Sustaining a traumatic brain injury (TBI) as an adolescent has a significant impact on life roles and most notably on that of school participation. In the literature there is a wide range of studies that provide clinicians with information regarding recommendations for assisting students in their return to school. However this information has predominantly been provided from the perspectives of educators and rehabilitation staff. The aim of this preliminary project was to hear the stories of three male adolescent students as they reflected on their own experiences of what it was like to go back to school after sustaining a severe TBI. Using a qualitative research design and in-depth interviews, the students' stories were transcribed and coded using grounded theory principles. Despite persisting communication difficulties, the students were able to provide rich stories indicative of their personal experiences. Three key themes emerged from the interviews: the adolescent student's sense of self, changes the students noted; and supports the students identified. A tentative model illustrating the relationship between these areas was developed. It is anticipated that this model will assist clinicians and educators to develop a holistic picture of a student's school participation from transition to ongoing school life.

This article presents an introduction to some potential applications of a critical discourse perspective to the field of traumatic brain injury. Critical Discourse Analysis (CDA) examines spoken and written texts as a means to understand the two-way relationship between discourse and cultural context. CDA is particularly interested in how language use reflects and creates power relationships between those involved in the communication. In order to illustrate this perspective, this paper discusses a purposively selected set of written texts about brain injury from a range of institutional contexts: a scholarly journal article, a submission to government from an advocacy group, the home web page of a support group, a newspaper article from the general media, and personal letters written by people with traumatic brain injury. The analysis involved investigation of key linguistic features reflecting the experiential, interpersonal and textual aspects of these texts. Three main lines of tension between competing discourses emerged from an examination. Tension emerged within each text between medical vs. lay terminology, and this was seen as reflecting the widespread power of the scientific paradigm. Tension was apparent between problem talk vs. positive talk. Talk about the problems associated with brain injury forms an essential component when seeking support, and yet talk about positive outcomes forms an essential component when describing the rehabilitation journey. There were also competing discourses in terms of the focus of the talk, between person centredness vs. other centredness. The methodology of CDA is proposed as a tool for reflective clinical practice at both an individual and professional level, as it provides a systematic means to examine health professionals' interactions and promotes the development of a critical understanding of the cultural ideologies and institutions in which practice is located.

The aim of this research was to identify the number and characteristics of adults under the age of 65 with a diagnosis of traumatic brain injury (TBI) living in long-term care homes (nursing homes, homes for the aged and charitable homes) in Ontario, Canada. Methods: The study used a cross-sectional design. Secondary data analysis of a comprehensive provincial database of long-term care homes was conducted. Results: Of the 399 residents coded as having a TBI, 154 were < 65 years of age. Virtually all residents were limited in personal care and required assistance for eating (94.2%), toileting (92.2%) and dressing (99.4%). A large percentage also required care for challenging behaviours, while care needs due to substance abuse was common among 12.3% of TBI residents. Conclusion: As similar research in Australia has found, young persons in long-term care homes in Ontario, Canada, have high level personal health needs, however the appropriateness of this environment is questionable.

Traumatic brain injury in older adults is an increasing problem in our aging community. Traditional functional outcome measures, such as return to work or academic achievement, as used with younger samples following traumatic brain injury are of limited use for older people. Although challenging to assess reliably, evaluation of prospective memory is gradually being included in outcome assessments following traumatic brain injury in younger samples and may be a useful index of cognitive competence in everyday life when assessing older adults following traumatic brain injury.