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traumatic brain injury
By Michelle Kemper
GOALS IDENTIFY WHAT traumatic
brain injury (TBI) IS
HOW MIGHT TBI DIFFER FROM OTHER DISABILITIES OR BEHAVIORAL ISSUES
SUGGESTED CLASSROOM INTERVENTIONS
WHAT TEACHERS NEED TO KNOW
INFORMATION REFERENCES
What is it?“A bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”(Center for Disease Control and Prevention)
Injury ranges from mild to severe Majority of injuries are concussions or mild TBIs Not ALL impacts to the head are TBIs CDC considers TBI a serious public health
problem TBI Video (Nucleus Medical Media):
http://www.youtube.com/watch?v=55u5Ivx31og
Interesting TBI Facts
(Center for Disease Control and Prevention) Leading causes include:
Falls (50% children 0-14 yrs.) Traffic Accidents Struck by/Against Events (25% children 0-14
yrs.) Assaults (2.9% children 0-14 yrs.)
Higher for males than females (in general) Highest age groups at risk 0-4 yrs. and 15-19
yrs. 75% Concussions or mild TBI Individuals who experience TBI have 3X
increased risk of re-injury 1.7 million TBIs each year
(MS, Spinal Cord Inj, HIV/AIDs, and Breast Cancer combined)
What happens when a student has a TBI?
Immediate changes (may include):
Confusion or disorientation Loss of consciousness
(minutes, hours, days) Evaluated by doctor/hospital May or may not be reported to
school (depending on severity)
What happens when a student has a TBI?
Long-Term (Possible Changes Over Time)
Physical:
•Tired/Sleep Issues•Lack of interest •Headaches •Weakness/Dizziness•Coordination/Motor Function•Slow reactions •Light/Noise Sensitivity
Cognitive:
•Forgetfulness/Foggy•Struggles w/new material•Word-finding difficulties •Organization problems•Inattentive•Concentration difficulties•Easily distractedEmotional:
•Moodiness•Unstable emotions•Depression•Anxiety
Behavioral:
•Irritability•Aggressiveness•Easily Frustrated/Angered•Issues w/unexpected events•Social Withdrawal
HOW TBI DIFFERS FROM LD/ED
Distinguishing Characteristics Functioning at higher level prior to injury Marked medical changes
(balance, weakness, paralysis, visual,.) Recovery of some functions
(slowly, quickly, unpredictably) Perform inconsistently Short-term memory issues Previous learning intact, may have
difficulty learning something new Full or partial awareness of capabilities
and loss (especially in older children) Agitated, restless, impulsive, New problems with peers, behavioral
difficulties, lack of understanding issues
*
SIMULATIONS(As time permits)
Visual-Motor Function Apraxia – loss of ability to carry out familiar, purposeful movements without motor or sensory impairment.
Examples: Feeding yourself, brushing teeth, writing notes, taking a test
Speed/Processing FunctionExamples: Cannot keep up, trouble concentrating, frustrated
Classroom Management
1. Teaching methods and strategies used with learning and emotional disabilities can also be used with traumatic brain injuries.
2. Accommodations used for students with TBI can likewise benefit all of the students.
3. There is not one teaching program that applies to every student with a brain injury; therefore, each student’s plan will need to be adapted to their specific needs.
Post TBI Strategies & Interventions I
Attention/Concentration
Minimize Distractions (eg. Seating)
Technology Options Peer Notes Small Groups Adjust Schedules Verbal/Non-verbal Cues Breaks
Information Processing
(Examples)
Slower pace Extended time
(eg. tests, assignments)
Workload adjustment Repetition Color-coding Written assignments Record instructions
Post TBI Strategies & Interventions II
Memory
Written Instruct/Assign Recording Information M/C Test Formats Highlighted Information Emphasis on learning
mode (visual/auditory) Organizer Repetition to comprehend Memory notebook
Executive Functioning
(Examples)
Rehearse routines Organization systems Break large tasks into
smaller steps Display schedules Color-coding Designated locations
(eg. for homework) Practice sequencing
material
Personal Stories (Examples, as time permits)
Jessica’s StoryStrategy differences may exist for TBI students and students with other disabilities.
Julie’s StoryInjuries may not be recognized due to poor transition between hospitals, parents, and schools.
