Chapter OneIntroduction What is TBI? TBI stands for Traumatic Brain Injury “From 2001 to 2009, theestimated number of sports and recreation related TBI visits to emergency departments(EDs) increased from 153,375 to 248,418, and the estimated rate of TBI visits increasedfrom 190 per 100,000 population to 298.” (MMWR, 2011, p2). Courville and othersstates: Traumatic brain injuries (TBI) are the most common cause of brain damage in the western world. Direct impact to the skull along with rapid acceleration– deceleration of the brain within the skull cavity leads to multifocal and diffuse injuries, with pathology typically concentrated in the ventrolateral and orbital frontal lobes and the temporal lobes (Courville, 1945; Gentry, Godersky, & Thompson, 1988; Hadley et al.,1988)For educators, parents, and students with TBI, TBI can be translated into just one word—Devastating. Pieper in 2001 best described it by stating, “those experiencing traumaticbrain injury (TBI) is that they often express frustration and pain at ‘“losing”” the childthey knew.” (p 5). The purpose of this project is to try to alleviate this frustration. Someof the ways to alleviate frustration are to acquire information, knowledge, and strategies,to deal with issues. This project does just that, with the design of an interactive website,with practical research-based learning strategies, that demonstrate and model effectivetools for working with students with TBI.
Masters Project TBI 2 Educators are constantly looking for new ways to teach in order to deliver ourmost effective lessons to all children. “Thus, it is not surprising that educators havesought to incorporate neuroscience research findings into the special educationclassroom.” (Alferink & Dugan, 2010, p 42). “Special educators strive to arrange theirclassrooms to elicit the best learning outcomes.” (p 42) In the same article, According toquoted authors such as Sprenger (1999), arrangements that are brain compatible shouldelicit the best learning. More speciﬁcally, Sprenger and others suggested that this can beaccomplished by teaching to different learning styles or a child’s multiple intelligences.(p43)Statement of the Problem There is plenty of research on how TBI occurs and how it debilitates the brain, butthere are few strategies available to parents and educators, to help a child with TBI re-learn to function. During the past several months, this Educator, was providinginstruction with a child who has suffered a TBI. This required spent many hoursresearching TBI to determine what strategies are practical and effective for a student withTBI. (See Appendix). There are several websites providing information about TBI. The availability ofcomprehensive and practical strategies for working with children with TBI is woefullyabsent. This web site was developed to provide a comprehensive website that providesinformation on TBI and strategies for parents, educators, and students. This websiteprovides effective and practical methods for addressing the education needs and will toolsto re-assimilate children with TBI with life skills.Background and Need
Masters Project TBI 3 “Students with brain injuries tend to have cognitive problems in four areas:attention and concentration, information processing, memory, and executive functions.”(Disability Rights Network, 2008 p12). Working with someone who suffered Hypoxic-Anoxic Bran Injury, caused by strangulation started this quest. Hypoxic-Anoxic BrainInjury is one of the many types of TBI. According to the Brain Injury Association ofAmerica, Hypoxic refers to a partial lack of oxygen and Anoxic means a total lack ofoxygen. Therefore, the more complete the deprivation of oxygen to the brain the moresevere the damage to brain. This will then result in the greater the consequences (p. 1) After testing the student, the student results were two-standard deviation drops inall areas of academia from previous testing. The school psychology report also showed atwo standard deviation drop as well. The biggest loss for this student is memory,especially short-term memory. Intervention for this student included support in math,reading, and writing. Each of these areas, the memory processing is largely affected. Research showed several methods to help a student with TBI but no modeling orphysical visual representation. The majority of the websites researched for methods andstrategies stated something like this: • Use a multi-modal approach (overheads, videos, hands-on activities) when presenting material and instructions for assignments. • Teach compensatory strategies to students and structure choices. • Begin class with review and overview of topics to be covered. • Provide the student with an outline of the material to be presented, to assist in comprehension. • Emphasize main points and key ideas frequently.
