|Physical||Communication||Cognitive||Behavioural / Emotional|
An acquired brain injury can lead to disinhibited or poorly controlled sexual behaviour which can involve:
Inappropriate sexual behaviours do not occur because the person has an increased sexual drive, but occur because the person has lost the ability to inhibit behaviour and comply with accepted social norms. They may had decreased insight or awareness of their behaviour and a lack of understanding of usual social and interpersonal conventions. They may not appreciate that they are making other people feeling uncomfortable or threatened. Sexual behaviour can then occur at the wrong time or place or with the wrong person. This can be very uncomfortable for family and friends and could result in the person with the brain injury be subject of unwanted attention or even assault.
It is important not to ignore inappropriate sexual behaviour. The only way the person is likely to realise the effects of their behaviour is to talk to them about their behaviour and other persons expectations and perceptions. If they have an awareness of how they are making other people feel they can then work on managing their own behaviour. Feedback should be early, clear and consistent to help the person to learn.
It may assist to implement strategies to minimise sexually disinhibited behaviour. Try to predict situations were inappropriate behaviour is more likely. Pre-brief the person on your expectations before going into the situation; and then debrief the person afterwards. They may have behaved really well or they may have passed a comment they should not have or intruded in someone’s ‘personal space’. By pre-briefing and then debriefing the person can start to learn an appropriate way to behave and which behaviour is inappropriate and is to be avoided. Patience is key.
Personal supervision or one to one support may be required until the behaviour can be minimised or brought under control. Additional support may have to be put in place if the person has severely disinhibited sexual behaviour and is at risk of exposing himself or inappropriately touching someone. Contact with children or other vulnerable groups should be considered and managed.
"Thousands of children and young people living in the UK today without the help and support that can make a huge difference to their lives"
"When someone has a brain injury, early access to local, specialist rehabilitation is crucial to ensure the maximum recovery and make significant savings to the state in health costs"
"We are medical practitioners. The real experts are the parents. Over the last 35 years they have taught me everything I know"
"When different organisations assess different aspects of a child's neuro-rehabilitation needs, everyone looks at things from a different perspective and have conflicting priorities"
"Positive and coordinated neuro-rehab interventions for children and young people is proven to bring health improvements; improve independence; reduces the need for sheltered living; decreases vulnerability; decreases drop-out rates in schools; decreases youth offending"
"Our 10 year study proves that family-led home-based neuro-rehab interventions deliver the best outcomes for children and young people"
"There are problems with getting people into neuro-rehab. Those most in need are often those most excluded due to a lack of socio-economic resources."
"Children and young people have poor social competence post brain injury due to reduced cognition, executive functions, and emotional control. As a result they are twice as likely to have mental health issues in the future"
"NHS clinicians struggle with what intervention to prioritise in paediatric neuro-rehabilitation due to limited clinical time and the complexity of needs. Children, clinicians, parents and schools all have different neuro-rehabilitation priorities"