When disabilities related to brain injury have no visible marker-as is the case with symptoms such as depression, pain, fatigue, personality changes, or cognitive problems-brain injury survivors can face a lifetime of negative consequences. People commonly have unrealistic expectations of people who have disabilities, but no obvious, physical marker of injury.
Early after a brain injury, people are marked with bandages or scars. Time goes on, and the bandages come off and the scars fade. In both cases, the presence or absence of a physical marker of injury can influence the way other people treat a TBI patient.
Recent research has found that when an adolescent does not have a visible scar, his negative behaviors are attributed to his age. However, when an adolescent has a visible scar from a brain injury, his negative behaviors are attributed to the brain injury.
Furthermore, when people attribute symptoms to the brain injury, there is also an expectation that the symptoms will persist in the future. This can influence the amount of assistance and rehabilitation that is offered to the TBI patient. Children who do not show a visible scar may receive fewer rehabilitation benefits and resources because people expect them to grow out of their negative behaviors.
McClure J, Patel GJ, & Wade K. Attributions and expectations for the behavior of persons with brain injury: The effect of visibility of injury. Journal of Head Trauma Rehabilitation. (January 2011).