Masters Project TBI 4 • Incorporate repetition into instruction. • Provide specific, frequent feedback on student performance and behavior. • Encourage questions. • Break down large assignments into smaller components. • Use task analyses to determine skill acquisition and maintenance. • Ask the student how he or she could improve learning. • Use a variety of open-ended and multiple-choice questions to encourage independent thinking. • Present difficult material in a simplified fashion, using illustrations or diagrams if possible. • Provide the student with cues when appropriate. (Louie, Brett, et al. , 2002, p 65)The main question is what does this really look like to a teacher or parent? How do youapply these strategies? How do these strategies differ than other strategies? How will thispart access that needed rouge memory.Rationale A report to Congress, December 1999 (http://www.cdc.gov/ncipc/pub-res/mtbi/mtbireport.pdf), “TBI is the leading cause of death and disability among childrenand young adults in the United States.” (p. 1). Teachers many times do not even know astudent has TBI because there are no visible damages. Unless the parent has reported tothe school that the child has suffered a TBI, there is no way to know. In the same reportthe disabilities and impairments are described, “TBI is referred to as the invisibleepidemic these disabilities arising from cognitive, emotional, sensory, and motor
Masters Project TBI 5impairments often permanently alter a person’s vocational aspirations and have profoundeffects on social and family relationships.” (p. 1-2). Educators, are required to instructand educate all children. According to the Free Appropriate Public Education forStudents With Disabilities: Requirements Under Section 504 of The Rehabilitation Act of1973 states “education services designed to meet the individual education needs ofstudents with disabilities as adequately as the needs of nondisabled students are met.” Aseducators we need to have strategies that are proven effective, and research-based. Sowhich strategies do we use? Where can we find the most information possible tocomplete this directive? That is what this project is going to provide creating one sourceof effective, research-based strategies that are modeled and available, for educators andparents.Purpose of the Project The purpose of this project is to provide an interactive website for educators andparents with information about TBI other websites and to provide tools and strategies tohelp students with Traumatic Brain Injury (TBI).
Masters Project TBI 6The website includes a Home page with information about the websiteAn Information page provides medical information, services available, and otherimportant information.
Masters Project TBI 7There also is a survey link on the first page to allow for the informal evaluation of thewebsite. This includes • Evaluation of research based strategies • Recommendations • Overall effectiveness of the websiteMath Strategies page provides teaching strategies for Mathematics. This includes videolinks to teacher’s modeling the strategy and information as to why it might be effective.
Masters Project TBI 8Language Strategies page provides teaching strategies for English Language Arts (ELA).This page also provides links to videos that have educators modeling the strategies, andwhy they might be effective.Memory Tools: This includes links to memory games, practices, and strategies thatmight be effective for improving memory. (see ELA-same format)
Masters Project TBI 9The last page is a list of all Links that this author has found, on TBI, and strategies forteaching students with TBI.This website may be helpful to all educators, however; this website was geared to thedemographics of educators and parents of children who have TBIProject Objectives • To research best practices strategies to use with individuals with TBI. • To create a website where information is available for students with TBI • To create a website for teachers and parents to find and practice reached based strategies for Mathematics, English language Arts and Memory o Effectiveness of the students with TBI determined which strategy used o Videotaped and uploaded to the website, o The strategy used is not a recommendation of one strategy over another strategy.Definition of Terms all terms have been defined in the chapter.
