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behavior

There is very little information available regarding behavioral issues that specifically deals with children who have hemiplegia or stroke. The information provided on this page is more general and deals with behavior issues in children who have a traumatic brain injury. These issues may or may not be similar to behavioral issues in children with hemiplegia or stroke.  This hope that the research community will notice this lack of information and begin to design and implement studies in this area.

Behavioral Issues resulting from Traumatic Brain Injury in Children

Children with a "mild" brain injury may experience difficulties with concentration, organization, managing multiple tasks simultaneously, memory, and relationships with others.  Children with a "moderate to severe" injury may experience varying degrees of difficulty in emotional, behavioral, physical, social, and cognitive areas.  Some challenges do not become apparent until the child matures and more complex skills are required of the child.  In other words, a child may not experience these problems at age three, when little organizational or behavior control are expected, but may experience problems as a teenager when more control is expected.

The following lists possible outcomes of traumatic brain injury. While children who have hemiplegia/stroke from birth may not have "changes" in skills, they may still experience some of the following issues.

Changes in Cognitive (Thinking) Skills

  • Less attention and concentration; trouble paying attention to someone who is talking; changing from one topic to another; trouble staying on task or completing a task

  • Memory difficulties; unable to organize and remember information; may get lost, forget names, miss instructions, and/or have trouble learning new information

  • Speed of Processing

  • Impulsiveness

  • May have problems with judgment, problem solving and considering others' ideas

  • Language Processing

  • "Executive Functions" - refers to difficulties relate to planning, organizing and strategizing behaviors

  • Less endurance; tires more quickly, takes longer to understand information, reacts less quickly, and is easily overwhelmed with even small amounts of information

  • Unable to interpret the actions of others and therefore have great problems in social situations

Challenges in Language and Learning

Changes in Social-Emotional Functions

  • Dependent/regressive behaviors

  • Mood Swings

  • Depression or Anger

  • Irritability/aggression

  • Dis-inhibition/risk taking behaviors

  • Anxiety (mentioned on the Hemihelp site as being specific to hemiplegia)

  • Irritability (mentioned on the Hemihelp site as being specific to hemiplegia)

  •  

Other possible long lasting effects of a brain injury include:

Behavior or Personality Changes
(Source: Intermountain Health Care)  

  • Easily frustrated

  • Easily upset or angered

  • Anxious/moody

  • Withdrawn or isolated

  • Impulsive/bold; causing you to have concern for child's safety

  • Does not tolerate daily routine (cannot go to school all day, sleeps early or late, gets upset with daily activiites)

Sources:  New York Department of Family Assistance; Utah Primary Children's Medical Center Pediatric Education Services

Temper Tantrums from KidsHealth

Finding a therapist for your child from KidsHealth

Approaches to Counseling and Therapy  American Academy of Pediatrics

Know when to seek help for your child American Academy of Child & Adolescent Psychiatry

Facts for Families from the American Academy of Child & Adolescent Psychiatry. A variety of fact sheets providing information on issues that affect children, teenagers, and their families.

Bullying and your child  from KidsHealth

Self-image, adolescence, and disability. Oct. 2003. Sweden

Factors associated with self-esteem in pre-adolescents and adolescents with cerebral palsy. June 2003. North Carolina.

Ecology of development in children with brain impairment. March 2003. Belgium.

Does the Child Behavior Checklist Reveal Psychopathological Profiles of Children with Focal Unilateral Cortical Lesions?  2002. Canada.

Treatment of attention-deficit disorder, cerebral palsy, and mental retardation in epilepsy. Oct. 2002. New York

Problems of Children with Hemiplegia in Mainstream Primary Schools A representative sample of 55 mainstreamed 9–10-year-olds with hemiplegia were compared with all classmates on sociometric measures of popularity and friendship, and with 55 matched controls on measures of victimization. Children with hemiplegia were more rejected and less popular, had fewer friends, and were more often victimized; they were not more likely to be bullies themselves. These differences were not fully accounted for by group differences in teacher-estimated IQ and behavior. Possible explanations range from neurologically determined deficits in mentalising skills to peer prejudices about children with disabilities. The development of appropriate intervention strategies should be a high priority, particularly since peer problems not only result in current distress but also predict psychosocial problems in the future. Abstract from The Journal of Child Psychology and Psychiatry, Vol. 39, Issue 4, pp. 553-541.

Pain in children with cerebral palsy: common triggers and expressive behaviors, Sept. 2002. To obtain parents' identification and description of the behaviors, health care procedures and daily living situations associated with pain in children with cerebral palsy. Canada.

Behavioural profiles of children and adolescents after pre- or perinatal unilateral brain damage May 2001

Cognitive and neuropsychological functioning in children with cerebral palsy Jan. 2001

Health and educational outcomes of children who experienced severe neonatal medical complications. 1999, Utah

A population-based analysis of behavior problems in children with cerebral palsy. 1996

© Copyright 1997-2004, CHASA, All Rights Reserved

The information contained in this Children's Hemiplegia and Stroke Association (CHASA) Web site is not a substitute for medical advice or treatment, and CHASA recommends consultation with your doctor or health care professional.