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One of the most devastating effects of TBI may well be the memory difficulty associated with new learning. Your family member may have considerable difficulty learning new job skills, new procedures to be used at the job sites, and new routines in the home. Difficulties in memory, concentration, organization, sequencing, and problem solving will all slow the new-learning process. However, the memory difficulties are the biggest problems to this process. Your family member will not be able to increase his skills from day to day if he does not remember from day to day. To affect new learning of either a household task or job skill, your family member will need to repeat that particular task over and over again until it becomes automatic. For example, if you are teaching your family member to use a new system of balancing the checkbook, you will have to go over this system with him step by step, over and over again. At some point the system will be "automatic" for him, and the system will be his.


The following are examples of new-learning problems you may observe:

1. When your family member returns home, you give him the responsibility of taking the kids to their after-school appointments. He is not able to keep up with the schedule. The kids do not get where they need to be on time.

2. While your family member was gone, a new system of billing was developed at work. He complains, "the people at work have really screwed up this time.. . they have a system so complicated that no one can figure it out!"

3. Your family member was always a game player. Your friends found a new board game they want to teach him. He becomes very frustrated when he cannot follow the rules.

4. When he first returns to work he does very well. After 3 months, a new supervisor is hired, and procedures change. Your family member is not able to catch on to the new procedures and fears for his job.

Management Techniques

1. Work with your family member in setting up his own system for transporting the children from place to place. He is more likely to remember the pick-up points if he develops his own system rather than attempting to adjust to yours.

2. Work with your family member in helping him understand that he has to learn the new system. Ascertain whether there is a friend at the work site who could help him learn the new system.

3. Teach your family member new games and activities on a one-on-one basis. Once he has mastered the skills, then play these new games in social situations.

4. Be aware that TBI clients often lose their jobs when there is a change in a supervisor or in management staff. Enlist the assistance of rehabilitation professionals to help your family member in the transition between supervisors. This is a time when you will need to be very supportive to assist him through a particularly difficult time.