Brain injury and social skills

Posted in Fresh Thinking

Brain injury and social skills

Brain injury can have a huge impact on a survivor's social skills, and now scientists are beginning to see why...

Thanks to new imaging techniques, it appears damage to specific areas of the brain’s outer layer – the grey matter - may not be the only reason behind impaired social cognition.

A team of Australian researchers have now found the white matter, in the deeper tissues of the brain, is also very vulnerable in a brain injury.

The white matter is made up of nerve fibres (axons) which act as connections, or wiring, between nerve cells (neurons). The whiteish colour comes from the fatty wrapper around these axons called myelin.

The study of traumatic brain injury (TBI) survivors by the New South Wales University team used new imaging techniques to focus in on this area, and to see the extent to which it was damaged.

Participants also complete a social cognition assessment in which they observed people in typical social situations and then answered questions about what those people might be thinking, intending, feeling and meaning.

The results showed reduced functional connectivity in several brain regions and that this loss of white matter ‘wiring’ was associated with impaired social cognition.

NSWU Professor of Clinical Neuropsychology, Skye McDonald, who authored the study, said: “I hope this demonstrates that connections in the brain are as important as the ‘brain centres’ they connect.

People who suffer brain injuries may lose a function, not because a brain centre is damaged, but because connections to that centre may be lost.

Scientists already know that some our functions, such as social cognition, need different areas of the brain to work together to achieve the expected outcome. But these areas need to be well connected for that to succeed.

For example, listening to someone else engages the left side (hemisphere) of our brain while understanding their emotional state requires the right hemisphere.

What do we mean by social cognition?

Social cognition involves a number of processes, including:


  • Perceiving your own and others’ social cues
  • Interpreting and understanding your own and others’ emotions, beliefs and behaviours
  • Producing a response to those cues, emotions, beliefs and behaviours


TBI survivors often suffer poor social cognition if damage is suffered in the areas of the brain controlling verbal, non-verbal, auditory, visual and emotional input.

Those areas are mainly found in the frontal lobe, our personality and communication ‘control panel’, and the temporal lobe, which plays a key role in auditory processing, memory formation and speech and language.

Signs of impaired cognition may include:


  • Attention and concentration difficulties
  • Memory problems
  • Reduced reasoning and problem-solving skills
  • Cognitive fatigue
  • Slower information processing
  • Reduced insight
  • Literally interpreting verbal information
  • Impaired social skills


What sort of social skills can brain injury affect?

Each culture adopts its own behavioural norms but when the brain is injured, we may no longer be unable to recognise those norms.

Impaired social cognition can present a number of problems, therefore, including:


  • Saying the wrong thing at the wrong time
  • Inability to take turns
  • Interrupting others
  • Altered ability to talk around a shared topic
  • Talking only about themselves
  • Fixating on certain subjects
  • Being sexually explicit verbally
  • Inappropriately swearing
  • Repetition on a favoured subject
  • Problems ‘reading’ facial expressions or body language


Support, rehabilitation and awareness can reduce the effects of impaired social cognition, and your Occupational Therapist will be able to offer guidance on this.

We are passionate about occupational therapy and neurological rehabilitation. ‘Talking heads’ is a means of bringing together individuals and professionals interested in brain injury. The blogs, stories, films, current research and news items aim to inform and spark moments of inspiration, reflections and points of discussion. Talking Heads is here.


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