Traumatic Brain Injury: Short, Long, and Very Long-Term Vocational Outcomes

Traumatic brain injury (TBI) has proven to be a major public health problem with an annual incidence of over 1.5 million people (Langlois, Rutland-Brown, & Thomas, 2006). Medical advances have contributed to increasing the survival rate of TBI allowing many individuals with varying severities of TBI to receive treatment from the ER and be discharged immediately to their home or receive additional hospitalized treatment, but with a greater possibility to return to the community at a later time. Prevalence statistics reveal that over 3.17 million people live with TBI-related long-term disability and almost three-fourths are working-aged adults between 20 and 69 years old (Zaloshnja, Miller, Langlois, & Selassie, 2008). The statistics by Zaloshnja and colleagues indicate that a large percentage of individuals who sustain TBI will more than likely return to their community, not truly cognizant of the residual physical, cognitive, and emotional deficits that often disrupt pursuit of employment or return to productive living. This chapter provides a narrative review of research that reports short, long, and very long-term vocational outcomes for persons with brain injury and any influence of demographic and injury-related factors. Specifically, the areas to be covered are the definitions of short, long, and very-long term with regards to functional recovery from TBI, report of vocational outcomes from 3 months to 15 years post-TBI, specific demographic variables known to significantly influence vocational outcomes after TBI (e.g. age, gender, race/ethnicity, marital status, education and pre-injury employment), specific injury-related variables known to significantly influence vocational outcomes after TBI (e.g. cause of injury, injury severity, and functional status), update of disability legislation, summary of health professionals and what they contribute to the enhancement of vocational skills for individuals following TBI, and community-based interventions to improve vocational outcomes after brain injury.