Kids Health Info

Brain injury - Impulsivity

  • Sometimes, after a brain injury, the child/young person may act without thinking about the possible consequences of their actions or the effects of their behaviour. This is called impulsive behaviour. 

    While it is challenging to manage, it is important to remember that often your child will not be aware that their behaviour is impulsive. There are general ways to help manage impulsive behaviour and, if needed, a clinical psychologist can develop individual strategies for each individual child.

    What is impulsivity?

    Children with a brain injury may be more impulsive than they were before their injury. This is because they can have difficulty controlling and checking their behaviour. An impulsive child acts quickly on an urge without considering the consequences of their actions.

    Examples of impulsive behaviour

    • not looking for traffic before crossing the street
    • reaching up to get a toy near the hot stove
    • trouble waiting and taking turns
    • using a sharp knife to cut fingernails
    • rushing into an activity, making lots of mistakes
    • starting another task before finishing the first
    • lashing out physically or verbally without thinking of the consequences
    • making inappropriate comments

    Ways to help a child with impulsive behaviour

    Impulsivity is challenging to manage as the child's urge to act is sudden and strong. It is important to remember that often your child is not aware that their behaviour is impulsive.

    • Try to reduce situations that may put your child in danger. For example, provide supervision when crossing roads and don't leave dangerous tools around the house.
    • Your child's ability to plan their actions does not come naturally. Break tasks down into a set of steps (say them or write them down) and use check-lists to help them with planning. This can help reduce the chance of impulsive behaviour.
    • Give verbal or visual prompts (e.g. 'stop, think, do') as a reminder to think before acting.
    • Talk with your child about the steps involved in a task. During the task, it may be helpful for you and your child to say the steps out loud.
    • After a task, discuss the successes as well as the mistakes. This approach can help children to respond better when faced with similar situations at a later stage.
    • Establish clear rules and make sure your child understands the rules, the consequences of breaking them, and also the rewards for sticking to them.
    • Provide clear feedback and help them recognise the consequences of their actions on themselves and others.
    • Try to be positive and calm and not respond in anger.

    Who do I see?

    If impulsive behaviour is happening often and is affecting your child's safety, it may be helpful to get a referral to a clinical psychologist. The clinical psychologist can develop individual ways to modify and cope with your child's impulsivity. A program usually involves ways to develop alternative responses as well as consequences for problem behaviours.

    Key points to remember

    • Impulsive actions are those made without taking into account possible problems or thinking about possible consequences.
    • Children with a brain injury may be more impulsive than they were before their injury because they can have difficulty controlling and checking their behaviour.
    • If impulsive behaviour is happening often and is affecting your child's safety, referral to a clinical psychologist may be helpful.

    For more information

    Developed by the RCH Paediatric Rehabilitation Service. Based on information from the Brain Injury Service at Westmead Children's Hospital (with permission). First published Feb 2007. Updated November 2010.


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.