Talking With Children About 

Moderate or Severe TBI

FAMILIES
How Can I Explain Moderate 

or Severe TBI* to a Child?

Here are some suggestions:

 • The brain is similar to the command station of a space 

ship. If a meteorite hit the command station, the crew 

would not be able to control what the space ship does. 

If the brain is hurt, it may send out the wrong signals to 

the body or no signals at all. A person with TBI may have 

a hard time walking, talking, hearing or seeing.

 • The brain is the computer for the body. When it is injured, it 

doesn’t boot up properly, runs slower and has less memory.

 • A broken bone will usually heal and be as good as new. 

A brain injury may not heal as completely. Even though 

people with brain injuries may look the same, they may 

still be injured. They may have a hard time paying attention 

or remembering. They may get tired easily and need to 

sleep. They may say or do things that seem strange or 

embarrassing. They may get angry and shout a lot.

 • Many people develop anger as a direct effect of the damage 

to the brain. In other words, the parts of the brain that 

normally stop angry flare-ups and feelings have been 

damaged and do not do their jobs as well. Survivors 

of TBI may be mad because they can’t do the things 

they used to do. Their feelings may be hurt because 

others treat them differently than before the injury. 

• A cut may take a few days to heal, a broken bone a 

few weeks. Getting better after a brain injury can take 

months or even years. Sometimes, the person will not 

get 100 percent better.

* Traumatic Brain Injury (TBI)
• Brain injury changes people. These changes can be 

confusing. Try to remember that the changes you see 

are caused by the brain injury. You can still love and 

care about the person.

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

Notes
What Are Some Tips for Helping Children 

Cope With Moderate or Severe TBI?

• Provide information to your children about what to expect 

before they are reunited with their parent with TBI. For 

example, explain in advance what they may see in the 

hospital. Describe how their parent will look, behave 

and react before he or she comes home.

• Be flexible. Take your cue from your children about when 

they want to resume their normal routine. Encourage 

children to stay involved with friends and school activities.

• If your children choose to attend their activities, ask friends 

or relatives to take them. Ask friends to take over caregiving 

when you need to go to watch your son or daughter play 

basketball or appear in the school play.

• Encourage your children to talk about their fears, hopes 

and worries. Allow safe and appropriate ways for your 

children to express their emotions.

• Meet with your children’s teachers to explain what has 

happened and the effects on the family.

• Encourage other family members, friends or other 

important adults in your child’s life to share time 

with your child and to act as a sounding board, if needed.

• Your children may say upsetting things to you. Just listening 

can be the best support for them.
• Re-establish routines for your children. Consistent 

dinner and bed times may help.

• Encourage your children to talk about the familiar 

characteristics and behaviors they are starting to see.

• Be easy on yourself and your children. A certain 

amount of stress is normal.

• Be careful not to set a timeframe with your children for 

when recovery will occur. Children want it all to happen 

quickly, and it is hard to predict recovery after TBI.

• Stay alert for changes in their behavior. Get counseling for 

your child to help him or her cope with grief, especially if 

the child appears depressed or is adopting risky behaviors.

• Recognize that some children may pull away for a while. 

Others may regress to younger behavior, becoming very 

dependent, demanding constant attention or exploding 

in temper tantrums. These behaviors should return to 

normal over time as the child adjusts.

• Teenagers may be embarrassed about their parent with TBI. 

Rehearse with them how to respond to comments or questions 

about how their parent looks, behaves and speaks.
Age and Stage of Development

Age 4-5

More self-secure, can play well with others, 

tests the rules, “magical thinking”

Age 2-3

Can differentiate expressions of anger, 

sorrow and joy

Age 6-7

Capable of following rules, enjoys having 

responsibility

Uncertain of the relationship between cause 

and effect; parent is the primary source of 

self-esteem

Age 8-11

Has a better understanding of logic and 

cause/effect, less centered on self, able to 

understand others’ feelings, can empathize

Age 12-17

Experience puberty and physiological changes, 

seek freedom and independence, acceptance 

by peers is extremely important, develop more 

intimate relationships, more thoughtful and 

caring
• Select books with stories that mirror families 

like yours to help your child relate.

• Familiarize your child with pictures of objects 

and concepts related to medical care and health 

(hospital, gown, doctors, flowers, bed, coming 

home from the hospital).

• Incorporate play with a child’s doctor kit to familiarize 

your child and symbolize what is happening.

• Communicate using simple words.

• Use picture books.

• Create simple books with pictures of family members 

and simple objects that the child understands (hospital, doctor, bed, rest).

• Offer dolls to play with so they can recreate what 

is happening at home or at the doctor’s office.

• Use interactive communication — reading books 

and creating stories with your child.

• Help your child create his/her own “this is our family” 

album and talk about the photographs and memorabilia.

• Watch movies with story lines similar to what your 

family is experiencing.

• Listen to your child’s thoughts and opinions.

• Ask questions that go beyond yes and no.

• Depending on your child’s level of development 

and understanding, speak with direct, realitybased explanations that include facts.

• Include the sequence of events involved 

and what to expect.

• Give facts: what is expected to happen including the 

diagnosis, prognosis, treatments, and expected outcomes.

• Talk with your children, not to them.

• Check in and offer time to discuss concerns frequently.

• Listen attentively.

• Ask questions that go beyond yes and no.

• Stay alert for risky behaviors or acting out. Also be 

aware if they seem noticeably withdrawn.

• If risky behaviors are present, seek professional help.
June 2012 www.DVBIC.org | info@DVBIC.org