Case study A: 16-year-old boy

This 16-year-old male suffered a severe traumatic brain injury and facial fractures in a motor vehicle accident. His rehabilitation progressed well and he returned to live in the family home. A year after his injury he planned to return to school to do his HSC and eventually go to University, as he had always intended to do.

A review neuropsychological assessment was conducted around the same time.

On interview the young man complained that he forgets things he has been told, needs to go over and over information to remember it, needs to reread paragraphs to be able to understand what he is reading, and has difficulty following conversations.

The assessment found:

• he had a very short span of attention
• he could not divide attention (unable to follow more than one thing at a time)
• his processing speed was slow
• new learning was poor, information needed to be repeated
• he did not recall much after a delay
• he had difficulties remembering if his learning was interrupted by another task or
  different information]
• he was disorganised and did not plan how to work things out
• some concrete reasoning
• rapid fatigue when maintaining mental effort

He also demonstrated:

• general problem solving skills at an appropriate level
• excellent arithmetical ability
• good adaptive skills, so could modify what he was doing to meet change and utilise feedback
• he was able to recognise more information than he was able to recall
• some insight towards his cognitive difficulties
• an eagerness to get into University (which may be good or bad).

Questions

What strategies could you suggest to assist this young man with managing his HSC studies?

Think about what he could do himself, what the school might be able to provide, and what changes may be needed at home.