Recovering From
Head Injury
A Guide for Kids
Katrina Rayls, Ph.D.
Mary Bridge Children’s Hospital and Health Center
Wiley Mittenberg, Ph.D., ABPP
Nova Southeastern University
Cover drawing by Ruth Powell, age 11
Recovering From Head Injury
A Guide For Kids
This booklet was prepared especially for kids like you who have had a
head injury. Most children recover quickly and get going quickly. This
booklet describes problems that children often have after they have had a
head injury. It also gives you ideas and helpful hints about what to do when
you have these problems.
We know you’ll be feeling better soon! We hope this booklet is helpful to you
along the way.
What Is Head Injury
A head injury means that your brain has been hurt or injured in some way.
Head injuries can happen many different ways. Some examples include
car accidents, falling off your bike or skateboard, and being hit in the head
with something hard like a baseball or rock.
The accident
“Ouch” “Ouch”
“My head”
by McKensie Holthourser, age 10
What does your brain do?
Your brain is the most important part of your body because it tells every
other part of your body what to do. Your brain is made of thousands of tiny
cells that can only be seen with a microscope. These cells are called
neurons and they all connect with one another. They communicate
together, talking back and forth, and control everything you do. Different
parts of your brain control how you walk, how you talk, how you think, and
how you feel. When your brain gets hurt, it may not be able to do these
things as well as it did before the accident. The good news is that your
brain gets better quickly.
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What happens when your brain gets injured?
Your brain is protected from injury by your skull. It acts like a crash helmet
and protects the brain whenever your head is hit. If you hit your head hard
enough, the skull can break or crack. This doesn’t happen very often, but
your skull can break or crack like other bones in your body, like your arms
or legs. A skull fracture is similar to these other broken bones and will heal
with time.
Your brain can also be shaken around inside the skull when you hit your
head. Like many other parts of the body, your brain can become bruised
and swollen. These bruises are no different than the types of bruises you
get on your arm or on your leg. The black and blue marks and the
swelling go away with time just like other bruises. Shaking the brain
around can also damage or hurt the neurons, the tiny cells that control the
things you do. When this happens, the neurons cannot send messages
back and forth as easily and it may take you longer to do things. The good
news is that these cells heal in time and many kids recover completely.
This information is not meant to upset or scare you. Bruises, swelling, and
damaged neurons are all very common in head injuries. They may also be
responsible for some problems and feelings you might have as you get
better. The important thing to remember is that many people have similar
problems after a head injury. These problems don’t last forever and they
usually go away on their own with time. Worrying or stressing out about
them will only make them worse. Keep in mind that any symptoms or
problems you may have (e.g. headaches, tiredness) are normal and
usually go away quickly.
Forgetting
“Are you sure this is my house?”
“Yes”
by McKensie Holthourser, age 10
“Are you sure this is my bed?”
“Yes, you need to rest.”
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“What’s my dog’s name again?”
Getting Better
How Long Does It Take To Get Better?
This is a good question. Unfortunately, there isn’t a good answer. Not
everyone recovers or heals at the same speed. Some people get better
faster than others. Some people take more time to get better. It really is
hard to say how long it will take. Most kids rebound quickly and return to
normal in a short period of time. You have probably already begun to feel
better in the last couple of days and will continue to improve. Recovery
can take anywhere from a few weeks to six months. Healing can take
longer if you were knocked out or unconscious. Although some kids get
better faster than others, everyone does improve.
What Can You Expect As You Get Better?
The table below lists some of the symptoms or problems you might have
after a head injury. These are very common and are part of the normal
healing process. These symptoms are signs that the brain is healing and
may be the brain’s way of telling you to slow down and take it easy. They
are not signs of brain damage and do not mean that you are getting
worse.
Most kids get one or two of these symptoms, but you may not have any
at all. No one gets all of them. You may not notice the symptoms right
away. It could be a few days or weeks before they begin to bother you.
If you do have any, it is OK and should be taken as a reminder that you
are still healing and need to take it easy as you get better. The good news
is that these symptoms often go away on their own without any special
treatment.
It takes a while
“I hate not remembering”
“Wait and see”
by McKensie Holthourser, age 10
“Why are you sad?”
“I don’t know”
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“A few months later”
Common Symptoms in Children After Head Injury
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Fatigue/Tiredness
Headaches
Trouble Seeing/Blurry Vision
Sensitivity to Bright Lights
Sensitivity to Loud Noise
Dizziness/Head Spinning
Memory Problems
Poor Concentration
Trouble Thinking
Irritability/Crankiness/Feeling Grumpy
Anxiety/Feeling Worried/Nervousness/Butterflies in Stomach
Sadness/Crying
I remember!
by McKensie Holthourser, age 10
“I don’t feel so sad”
“My head feels better”
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“Angel your my dog!”
