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/