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Brain injury and autism

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Brain injury and autism

Tue 02 Apr 2024

Researchers and clinicians at King’s College London are currently investigating the experiences of autistic people who have sustained a traumatic brain injury.

Dr Richard Cole is a psychiatrist and PhD student at King’s College London, researching the interaction between emotion recognition and traumatic brain injury. During the last 6 years he also has worked as a doctor in the specialities of brain injury neurorehabilitation and psychiatry in North and East London.

Here, Richard explains more about the connections between neurodiversity and brain injury, and outlines some of the opportunities for vital research in the field.

The term neurodiversity encapsulates how people’s brains differ in terms of how they are wired and how they function. It can arise through differences in how the brain develops (e.g. in autism spectrum condition), and it can also be acquired (e.g. from stroke or brain injury).

Someone who is neurodivergent sees, understands and experiences themselves and the world in a way that is not typical of the society in which they live.

These differences can result in unique perspectives and strengths (e.g. eye for detail, pattern recognition) but also challenges that can significantly impact daily life and how individuals interact, learn, communicate, and navigate the world around them.

Whilst some might say these challenges arise from the individual lacking certain abilities which are typical of the people around them, others might say that it is society that does not do enough to cater for those differences.

Some of the challenges that neurodivergent people experience include social difficulties (which can result in lower employment as well as loneliness) as well as increased risk of mental illness (such as depression and anxiety disorders).

Currently, we do not know what challenges someone who is neurodivergent because of how their brain developed (i.e. an autistic person) might face when they suffer a traumatic brain injury.

Understanding traumatic brain injury and autism

Traumatic brain injury (TBI) includes a range of injuries of differing severities and brain sites. In the UK it is the commonest cause of death and disability in those under 40 and is mostly caused by falls, followed by road traffic accidents. It is categorised as mild TBI (also known as concussion, often involving dizziness or momentary loss of consciousness after a blow to the head), or moderate-severe (when brain damage is seen on scans, and loss of consciousness is more prolonged). You can read more about the severity of brain injuries here.

Autism is a lifelong condition present in 1-2% of the population in England. It arises from genetic influences on how the brain develops and cannot be acquired from a TBI or stroke. It presents in diverse ways but is characterised by specific differences in social communication and interaction (e.g. use of spoken or non-spoken language, ability to form social relationships), along with specialised, focused interests and behaviours (e.g. narrowed interests, preference for routine and sameness) and sensory differences (e.g. seeking out certain textures, or avoiding certain brightness intensities).

Whilst no two autistic people are the same, there are common strengths within the community, such as original thinking, specialised interests, attention to detail, honesty and authenticity, empathy and unwavering integrity.

Overlapping challenges

There's a notable overlap in the challenges faced by both autistic individuals and TBI survivors:

Autistic people could be at increased risk of TBI

Data on the percentage of autistic individuals who've sustained a TBI is lacking, but there are reasons to believe they may be at an increased risk.

Understanding the experience

Autistic individuals have distinct characteristics that might influence their response to the physical trauma, and often psychological distress, that head injury entails. These characteristics influence rehabilitation processes, vulnerability to symptoms, and the individual's ability to communicate challenges or discomfort effectively.

Understanding the autistic experience of TBI is inherent to embracing neurodiversity, especially in worlds of healthcare, research and contact sport (where repetitive head injury is common). To embrace neurodiversity is to acknowledge that neurological differences should be accommodated and respected, and the first way to do this is the characterise how those differences present.

We simply don’t know the challenges that autistic TBI survivors experience as there is no published data, so the first step is to explore the relevant themes as brought up through semi-structured interviews.

The call for research

Researchers and clinicians at King’s College London are currently investigating the experiences of autistic people who have sustained a traumatic brain injury. For further information on this study, contact


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