“It just takes time”
What Can You Do About
THESE SYMPTOMS?
The most important thing you can do is remember that these symptoms
are part of the healing process. They usually go away on their own and
do not require special treatment. You may think that your symptoms will
never go away and you may find it hard to deal with them. These are really
normal feelings, but there are things you can do to help. Trying to stay
calm and not worry about your symptoms is the best way that you can help
yourself.
1) Pay Attention to What Your Symptoms are Telling You
If your symptoms get worse, or if you get new ones, this is a sign that you
are pushing yourself too hard. It may mean that you are trying to do too
much too soon. If you are feeling really bad, you should call your doctor.
You may need to take school work, chores, and activities with friends one
step at a time. Be sure to get all the rest you need.
2) Try to Avoid Stress
One of the most important things to remember is that a head injury is a
stressful thing to have happen to you. Keeping your stress level under
control is a very good way to help yourself as you get better. This may
sound silly, but it’s true. Scientific research shows two things about stress
and head injuries. First, feeling stressed out, feeling nervous, or feeling
worried is very common after a head injury. Many kids, and adults too, feel
this way. Second, stress can make many of your other symptoms worse.
If you work at keeping calm, you are likely to recover much faster. The
good news is that you are probably already feeling better. Staying calm
and keeping your cool will make you feel even better.
The stress of every day life can be hard. Below is a list of some things that
many kids find stressful and hard to handle. Many kids who have never
had a head injury stress out over these things and get the same kinds of
symptoms you may have. It’s harder to deal with day to day stress after
a head injury. Stress can cause your symptoms to appear sooner and
happen more often. Trying to do as much after your accident as you did
before can be stressful. You may need to take it easy and build up your
activities slowly.
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Common Stressful Events in Everyday Life
• Problems with Friends
• Arguing with a Sister or Brother
• Parents Arguing
• Death of a Family Member
• Becoming Seriously Ill or Sick
• Death of a Friend or Pet
• Homework/Tests/Grades/School • Physical Appearance/Attractiveness
• Chores at Home
3) Don’t Worry About Your Symptoms
Remember, worrying about your symptoms can stress you out. This can
make your symptoms seem worse than they really are. Paying attention to
something can make it seem bigger. For example, if you pay attention to
your heartbeat or your breathing for a minute or two, you will notice that
they become louder and you are more aware of them now than you were
before. The same thing is true of a headache, a sad feeling, or being tired.
The more you think about them, the worse they become.
4) Remember That These Symptoms are Common
Many of the symptoms you have are a normal part of getting better.
Everyone has these symptoms now and then even if they have not had
a head injury. It’s easy to forget that before your injury you may have had
times when you had headaches, have been tired or irritable, and couldn’t
concentrate. The best thing to do is to try to deal with these things the
same way you did before the accident.
5) Talk to Someone
Lots of times it will help if you can talk to a grown-up about your
symptoms. Sharing your feelings with a parent, grandparent, aunt or uncle
can make you feel better. Someone you can also talk to is your teacher,
sister, brother, or a friend. Sometimes just having those people close by or
playing with your dog or cat can help you feel better. Remember, you don’t
have to deal with stressful times alone. You may also want to write down
your daily thoughts, feelings, and experiences in a diary or journal. This
may help you think things through and also serve as a reminder.
6) Keep Practicing Good Health Habits
You need to have fun playing and exercising. Rest, relax, and get plenty of
sleep. You should also eat good food.
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What Can I Do About
SPECIFIC SYMPTOMS?
Fatigue/Tiredness
It is normal to be tired after a head injury. The best treatment for being
tired is rest. You should gradually increase your activity level and avoid
wearing yourself out. Many kids have more energy in the morning than
they do later in the day. Taking a rest break or an afternoon nap can
increase your energy level. If you find that you’re tired all of the time and
your other symptoms are getting worse, it likely means that you are
pushing yourself too hard. Slow down and take it easy. You may even call
your doctor if you continue to feel tired.
Headaches
Headaches are common following head injury and are part of the
normal recovery process. Like any headache, they can be painful and
bothersome. They can also make you irritable and grouchy and may make
it hard to concentrate after a head injury. Headaches can have many
causes and your doctor can help in deciding if you need medicine for your
headaches. This is usually not necessary.
