Brain Injury is Different

Brain Injury is Different - 2 cartoon Spot the Difference drawings drawings

Image from Japan Wikipedia

Brain injury is unique, its outcomes distinct.

Often I have heard of confusion about brain injury with mental illness and brain injury with intellectual disability.

So today I am updating and reposting an article I wrote a while ago that reminds us of the differences.

Brain Injury is DIFFERENT to other conditions, illnesses, and disabilities:

  • Sometimes brain injury is confused with, or misdiagnosed as, another disorder.
  • Understanding that brain injury is different can assist you to encourage correct diagnosis, and be able to provide support more successfully.
  • If you have experience supporting people with other disorders you may need to review, change, or tailor your strategies to meet the needs of a person with brain injury.
  • Understanding how brain injury is different can help you do this. For example it is important to understand why working with a person with an intellectual disability requires different strategies to working with a person with brain injury.

Brain injury is different to:

  • Intellectual Disability
  • Mental Illness
  • Attention and Hyperactivity Disorders
  • Learning disorders

How is brain injury different?

This brief introduction will focus on what about brain injury is different from other disorders. I am not giving detailed information on other disabilities and disorders; these are not my area of expertise.

If you would like to know more, I recommend you seek assistance from those who have specialist knowledge in your area of interest.

Warning – the table below is a bit gruff and blunt. More kind of blunt than I like to be. I apologise in advance if it is upsetting.

As a quick reference this table gives examples of the differences between Brain Injury, Mental Illness and Intellectual Disability:

Brain Injury Mental Illness Intellectual Disability
Commonly cognitive impairment. Varies from person to person. Can be specific, or more diffuse.


Difficulties with aspects of daily life according to the cognitive damage a person sustains.


Often no cognitive impairment.



There can be temporary disruption to daily life and caring for self

More global cognitive and intellectual impairment



Often involves limitations in both intellectual abilities and day to day life function.

Damage and changes to the brain are often permanent.


May have difficulty with new learning but able to remember or relearn past known skills.

Episodic or temporary illnesses. Sometimes recurring.


Able to learn new skills and knowledge.

Most often permanent changes from birth or developmental years.


Difficulties with learning, and developmental milestones but able to learn with appropriate support.

Occurs at any age Occurs at any age, more commonly adolescence and adulthood. Occurs in developmental years – before birth up to 18years
May be no change in intellectual abilities.  There may be difficulty accessing and using intellectual abilities because of cognitive impairment. Usually no change in intellectual abilities. Changes in general intellectual abilities.
Physical damage to the brain structure that may alter brain function There maybe abnormal functioning of the brain. Thought not usually structural damage. Chemical changes may be occurring. Sometimes children with brain injury are classified as intellectual disability if occurring in early years. Strictly not the same.


Why is it important to understand the differences?

  • You may come across people who have been misdiagnosed and may not be getting the right kind of support.
  • Understanding the difference will enable you to provide more appropriate support for a person with brain injury.
  • If you have, or are supporting people with other disorders it can help you to see how you need to change your approach.
  • Understanding the differences can build your knowledge about brain injury, and provide clues for developing good strategies.

What is different about brain injury?

Image by ilker

Image by ilker

Here are some of the differences you might see in a person with brain injury, whatever the cause might be:

  • No two people will have the same outcomes. There may be similarities, but EVERY person will have a different outcome.
  • Damage to the brain is generally lifelong. For many people with brain injury it will change with time and work to improve. With some brain diseases damage will continue to deteriorate.
  • A persons IQ may be unchanged yet the ability to access stored information is changed. For instance a person may have an average, or even above average IQ, but find it difficult to learn new information, or to use the information they already have.
  • There is likely to be memory of life before brain injury. Memory of what has been lost. Memory of prior skills and knowledge which can be helpful for rebuilding skills.
  • There is likely to be memory of what achievement and being successful looks like in all aspects of daily life. This can mean no acceptance of second best – a great outcome.
  • Previously learned skills and knowledge may be used to assist relearning.
  • Functions and abilities may be unpredictable and changeable.
  • A person with brain injury may look the same as other people their age, but think and act differently.
  • The combined effects of brain injury, from the different parts of the brain damaged may create extra or different problems. Combinations are likely to be unique to brain injury. For instance inappropriate behaviour and short term memory loss could make it difficult to remember what happened, or what strategies to put in place.
  • Recovery and improvement occurs after traumatic brain injury. This may be rapid at first and then slow, or even appear to stop, but recovery and improvement can continue for many years; sometimes lifelong.
  • The range of cognitive impairments such as concentration, memory, organization and planning, monitoring behaviour etc are likely to be more pronounced following brain injury, and fluctuate in ability.

While some of these points may be similar to people with other disorders, the combination makes brain injury different. It also means a different approach is needed.


Brain injury is different - cartoon of penguin with the word support across What can you do?

  • Understand as much as possible about how brain injury is different to other disorders. Well really it’s best to understand as much as you can about brain injury full stop!
  • See each person as an individual with individual needs, both through their life choices and goals and as a result of brain injury.
  • Get to know the potential differences. What can be built on. What do you need to be aware of? For example if a person was a chef before brain injury: What previous skills, talents and knowledge might assist progress now?
  • Be flexible. Even when you have agreed strategies remember that day to day (even hour by hour) a person’s abilities can change occur because of fatigue and other outcomes of brain injury.
  • Think about and be sensitive to the grief that comes with knowing what has been lost. Remembering life before brain injury has advantages, but it can also be a source of grief and sorrow at what has changed.


And Finally

If you see every person for who they are, and not their appearance, disability, culture.

If you build on what a person CAN DO.

If you look to help build the best life possible.

You are more likely to be providing great support whatever a person’s diagnosis might be.

What other differences have you been aware of?

Oh and if you like this kind of difference spotting – there really are 15 differences between the cartoons at the beginning of this article!


6 Responses to Brain Injury is Different

  1. Alison Smith October 8, 2015 at 5:49 pm #

    Thanks Melanie, this is a great post. Hope it’s ok if I use it for my Cert IV disability students.


    • Melanie Atkins October 8, 2015 at 9:43 pm #

      My pleasure, feel free. If you could acknowledge or better still encourage visitors to Changed Lives that would be wonderful. Thanks for the support Alison. Regards

  2. Ruth Burrill November 19, 2015 at 5:58 pm #

    Hi Melanie,

    A great read as always.

    A person with an Acquired Brain Injury is also extremely vulnerable. And highly influenced by others, partically when massively fatigued.

    One’s identity of the person they once were flies out the window.


    • Melanie Atkins November 19, 2015 at 6:10 pm #

      Thanks so much Ruth. Yes that is a great reminder – particularly that both vulnerability and being influenced by others can increase with fatigue. Regards Melanie


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