Masters Project TBI 10 CHAPTER 2 What is TBI? TBI stands for Traumatic Brain Injury. There is plenty of researchon how TBI occurs and how it debilitates the brain, but there are few strategies availableto parents and educators to help a child with TBI re-learn to function. For the purpose ofthis project, the following questions are asked: 1. What is TBI and how does it affect the brain? 2. What strategies are there for Teachers in the area of memory loss? 3. What strategies are there for Reading Comprehension? 4. What strategies are there for Math Intervention?The review of the literature is from peer-reviewed, research-based documentation, as wellas government-sponsored reports to demonstrate truth in the findings of this review.What is TBI and how does it affect the brain? “A TBI results from a blow or jolt to the head or a penetrating head injury thatdisrupts the function of the brain”(Polito,Thompson & Defina (2010, p504) In a Reportto Congress(http://www.cdc.gov/ncipc/pub-res/mtbi/mtbireport.pdf ) in 2003 states thefollowing: According to existing data, more than 1.5 million people experience a traumatic brain injury (TBI) each year in the United States. Of them, as many as 75 percent sustain a mild traumatic brain injury—or MTBI. These injuries may cause long- term or permanent impairments and disabilities. Many people with MTBI have difficulty returning to routine, daily activities and may be unable to return to work
Masters Project TBI 11 or many weeks or months. In addition to the human toll of these injuries, MTBI costs the nation nearly $17 billion each year.(p 1)Medscape states that “Traumatic brain injury (TBI) is a nondegenerative, noncongenitalinsult to the brain from an external mechanical force, possibly leading to permanent ortemporary impairment of cognitive, physical, and psychosocial functions, with anassociated diminished or altered state of consciousness.” American Congress ofRehabilitation Medicine defines mild head injury as "a traumatically induced physiologicdisruption of brain function, as manifested by one of the following: • Any period of loss of consciousness (LOC), • Any loss of memory for events immediately before or after the accident, • Any alteration in mental state at the time of the accident, • Focal neurologic deficits, which may or may not be transient."There is another type of TBI called Hypoxic-Anoxic Brain Injury HAI. We know thatthe brain is dependent on oxygen. HAI is the deprival of oxygen to the brain as is statedby the Los Angeles Caregiver resource center. “the term hypoxic means partial lack.Other HAI injuries are due to a complete lack of oxygen; the term anoxic means totallack. The greater the loss of oxygen, the more wide-spread and serious the injury willbe.” (CDMC, 2004,p. 1) Research resulted in another question, what happens to thebrain? What do we need to look at or know? As an Educator, knowledge is power, andunderstanding how the brain reacts to this injury is just as important as well as, how thefamily, school, and student will react. The Traumatic Brain injury In the United StatesReport to Congress 1999 (sums it up perfectly:
Masters Project TBI 12 For the estimated 5.3 million Americans who live with a TBI-related disability, the financial cost is only part of the burden. The long-term impairments and disabilities associated with TBI are grave and the full human cost is incalculable. Yet because these disabilities are not readily apparent to the public--unlike a broken leg, for example--TBI is referred to as the invisible epidemic. These disabilities, arising from cognitive, emotional, sensory, and motor impairments, often permanently alter a persons vocational aspirations and have profound effects on social and family relationships. For many people they feel that they have lost the person they once knew. (p 2)What happens to the person? According to Polito, Thompson and Defina ( 2010) in thearticle, A review of the International Brain Research Foundation novel approach to mildtraumatic brain injury presented at the International Conference on Behavioral Healthand Traumatic Brain Injury: Psychological changes associated with TBI often include “executive dysfunction,” which may be seen clinically as disinhibition, (sic) inappropriate behavior, impulsivity, emotional lability, (sic) poor judgment, lack of insight, and regressed social and occupational functioning. Neurocognitive impairments usually involve a combination of problems with verbal and nonverbal working memory, verbal ﬂuency, attentional (sic) mechanisms, visual-motor processing speed, planning and organizing, a shifting conitive(sic) set, and personality changes. (p 505)With HAI’s the problems can be cognitive and physical. Los Angeles CaregiverResource Center states the following can be the results of the damage:
