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As we have already said, sometimes it's not obvious someone has a brain injury. One of the big problems, one of the most disturbing problems is challenging behaviour. Maybe somebody has always been plastered and kind and thoughtful before they had a brain injury. After brain injury, they could be an angry person. And a lot of this is through frustration.

As I previously said, I've worked at Headway for over 14 years. I've done thousands of assessments and at every single one of those assessments, without fail, the word frustration has been used. We think that someone can't communicate, they can't remember, they're going to get frustrated. That frustration leads to anger and sometimes that's violence. There are special units with people who are extremely violent and need extra special help. Specialists help to calm them down and help them to cope with that.

We do see challenging behaviour with people who are experiencing a mild and moderate brain injury. It could be that they are still violent, that they are still angry and thrashing out. Normally, it's people they love most that they take it out on. We also see people who are verbally aggressive maybe in the tone that they are using. But quite often, people swear a lot after brain injury. Even people who have never sworn before will swear after brain injury and it could be that the only words they can say are swear words. It's because that's a different part of the brain. And we have to remember when we're dealing with somebody with a brain injury, that if they're swearing at us, they may not know what they're doing and they may not be using it in that context. Okay, we might have to correct them so eventually, they learn that to swear and to shout and to be violent is not right but we have to understand that it's the brain malfunctioning, and not the person being angry or horrible. They have a brain injury, and it's just as much a problem and needs to be treated in a similar way with understanding as a mobility or communication problem.

How do you help or deal with somebody with challenging behaviour? First of all, are they tired? If they are tired, give them time out. They will need to sleep more than pre-injury. Is there too much stimulus around? Is the brain trying to concentrate on too much and therefore it just comes out as anger. It's like if you are asking your computer to do too many things at once it will just crash. Our brain's just a computer it will do the same thing it will just crash or turn out to be very very angry. Do we know the triggers? Do we know what makes somebody angry? For instance, I know somebody who will get very angry if has sweet corn on his plate. That's simple, don't give him sweet corn.

Other people get cross if are called by the wrong name, therefore make sure you know who you are talking to and you're using the correct name. As you get to know somebody with brain injury, you can change your own behaviour to help them. You can remove things that are going to make him angry, so they actually don't experience that.