I have an adopted son shaken by birth family at 4weeks old. He is now 11. He is very impaired physically...gtube, wheelchair, nonverbal, drooling, seizures, vision impaired... People would assume he is severely cognitively impaired. He just started fifth grade and he reads at an almost fourth grade level. He talks with a computer including jokes, typing out sentences, flirting with girls, being a sarcastic kid. He demands to pick out his own clothes, looks in the mirror before school, refuses to get a haircut, asks "who is in charge here" if he waits too long for the doctor at an appt. he says if he is mad, confused, scared. He listens to books on tape...age appropriate stories. He negotiated with his teacher to pat less "rent" during a business project bc he brings his own chair to class so he does not need one provided. He fishes with adaptive equipment and is a super sports fan. He has been continent since 2years 3 months though we have to lift him onto a commode. I could go on but my point is brain damage can be very different that what you might expect. It will always be sad but he has joy in his life. I am also a nurse doing primarily rehab but also some private duty. I have done work with post-stroke aphasia patients and other kiddos with brain injury, and I have seen others make great strides in communication and interaction. Sometimes it just takes belief and hard work from caregivers to support that progress.