Yvette’s StoryA teacher’s willingness to adapt can be critical to success!
What Teachers Should KnowBe aware of possible TBI.
Importance of Assessment: While interventions for other disabilities may be the same for TBIs, it will not focus and identify the cognitive impairments. Identification is essential to their success.
Annually follow-up: Students that have had a TBI need to be tracked for additional problems or progress.
TBI Classified as ED: Many times students labeled as ED have been found to have had a TBI (20% in one study); behavior is misunderstood and cognitive deficits are missed.
What Teachers Should KnowHow can you support these
students? Analyze and work with the student
Do not rush or challenge
Consistency in strategies
Understand the emotional challenges, talk to the student.
Older students may appear to “not care” but it is a common problem with memory deficits.
Watch for social issues, peers may need to be educated
What Teachers Should KnowRemember!
Many students with TBIs may fail in school due to unrecognized injury, or due to “mild” mis-diagnosis. (15% have significant injury)
Early TBI may be academically normal but experience significant issues with new demands of middle or high school.
With older students, previously learned material may remain intact, while learning new information may be compromised.
The End
ED584 - November 2013
References
Bowen, J. (2004). Classroom Interventions for Students with Traumatic Brain Injuries. Retrieved November 2013, from Brainline.org (brainline
kids): http://www.brainline.org/content/2008/07/classroom-interventions-students-traumatic-brain-injuries_pageall.html
Dawson, P., Devine, A., Gioia, G. A., Jones, V., Dohrn, E., Dunn, C., et al. (n.d.). TBI Compared to ED,LD,ADHD& Autism. Retrieved November
2013, from CBIRT: http://media.cbirt.org/uploads/medialibrary/2010/10/TBI_Compared_to_ED_ADHD_LD_ASD_FINAL.pdf
DePompei, R., & Blosser, J. (2003). TBI Compared to Other Disabilities. Retrieved November 2013, from CBIRT:
http://media.cbirt.org/uploads/ medialibrary/2010/10/TBI_vs_Autism_LD_ED_ADHD.pdf
Hibbard, M., Gordon, W. A., Martin, T., Raskin, B., & Brown, M. (2001). Students With Traumatic Brain Injury: Identification, Assessment and
Classroom Accommodations. Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury,
Department of Rehabilitation Medicine. New York: Mount Sinai School of Medicine.
Injury Prevention & Control: Traumatic Brain Injury; What are the Leading Causes of TBI? (n.d.). Retrieved November 2013, from Centers for
Disease Control and Prevention: http://www.cdc.gov/TraumaticBrainInjury/
Lash, M. (2000). Teaching Strategies for Students with Brain Injuries. Retrieved November 2013, from Brain Injury Association of America: http://
www.biausa.org
Learning Difficulties and Strategies to Assist Students with Traumatic Brain Injury. (2011, November). Retrieved November 2013, from Duke Health
Organization: http://www.dukehealth.org/services/speech_and_audiology/care_guides/speech_pathology_resources/traumatic-brain-
injury/pediatric-traumatic-brain-injury-resources/learning-difficulties-and-strategies-to-assist-students-with-traumatic-brain-injury
References(Continued)
New Start Program: Center for Community Participation . (2004, September). Learning About Brain Injury: An Activity Manual For Elementary
School Students. Retrieved November 2013, from Colorado State University: http://www.colostate.edu/Dept/CCP/Programsfolder/
Disability%20Awareness%20Curriculum%20final%209-04.pdf
Nucleus Medical Media. (2012, March 14). Concussion, Traumatic Brain Injury (TBI). Retrieved November 2013, from YouTube: http://
www.youtube.com/watch?v=55u5Ivx31og
Resources: Traumatic Brain Injury. (n.d.). Retrieved November 2013, from National Association of Special Education Teachers (NASET): http://
www.naset.org/traumaticbraininj2.0.html#c9611
Traumatic Brain Injury Basics. (n.d.). Retrieved November 2013, from brainline.org: http://www.brainline.org/landing_pages/Basics.html
University of Oregon. (n.d.). Service Providers. (I. a. Office of Research, Producer) Retrieved November 2013, from The Center on Brain Injury
Research and Training (CBIRT): http://cbirt.org/resources/service-providers/