Most TBI individuals suffer closed head injuries that cause both focal and diffuse damage. Focal trauma happens when the brain bounce against the inside irregular contours and bony ridges inside the skull causing tears, hemorrhages or bruise. Diffuse trauma occurs when the nerve fibers through the brain stem and into the brain are stretched or torn. Both diffuse an

Music therapy also, has the power to heal. Therapist use music to promote, maintain, and restore mental, physical, emotional, and spiritual health. Which can be gained through guided imagery, active listening, singing, visual art, drama, poetry, and relaxation music. According to American Music Therapy, Music has nonverbal, creative, structural, and emotional qualities. Music facilitates contact, interaction, self-awareness, learning, self-expression, communication, and personal development. Music's clinical value provides a non-threatening vehicle of interaction and communication with patient. Activities include, singing which helps with speech impairment and improves patient's breathing control. Listening to music helps develop cognitive skills such as, attention and memory. It also provokes memories and stimulates thoughts, images, and feelings, which can be further examined and discussed, later with the therapist. Composing facilitates sharing of feelings, by wr!

According to the National Pediatric Trauma Registry, (NPTR) the brain cannot repair itself. It cannot grow new brain cells, called neurons, once they are damaged. In addition, NPTR states,

And according to The National Institutes of Health

Ø Those individual eighteen and over that are afflicted with adult-onset brain impairments is between two million five hundred thousand and three million seven hundred thousand.

The article by National Institute of Health (NIH) (1998) states in 1989, the US Congress passed a joint resolution proclaiming the 1990's the "Decade of the Brain". The resolution called for greater recognition of, and advances in, all areas of the neurosciences and other research-seeking causes, cures, and treatment for Americans of all ages afflicted with brain diseases and disorders.

Finally, play therapy; there are many different forms of play such as puppet interview and sand box therapy. Regardless of which one is used play therapy is resourceful for children with traumatic head injury because it can help the child cope with a stressful situation. In addition it doesn't make the child feel inferior or overpowered by the therapist. Play is the child's natural way of communicating, during therapy the child is responding to feelings in their heart in a safe non-threatening, therapeutic environment. Under these circumstances the child will express what he or she cannot, will not, or does not say with words. Play therapy is a volunteer activity it allows the child to feel in control of the situation and conversation.

but focuses are on helping find ways to master everyday activities. It includes teaching patient that may have trouble swallowing how to eat or drink. Later in therapy focus is on showing patient how to use special tools to put on shoes and socks, close zippers, and button shirts. For patient going home the focus is on cooking and housekeeping. Respiratory therapist also cares for the patient the focus is on breathing retraining, through breathing and relaxation techniques, which teaches ways to conserve energy. The goal is to decrease respiratory symptoms and complication.

rsen the cerebral injury and may cause secondary brain injury, such as, hypotension, hypoxia, anemia, hypothermia, and other abnormalities.

Pet therapy is another rewarding and enhancing therapy for patients with traumatic brain injury. Pets provide unconditional love and affection. In the hospital where patient may feel isolated, loneliness, loss, separation from home, and a sense of no longer being needed the comfort of pet therapy is a gift. In a study published by Jama vol 275, 1001 apr 3 96 the author states pet therapy provides a "significant positive" changes in patient well-being. According to Delta Society animals have a way of "accepting without qualification." They don't care how a person looks or what they say. An animal acceptance is nonjudgmental. Pet therapy provides many benefits such as fee

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