Traumatic Brain Injury Definition

• Injury to the brain (not including conditions present at birth, birth trauma, or degenerative diseases or conditions) resulting in total or partial disability or psychosocial maladjustment that affects educational performance; may affect cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem solving, sensory or perceptual and motor disabilities, psychosocial behavior, physical functions, information processing, or speech.

TBI Definition Cont.

• Closed – caused by a blow to the head from an auto crash, assault, fall, etc.

• Open – caused when an object (or fragment) goes through the skull and into the brain. Could be from an accident, assault, bullet, etc.

TBI Categories Mild

• Concussion with brief (<15 minutes) or no loss of consciousness.

• Usually no complications, i.e. hematoma.• Can have normal neurological exam.• Symptoms usually improve over 1-3 months. • 75% of all brain injuries.

TBI Categories Moderate

• Loss of consciousness for minutes to hours.• Confusion lasts for days or weeks afterwards.

TBI Categories Severe

• Loss of consciousness for days, weeks, or even longer.

Long Term Consequences

• May affect Mental Activities– Cognitive skills, Language skills, Perceptual Skills

• May affect Physical Abilities– Movement skills, Sensory skills,

Maintenance/Health• May affect Psychosocial Abilities– Personality changes, Psychological states,

Relationship changes

TBI General Symptoms

• Vision changes: blurred, double

• Dizziness• Vomiting• Headache• Confusion• Dilated pupils• Lethargy• Difficulty thinking

• Difficulty speaking• Numbness, tingling• Slow pulse, breathing• Ringing in the ears• Spinal fluid coming out

of the ears• Loss of consciousness• Respiratory Failure• Coma

Eligibility for Special Education

• The student had an acquired injury to the brain following a period of normal development

• Injury was caused by an external physical force• Injury caused adverse affects upon student’s

educational performance

Eligibility for Special Education- Areas affected

• Cognition• Memory• Reasoning• Communication• Problem Solving• Physical Functions• Psychosocial Behavior• Executive Functions

• Speech & Language• Attention • Abstract Thinking• Judgment• Sensory, Perceptual and

Motor Abilities• Information Processing

Research Based Practices

• After an 8-year follow-up the following proved to be effective in supporting students with TBI– Daily Routine– Positive Momentum– Reduction of Errors– Escape Communication– Adult Communication Style– Graphic Advance Organizers– Goal-Plan-Do-Review Routine

Appropriate Accommodations

• The following strategies are essential for appropriate education of students with TBI:– Transition from a hospital or rehabilitation center to the

school– A team approach involving regular and special educators,

other special teachers, guidance counselor, administrators, and the student’s family.

– An individualized education program concerned with cognitive, social/behavioral, and sensorimotor domains.

Appropriate Accommodations Cont.

• Educational procedures to help students solve problems in focusing and sustaining attention for long periods, remembering previously learned information, learning new things and appropriate social behavior

• Emphasis on the cognitive processes in which academic skills are learned

• Plans for addressing long-term needs

Getting Back to School

• A large problem with TBI students is getting back into school

• The student sees themselves as having not changed, they just had an accident

• Reintegration with their peers and in a classroom setting can be difficult and support is needed

• Assessment should be done through a support team

TBI Misc. Information

• Causes (MN)– #1 is falls– #2 is motor vehicle crashes– #3 is external force applied to head or neck– #4 is Shaken Baby Syndrome

TBI Misc. Information Cont.

• 5.3 million Americans have a TBI (94,000 in MN)

• In the US, a TBI occurs every 15 seconds, resulting in 5000 new TBIs per day or about 2 million a year– 50,000 of these cases result in death, annually– TBI is the leading cause of death and disability

among children and young adults until age 44

TBI Misc. Information Cont.

• More than 50% of all motor vehicle crashes, resulting in a TBI, involve alcohol

• Each year 230,000 persons are hospitalized with a TBI and survive

• Highest prevelance among males age 15-24– Male 2X as likely to receive a TBI than females

TBI Strategies

• ABC Model– “A” – Antecedent– “B” – Behavior– “C” – Consequence

Resources

• Brain Injury Association of Minnesota– www.braininjurymn.org