Siri Wieringa & Alison JacobsonTraumatic Brain Injury (TBI)
Definition: The Individuals with Disabilities Education Act defines Traumatic Brain Injury as "an acquiredinjury to the brain caused by an external physical force, resulting in total or partial functional disability orpsychosocial impairment, or both, that adversely affects a childs educational performance. Traumatic braininjury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition;language; memory; attention reasoning; abstract thinking; judgment; problem solving; sensory, perceptual,and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumaticbrain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced bybirth trauma.Common Associated Characteristics: * Onset: Sudden * Cause: One or more blows to the head accompanied by altered mental status, including loss of consciousness * Functional Changes: Marked contrast between pre- and post-onset capacities: memory loss, reduced processing speed, impaired executive functions * Physical Disabilities: May include loss of balance, weakness, paralysis, visual/ sensory changes, headaches * Emotional Difficulties: Labile mood, depression and anxiety frequently foundSuggested Teaching Strategies: (from nichy.org)Causes: Some of the major causes of brain injury include Brain hypoxia and ischemia may result fromtraumatic brain injury, circulatory problems such as cerebral vessel spasm or stroke, and lack of oxygenationthat may occur during cardiopulmonary arrest. Lack of adequate oxygen to the brain causes cell death that canbe localized or widespread. The extent of brain cell death influences the degree of neurological impairmentand disability. Trauma, lack of oxygen, lack of blood flow (ischemia), infection and metabolic disorders. Liverfailure, low blood sugar (hypoglycemia), kidney failure, and toxic exposure to such substances as alcohol,drugs, sedatives, poisons, and some heavy metals. In general, brain injury associated with metabolic disordersis widespread throughout the entire brain. Behavioral Difficulties: Unpredictable: possible agitation, aggressiveness, restlessness, impulsivity Awareness of Deficits: Limited-to-full awareness Skills and Knowledge: Pre-TBI learning is largely intact Difficulties with Learning: Old information is easier to recall than new Peer Interactions: Affected by cognitive deficits, behavioral difficulties, reduced social skills
* Find out as much as you can about the childs injury and his or her present needs. * Find out more about TBI through the resources and organizations listed below. These can help you identify specific techniques and strategies to support the student educationally. * Give the student more time to finish schoolwork and tests. * Give directions one step at a time. For tasks with many steps, it helps to give the student written directions. * Show the student how to perform new tasks. Give examples to go with new ideas and concepts. * Have consistent routines. This helps the student know what to expect. If the routine is going to change, let the student know ahead of time. * Check to make sure that the student has actually learned the new skill. Give the student lots of opportunities to practice the new skill. * Show the student how to use an assignment book and a daily schedule. This helps the student get organized. * Realize that the student may get tired quickly. Let the student rest as needed. * Reduce distractions. * Keep in touch with the students parents. Share information about how the student is doing at home and at school. * Be flexible about expectations. Be patient. Maximize the students chances for success. * Its important to remember that a student who has suffered TBI will have different educational needs than before their injury. Because of the sudden and traumatic nature of their injury, there are emotional and social changes to consider. There must be careful evaluation and planning to address the students needs in their IEP.Additional Resources:http ://nichcy .orgMisability/specific/tbi #helpThe National Dissemination Center for Children With Disabilities, this is a comprehensive website for alldisabilities. For TBI, there is information about symptoms, statistics, and help for parents and teachers.http://biausa.f>T:ian.com/rad.ex.htmThis website is for Brain Injury Association of America. This is very useful with resources for families andcaregivers, diagnosis and treatment, advocacy and more.http://www.cdc.gov/traumaticbraininjury/The Centers for Disease Control and Prevention discusses different types of TBI, statistics, causes and riskgroups, prevention, and long-term outcomes.http://wvvw.ninds.nih.gov/disorders/tbi/tbi.htmNational Institute for Neurological Disorders and Stroke gives information about diagnosis, treatment,prognosis, and organizations that can help.http://wvvw.mssm.edu/staticJiles/MSS]^BIKIDS.pdfThis PDF is a great resource for getting information about how TBI occur, the effects that are seen in thepatients, and what teachers can do to make a child with a TBI more comfortable in the classroom and able tolearn.