One of the momentous changes brought by Covid is a wave of people turning to digital ways of staying in touch and finding support. Many charities and specialist services quickly turned their work digital as soon as we went into lockdown. But in the brain injury field, this switch is not straight forward. An occupational therapist working with brain injured individuals observes: “It is no good saying to the people I work with, ‘try this support group on zoom’ because the impacts of their brain injury work against them accessing this sort of support.” A person living with the effects of a brain injury explains – “I know that I’ll just get really irritated looking at lots of people on a small screen…that’s not going to work for me at all.”
It is recognised that Traumatic Brain Injuries (TBI) can profoundly effect vision by damaging parts of the brain involved in visual processing and/or perception, for example the cranial nerves, optic nerve tract or other circuitry involved in vision, such as the occipital lobe (Powell et al, 2014).
What this means for individuals and their families in their daily lives can include: blurred vision, photophobia (bright light hurts or irritates the eyes), reading problems such as slower reading speed and loss of place when reading, diplopia or eyestrain, particularly after looking at a screen for a long time, difficulties in visually crowded environments, such as fluorescent lighting and light sensitivity, particularly to the light from phone and computer screens (Greenwald et al, 2012). These sorts of visual impairments are often missed or overlooked in the first year after a brain injury while other impacts may be more apparent. But such impairments are likely to limit the effectiveness of rehabilitation if, for example, vision problems trigger anger, frustration or withdrawal. Sensitivity to the light of screens, reading problems and cognitive overload can specifically make it difficult to use smart phones, computers and tablets for any length of time or with much complexity involved.
Although there are challenges for people who have had brain injuries, social media and digital platforms can have many potential benefits for people with brain injuries, including making and maintaining connections (Brunner et al, 2018). Brunner’s in-depth study of the social media experiences of 13 individuals with brain injuries shows although people reported cognitive fatigue, with support, these difficulties can be addressed. It also shows that people with brain injuries primarily use social media to connect with their family and friends and to a lesser extent to others with brain injuries or to professional support. There is a recognised benefit in using platforms like Facebook to connect with family and friends (and indeed this sort of digital contact may be easier for people with a brain injury than a long phone call).
This is an area that could be more fully developed by more peer-to-peer and brain injury professional support offered digitally, as it has been for other areas of disability, Brunner concludes.
One legacy of the pandemic is likely to be continued use of digital connections for health and disability groups; the recognition of things which have worked well during lockdown can be continued in some form, even after in person support can fully recommence. What might this mean for brain injury? It could be a catalyst for overcoming notions that people with brain injuries simply don’t get on well with screens. Through the Covid experience, there may be improvements in the way people with brain injuries use screen-based support and social media, together with individuals growing in their confidence in using technology after a brain injury. Although there are some impacts of a brain injury which may affect the way affected individuals get on using social media, with the right strategy and support in place, there are clear benefits in the connections offered by the digital world.
Vision after Brain Injury by Janet M. Powell, Ph.D., OTR/L; Alan Weintraub, M.D.; Laura Dreer, Ph.D.; and Tom Novack, Ph.D., in collaboration with the Model Systems Knowledge Translation Center. Vision Problems and Traumatic Brain Injury | Model Systems Knowledge Translation Center (MSKTC)
Brian D. Greenwald, Neera Kapoor & Adeepa D. Singh (2012) Visual impairments in the first year after traumatic brain injury, Brain Injury, 26:11, 1338 https://www.tandfonline.com/loi/ibij20
‘I kind of figured it out’: the views and experiences of people with traumatic brain injury (TBI) in using social media—self-determination for participation and inclusion online. Melissa Brunner, Stuart Palmer, Leanne Togher and Bronwyn Hemsley International Journal of Language & Communication Disorders DOI: 10.1111/1460-6984.12405