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Behavioural changes in students with an ABI fact sheet

Behavioural changes in students with an acquired brain injury

How do I know if my student is having difficulties with their behaviour?

Students may experience a number of changes in their ability regulate and manage behaviour after a brain injury. This is because the parts of the brain responsible for regulating behaviour and emotions are particularly vulnerable to brain injury. Following a brain injury, students may find it more challenging to inhibit responses so that they rush into tasks or activities without thinking about the consequences or task, may blurt out answers or inappropriate comments, or struggle to wait their turn. At times, students may be overly active or restless in class, while other students may find it more challenging to manage aggressive behaviours or seem unmotivated.

What can I do to help my student with their behavioural changes?

  • If you notice your student is impulsively rushing into a task or activity, they may benefit from some feedback.  Use a “stop, think, do” approach.  Have the student, ‘stop’, ‘think’ about what they should be doing, and then ‘do’ it.
  • Try to ignore minor impulsive behaviours. For more serious behaviour problems, set clear, consistent consequences and make sure you carry them out every time.  For example, if the student is constantly calling out in class, remind them to put their hand up. Only answer their question once they have put their hand up.
  • If your student is impulsive, they may require additional supervision in class and in the playground.
  • Assign the student active jobs in class, such as handing out papers or running an errand.
  • Where possible, allow the student to complete tasks standing up if they are overly restless.
  • To help prevent behavioural challenges (such as episodes of aggression or defiance) it will be important to:
    • Work with the student and other key caregivers to understand the cause of the behaviour (e.g., “Is it because the task is too hard?”, “Does the behaviour occur because the student is tired or misreading social cues?”).
    • Set up the task/ environment to minimise the likelihood of the behaviour.  This might include removing known triggers, reducing the impact of other cognitive challenges (see ideas on other tip sheets), and minimising the impact of fatigue.
    • Before introducing complex or difficult tasks, ensure the student has had success with easier versions of the task.
    • Ensure the student is aware of clear expectations on their behaviour – graphic organisers or class guidelines might be helpful.
    • Provide the student with plenty of positive feedback for their attempts at completing tasks and managing their behaviour.
    • Expect variability in a student’s behaviour in different activities and on different days.
    • Teach the student skills to help promote their competence and develop other ways of managing situations that might lead to behavioural challenges. For instances, managing social situations, assertiveness training, ideas to communicate distress or challenge, and calming strategies.
  • To help manage behavioural challenges when they occur, it will be important to:
    • Ensure that the student’s key caregivers are aware of triggers and the early warning signs of the student’s irritability or agitation. This is a good time to redirect the student to another activity or to assist the student in engaging in a calming activity.
    • Stay calm.
    • It might be useful to present yourself as a helper when the student is mildly disregulated (e.g., “What can I do to help?”) and speak clearly and calmly to the student.
    • When the student is calm, it may be helpful to discuss the difference between emotions (e.g., anger) and behaviour (e.g., aggression) and to discuss other ideas the student could try to help manage their feelings.
    • Ensure the safety of other students if the student becomes aggressive.
    • School based timeout procedures and quiet areas should be used to give the student the opportunity to calm down.
    • Have a school based plan that all relevant caregivers can implement should problems emerge.

Contact us

Queensland Paediatric Rehabilitation Service
Queensland Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: October 2017. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.