Stress and muscle tension are two of the most common causes of
headaches after a head injury. This is usually the case when you start
having headaches several days to several weeks after the injury. These
headaches are likely a sign that you are trying to do too much. They
often happen less frequently or disappear altogether if you take a break,
get some rest, and relax. Adjusting or shortening your school schedule
and activity level may be necessary if you continue to have headaches.
Trouble Seeing
If the things you see look blurry or if you see two of something, you
should have your eyesight checked by your doctor. You may need to
wear glasses. Blurry or double vision usually goes away by itself in most
kids in a short period of time. Resting and closing your eyes can help the
symptoms go away as well.
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Bright Light Sensitivity
You may notice that bright lights hurt your eyes. This is a common
symptom following head injury, especially if you have headaches.
Because bright light seems to hurt your eyes, you are likely to pay more
attention to this symptom, which actually makes it worse. Paying
attention to how something makes you feel can make the feeling seem
more intense than it actually is. The less you think and worry about your
symptoms, the faster they usually go away. One way to help may be to
spend time in a room with low lights until your eyes feel better.
Sensitivity to Loud Noise
Like bright lights, loud noise may also bother you and hurt your ears. This
is common in kids following a head injury. You are probably paying more
attention to noise right now because it hurts your ears. If you try to ignore
this and adjust to the level of noise around you, the symptom will likely
go away much quicker. You can also keep noise levels low by turning the
volume of the radio or TV down. You can also ask those around you to
speak in softer tones.
Dizziness
Feeling dizzy is common after a head injury, but should be checked
by your doctor to make sure that nothing serious is wrong with you.
While these symptoms may bother you, they usually go away by
themselves in 3 to 6 months for most kids. Some medicines treat
dizziness and motion sickness. Your doctor will know if this is the right
treatment for you. These medications can make you sleepy and make it
hard for you to pay attention and concentrate. Some kids find it helpful
to sit or lie still until the dizziness passes. Standing up and moving more
slowly can also be helpful.
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Memory Problems
Having some trouble remembering things is very common after a head
injury and can be caused by many things. Earlier, you were told that the
brain can become bruised in a head injury. The most common area of the
brain to be bruised is the part that stores memories. When bruises
happen it can be hard to remember things. Like other bruises, these will
heal in time and your memory will likely improve as this happens.
Forgetting things sometimes happens to everyone, so try not to worry if
you’re having some trouble. The table below lists some things that kids
often forget, even if they have not had a head injury.
Things Kids Often Forget
• School books
• Homework
• Where they put a toy
• What their parents told them to do
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Brushing their teeth
Chores
What time their curfew is
Why they went into a room
Memory problems may be a reminder that you are pushing yourself too
hard. Writing things down, using a pocket recorder, and asking people to
remind you of important things are other ways of coping with memory
difficulties.
Poor Concentration
If you find that it’s hard to concentrate, you are most likely tired or stressed
out. Taking a short break of 15 to 30 minutes can help. Relaxing for a bit
can also help. If you still have a hard time concentrating you may have to
cut back on the number of activities you are doing at home and at school.
If this happens your parents and teacher can work together to find the
right balance for you.
Working where it is quiet may also help. Make sure that the TV and radio
are turned off. These can be distracting and make it hard for you to
concentrate. You also do not want to do too many things at once.
Listening to the radio, watching TV, or talking on the phone while doing
your homework is not a good idea. It is best to do one thing at a time.
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Trouble Thinking
This problem is usually caused by other problems you may have.
Concentration problems, being tired, headaches, anxiety, and depression
can all make it hard to think clearly. Like many of these symptoms, trouble
thinking is probably a sign that you are trying to do too much too soon.
Slowing down, taking more frequent breaks, and trying to do one thing at a
time can help you to think more clearly.
Irritability
Being tired and feeling stressed out are two of the most common reasons
that people are irritable and grouchy. It is much easier to get mad when you
are tired and stressed. Getting enough rest can help you to not lose your
temper. You may find it helpful to cut back on the number of things you are
doing at home and at school.
You can also try staying calm in aggravating situations. When you feel
yourself getting angry, count to one hundred or take some deep breaths.
Your mom or dad may need to help you notice when you are getting
angry sometimes. Think about what is making you mad and how you can
respond. Try to think of several different ways you could handle the
situation. Pick the best solution and do it. Just seeing that there is more
than one way to solve a problem can make it a lot less aggravating and
irritating.
