Chad Staus

Name: Chad Staus

Age/Grade: 13 years 4 months; entering 8th grade

Parent: Shelby Staus

Condition: Traumatic Brain Injury (TBI) (occurred when Chad was 12 years 11 months)

Background: Chad was the sole survivor of an automobile accident that took the life of his father and older brother. Chad sustained closed head injuries, compressed vertebrae, and a fractured femur; although his leg has healed, Chad is still regaining mobility in his lower extremities due to the compressed vertebrae. His TBI , together with the emotional impact of the loss of his father and brother, have left Chad with impaired interpersonal communication skills and some explosive behaviors, for which his pediatrician has prescribed a Prozac derivative. Chad is also receiving counseling.

Shelby Staus, Chad's mother, has returned to work and is struggling to continue to provide a stable home setting for Chad and his two younger sisters. She is encountering great difficulties because of the struggles with Chad's surgeries, therapies, and long recovery as well as the trauma of dealing with the loss of a husband and son. Complicating the issues even further is the reality that she is dealing with a teen-aged son whose whole personality seems to have changed radically. Shelby feels overwhelmed and has shared hopes that Chad's return to school in the fall, the first return since his accident, will help bring some additional order to their lives.

Comments and Insights

Mother: I am almost frantic; before the accident, Chad was an outstanding student. He would devour books and set himself research challenges on the internet. He never could get enough of learning and sharing that learning with others. Not a day would go by without his popping up and saying, "Guess what, Mom!!" I don't think Chad's opened, let alone finished, a single book since the accident; he cannot remember simple tasks -- he will start somewhere and need to be reminded where he was going or what he was saying -- but he can remember in great detail the camping trip he and his father and brother took two years ago. He can't seem to tolerate his sisters now, but actually seems unable to explain what is wrong. . . he was such a talker and clear thinker before. It is very disconcerting. I almost think Chad can't ask questions anymore -- he seems to struggle to form a thought, then will shrug his shoulders and say (or sometimes yell) "Never mind, never mind!" He seems horrible frustrated, and that Prozac stuff just makes it worse -- I know I'm at my wits end because I'm sure Chad is just trapped inside this trauma trying to get out. We all need help.

Special Education Teacher: I'm also quite concerned; I understand that within the first six months of TBI, great changes can occur within the affected person. . . we must respond to the changed behaviors, but these changes may not be permanent. Our goals will be to re-establish communication, examine the effects of the short term memory loss, work to improve his expressive interpersonal communication, and discover what strengths remain from his earlier outstanding academic achievements. Perhaps some computer-based programs will help.

I understand Chad was quite the hiker and rock climber and that the loss of these activities is a source of frustration; perhaps, in consultation with his physical therapist (PT), we can find some outdoor recreational programming to augment his PT and incorporate opportunities for improved interpersonal communication. I would also suggest that we consider ways to provide assistance to Shelby and the rest of the family. The wounds are still pretty raw.

Regular Education Teacher (math and science): It just tears at my heart. I had Chad last year and he was the top student in both math and science -- tops in so many ways, academically and personally. I know we who staff the school and his friends among the students will help however we can. I know we'll need to get lots of in-service; for instance, I don't know how to respond to someone on Prozac. I mean, should Chad have immediate access to the school counselor whenever he needs it?

As for me, I'm trying to find computer programs that might interest Chad and help him with that short term memory problem. I don't know if his mom can afford one for Chad at home, but maybe some of that special education money might be available to help Chad use some of that assistive technology.

Counselor: Of course, my door will be open to Chad whenever he requires it; you may also be right that the family could benefit from counseling -- but I can't open a private practice in the school. It is also very important that Chad be given the opportunity to take part in some kind of recreational/leisure programming to help him re-establish the non-clinical part of his life. Such programming might also help provide an outlet or channel for his explosive episodes as well.

Speech/Language Pathologist: I really can't comment until I've had more time with Chad. It is highly likely Chad will need some language intervention -- for instance the expressive interpersonal and the question formulation -- but I do know that radical changes can occur within the first six months to a year. We'll just have to stay alert.

Physical Therapist: Chad's mobility should return if he can be encouraged to involve himself in some type of sport or recreational activity that would be relatively low impact, yet still involve his lower extremities, for instance, swimming or therapeutic horseback riding. Chad is still very much in recovery from his trauma; we should be intervening in ALL areas of his life to stimulate healing. He is also at that dangerous stage when he is recognizing how long the road to recovery can be as well as realizing the true extent of his loss.

Chad: I hate what happened and I wish I could be what I was. I used to be smart, you know. I never took pills, either. Say, I don't know who you are. . . . If I could I would not let Dad get in the car; Mom should have stopped him, you know. What? I'll be back in school in August. It'll be hard, you know, to be in the 8th grade classes because, oh. . . #@*. I lost it. That #@* physical therapist makes me work so hard I forget to think. Bet there's a PT site on the Web; I ought to look for, oh. . . #@* never mind, never mind. . .