I just subtracted 2 and got 15! Easy for me? Yes. Traditional? Perhaps not, but it worked for me!

Even today I can count from 17 to 510 simply by adding 20 and subtracting 3. Again, I stress the importance of trying new strategies and approaching and individualizing education for the child even when it may be untraditional. Because when an approach finally does click for a child, it feels fantastic!

Learning to Tie my Shoes

When I think of eventually mastering skills as a child, I think of learning to tie my shoes. It took a significant amount of time. I did not successfully learn how to tie my shoes until I was 8 1/2 years old. I do not recall previous attempts of shoe tying-aside from being at school and having to ask peers to tie my shoes for me.

But I do clearly remember the afternoon when I mastered shoe tying. My great-aunt who had been a nurse for many years was visiting and my parents told her about my shoe tying struggles. She asked if she might give it a try with me. I remember sitting with her on the living room couch with a single shoelace in hand. She had me practice crossing, tying, knotting a shoelace not on a pair of shoes but around my knee. Before the afternoon was up, I could tie my shoes!

The message: when a child is struggling to master a skill, don't give up. Just try a different approach! You never know what approach may be just what clicks for the child.......

Social Struggles

Having social struggles is nothing new for me. As a child through a teenager, while most of my peers were excitedly awaiting recess and/or lunch break as a chance to see and visit with their friends, I dreaded it. Why? Because it meant a span of time when I would be in large social settings and I would need to find someone to eat with or else be alone. I could usually find someone eat with that I happened to know and wouldn't care if I sat by them. Unfortunately, this typically meant that they wouldn't care if I wasn't there, either.

My lunchtime troubles were elevated my junior year of high school when my family moved to a new country and continent. I don't know that words can adequately describe what it was like to be living so far from home for the first time and attending school in a foreign country. Yet I still managed to thrive in that environment by participating in extracurricular activities. This strategy may not work for everyone, adding one more thing to a schedule might be too overwhelming, but for me it really worked! It led to leadership opportunities, responsibilities during lunchtime and even if my peers and I were not friends outside of club activities it gave us a connection and let me feel like I belonged.

Post-high school I needed a new strategy. I needed support for how to negotiate social situations- what to say, how to react, etc. I asked my sister to become my "social coach" and even today we discuss, we role-play and she gives me feedback, at my request. Recently, I wanted to have dinner with my friends to celebrate my grad school graduation. But the first round of invites brought no results and I was sorely disappointed. With my sisters guidance, new invites were sent out, using a new medium of communication, and nine friends accepted! It was a very sweet moment to go from years of eating alone to have so many friends surrounding me and supporting me.

Getting Lost and Then Finding My Way

My earliest memories of getting lost date back to kindergarten. I lived across the street and around the corner from the school, a 2-3 minute walk at the most. However, I was unable to find my way home on my own. And as I increased with age, my ability to navigate, did not.

My philosophy on why it was so hard for me to find my way around is this: if I had to find my way independently for the first time, and I had directions, I was more likely to be successful. Not gauranteed, but more likely. However, if I did not idependently find my way, if I was following someone or just riding in the car, my "brain did not learn the way." The next time I had to make that trip, I would remember very little about how to do it, even if I had made that trip several times.

The good news? Things got better for me. Much better. Though navigation is still not a strength of mine I have found ways to adapt so it does not limit my life. First, whenever I am going somewhere new I try to leave in plenty of time to get there. Stress/anxiety tends to disrupt my ability and think logically about how to get from here to there. Next, I get directions- from online, from friends, etc. Finally, I tell people, in good taste, that I have a poor sense of direction. For example, my group of friends that I go out with know that I have a harder time finding my way around. Letting them know that has been helpful because it takes the pressure off me to help navigate and if I give bad directions or something goes wrong we can laugh about it, etc instead of me feeling embarrassed.

A challenge does not necessarily mean it is a limitation. Remember that.

Introduction to Claire: A Success Story

Written by Dr. David Nilsson, Ph.D

I first met "Claire" about 9 nine years ago. She was first referred at that time for a neuropsychological assessment, presented as "bright" but with unusual variation in her academic function, presenting difficulty for hand/eye coordination, handwriting characterized as "horrible." Claire presented with particularly low stress and frustration tolerance, and promiment elevations of anxiety. Through her diligent effort she had been an excellent student, consistently on the honor roll but working unusually hard for grades. Math has been a particular concern; she nearly failed math, even with a calculator. Claire struggles socially still and becomes overwhelmed and over-stimulated. Her speech had been rapid and dysfluent, describing herself as an "intense person." Claire recognized the need for external structure having a difficult time relaxing and overreacting emotionally. She presented with an impressive tenacity, reactive irritability, and social anxiety. She displayed an unusually strong sense of right and wrong.

In completing neuropsychological testing, Claire presented with a mixed neurodevelopmental profile a pattern of impressive elevations and frustrating functional deficits. Based on history and testing it was my opinion that Claire experienced neurological injury, the source not clearly evident. No pregnancy or delivery complications were evident but Claire did have early vision problems (ie strabismus) undergoing surgery at 18 months. She developed asthma at age 2, clearly familial. She was described as her mother as beginning to stutter, expressive language becoming noticeably dysfluent, right after receiving a vaccination. Her oral motor function became somewhat imprecise. She did not learn how to ride a bike until 7 or 8 years of age.

Claire's drawings early in school were immature, drawing a circle as a straight line.

Subsequent to a rocky beginning, Claire has been very attentive in accepting feedback and applying it, continuing to the present day, having successfully completing a Master's Degree in Special Education. Claire continues to progress, making an important contribution to children and their development as a teacher.