ABSTRACT
People who suffer brain injury often experience the loss of their social role. The World Health Organization (WHO, 1980) provided a framework to understand the social consequences of serious injury when it published the International Classification of Impairments, Disabilities and Handicaps. After brain injury, impairment results from a loss of either physical or mental function caused by cerebral damage. This will disable the person in some way, by preventing or diminishing his or her ability to participate in certain activities. In turn, this can lead to a loss of some social role, defined as a handicap. Recently (WHO, 1997), there has been an attempt to clarify how people can be disadvantaged because of an inability to engage or interact at a social level. In this proposed revision of the nomenclature surrounding the social consequences of serious injury, disability is referred to in terms of the activities in which a person would normally engage and how performance in the abilities can be compromised. Handicap is referred to in terms of participation, describing how the opportunity for social interaction can be compromised, leading to social disadvantage. It is not yet clear whether these revised terms will be accepted into the jargon of rehabilitation medicine or whether they will apply equally to those with psychological problems as to those with physical problems. Whatever terms are used, Greenwood (1999) points to the fact that social disadvantage is a particular problem after brain injury. He examines how the revised language of disability reflects the disabilities implicit to a brain injured population, especially in respect of the role of mental functions in the control of how, when, and where activities are conducted. He suggests that cognitive and emotional
factors are central to understanding the management of many forms of physical disability, an argument used throughout the chapters of this book.