Anxiety/Worries
The main causes of anxiety for most kids are worrying about their
symptoms and problems at school. Understanding and knowing that your
symptoms are normal and part of getting better should make you feel less
nervous. Getting enough rest and gradually increasing your activities can
also help.
If you are feeling anxious or nervous, it is likely because of fearful thoughts
and ideas you may be thinking and telling yourself. Talking to someone
such as a parent, teacher, or friend and telling them how you feel can make
you feel better. Getting these ideas and feelings out in the open can stop
the anxious thoughts and make you feel calmer. Teaching yourself to relax
and stay calm can also help. Taking deep breaths, counting to ten, and
picturing yourself in a pleasant and peaceful place are all ways to help.
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For some kids, the kind of accident that happened when they hurt their
head can also lead to nervousness or feeling scared. You may have scary
memories of what happened that day that are hard to stop thinking about.
Some kids can have frightening dreams, fear of doing the thing they were
doing when they were hurt (like riding their bike), or have scary pictures in
their heads. This is also a normal part of getting better. If you’re having any
of these kinds of feelings, make sure to tell someone. Talking about it with
people or seeing a counselor or psychologist can help.
Sadness
Sadness and depression are common feelings after a head injury. These
feelings are usually associated with thoughts and beliefs that you may be
telling yourself. Thinking things that are bad or terrible can certainly make
you depressed. For instance, thinking that your situation is terrible, that
there is no end in sight, that you cannot do the things you used to do, that
it’s not fair, and that you’re never going to get better are all depressing
things to be thinking and telling yourself. This type of thinking can be habit
forming.
Usually, when people think and tell themselves unpleasant things all the
time it is out of habit, not because those things are really true. In fact,
things are usually not as bad as you might think. If you find yourself
thinking sad thoughts, STOP! Simply stopping a depressing thought can
make you feel better. Talk to a parent, a teacher, or a friend about how you
feel and what you are thinking. They can help you see if what you are
telling yourself is really true.
People also become sad and depressed when unpleasant things
happen to them. A head injury is definitely not a fun thing to have happen.
We would all rather have good things happen to us because they make
us feel good. An effective way to treat sadness is to make sure that good
things happen to us. One way to do this is to plan enjoyable activities for
yourself every day. You may have to discuss this with your parents to make
sure that what you want to do is all right with them. Decide on something
you like and be specific. Plan exactly what you want to do, where you will
do it, and when you will do it. This will give you something to look forward
to doing. You might even want to put enjoyable activities on a calendar as a
fun reminder. Anticipating and doing enjoyable things each day will surely
improve your mood.
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Important Things To Remember
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2.
3.
4.
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Always call your doctor if you are worried about any symptoms or
if they get worse.
Talk to your doctor about when to return to activities, especially
school and sports.
Talk with your teachers about any problems you are having at school
so that they can help. Your parents may want to find out if developing
a 504 Plan would be helpful in making sure that all your teachers
understand the things that will help with your recovery. This book and your doctors can be helpful in figuring out what
(if any) accommodations would be helpful.
Protect yourself from having another head injury - wear a helmet!
Resources
Your doctor.
Any of the doctors who treated you at the hospital.
Specialist in brain injury such as a neurologist, neuropsychologist,
neurosurgeon, or rehabilitation doctor.
Brain Injury Association of Washington (BIAWA)
206-388-0900 or www.biawa.org
Brain Injury Association (BIA) 1.800.444.6443 or www.biausa.org
Mary Bridge Pediatric Neuropsychology Program 253.403.4437,
option 2.
About This Guide
This booklet was prepared especially for kids like you who have had a
head injury. Using the ideas and hints on how to handle your symptoms
will help you feel better. Follow the suggestions or think of new ones.
Remember, the most important thing to do is stay calm and stress free.
Make sure to tell your parents if you are having these symptoms.
* The illustrations in this book were created by kids like you. Very special
thanks to all of the kids who shared their fabulous drawings.
** Thank you to Chris Ladish, Ph.D., Robert Beilke, Ph.D., and Jenise
Jensen, Ph.D. for their contributions to this project.
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Notes: _____________________________________
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This book was provided by the
MARY BRIDGE PEDIATRIC NEUROPSYCHOLOGY PROGRAM
If you have any questions, comments, or would like more information,
please call 253.403.4437, option 2
Allenmore Hospital
Good Samaritan Hospital
Mary Bridge Children’s Hospital & Health Center
Tacoma General Hospital
MultiCare Clinics
multicare.org