Masters Project TBI 13 • Short-term memory loss • Decline in Executive functions • Difficulty with words • Visual Disturbances • Ataxia (lack of coordination) • Spasticity Jerky notions • Quadriparesis (weaknees of the arms and legs) • In addition there can be depress, irritability, and an inability to focus or concentrate.As an educator, understanding the brain, and understanding the results of this injury, arethe first step in designing a strategy to assist the student with TBI to overcome theirstruggles. (p 2)In 2000 the CDC upon the request of the medical world issued the CDC InjuryPrevention report on TBI and Assessing children some of the recommendations, whichfollow along with the purpose of this project summarized the following There is a lack of communication for educational service that are appropriate, andmany times the students are identified as LD (learning disability) vs TBI. Caregiverslack the awareness of available services, and many times the actual knowledge as to theresults of the injury; and how damaging it can be is not presented. The article points tothe need for educators to be educated prior to assessing the student, and givesrecommendations of many different assessment tools for the school to use. (p 234-235)
Masters Project TBI 14 Understanding the brain of a student with TBI, as an educator, is likeunderstanding a road map. The student has always gotten from point A to point B bytaking a direct route. Now the brain needs to find an additional route to get to the sameplace, and that is very difficult, and frustrating. Studies have shown since this is calledthe silent disability there are so many issues that are not academia related. Krach,Gormley Jr., & Ward. (2009). Chapter 10: Traumatic Brain Injury. In , PediatricRehabilitation: Principles & Practice : Too often, children with TBI remain underserved and, in some cases, forgotten. Sometimes educators are unaware the child had a previous TBI, or if their academic performance on achievement tests was within the average or acceptable range, they are deemed to be unaffected by the brain injury. Their diagnosis is forgotten until they have failed academically. (p 248)TBI is real and incidents are increasing. Educators, parents and students need effective,easily accessible tools.What strategies are there for Teachers in the area of memory loss? Memory loss is one of the biggest concerns for students with TBI. According tothe article, Pediatric Rehabilitation: Principles & Practice Memory impairment is another common area of concern after pediatric TBI. Typically, the memory impairment that is seen is for the formation of new memories as opposed to long-term memory. This has significant implications for a child’s ability to learn new information. As observed in other areas, severity of memory impairment appears to be related to the overall severity of injury. Impairment is seen in both immediate and delayed recall in severe TBI. (p 239)
Masters Project TBI 15What are some of the researched based strategies for memory loss? The way the target memory task is presented – visually or orally – affects memory. The ‘picture superiority effect’ (Paivio, 1971) states that pictures are recalled better than words because they are encoded, and stored in both verbal and non-verbal codes. Item storage in image memory is more durable than in verbal memory. Furthermore, while processing visual information, participants develop the meaning behind pictorial stimuli more than words (Craik & Lockhart, 1972)Research of many strategies and areas of concern revealed in the article, Explicit memoryamong individuals with mild and moderate intellectual disability: educationalimplications by Lifshitz, Shtein, Weiss, & Svisrsky (2011) that one of the best ways towork with memory is to “utilize(sic) multimedia. When teaching the aforementionedmaterial, use multimedia devices such as the video and computer. These media do notrequire the use of expressive language and provide feedback after learning. Integrate thelearners’ own photographs into stimulus materials. (p116) As an educator, multimedia is used every day. Students have never been withoutcell phones, computers, and now iPADS. Simple games on the computer likeconcentration, Sudoku, and crossword puzzles can stimulate that short-term and long-term memory. We know the brain is a muscle we need to exercise it.What strategies are there for Reading Comprehension? As stated above Metacognition Strategies is the preferred strategy for teachingreading comprehension. What are some of those strategies? How should they beapplied? According to Othman, Darussalam, Brunei (2010)
Masters Project TBI 16 Metacognition is a concept that has been used to refer to the diversity of epistemology process. Epistemology is a theory on knowledge particularly the one related to critical research on method and scope of knowledge. In terms of its concept, metacognition basically means cognition about cognition that refers to second-order cognitions; thoughts about thoughts; knowledge about knowledge; and reflections about actions. (p 457-458)There are many comprehensive strategies. Which one works and which one does not?Each child is different; so are the strategies that a teacher should use. For all teachers it isextremely valuable to have a firm grasp of all reading comprehensive, research-basedstrategies that are effective have been presented. The following according to Kracch,Paivio, Yahya, in the CDC injury prevent report(2010)identifies the best ComprehensionStrategies Used by Teachers are Story Retelling, Think-Alouds, Question Answer,Relationships, KWL Charts, Story Maps, Graphic Organizers. (p 368) Teachers need to be creative, use checklists, try various methods, and thinkoutside the box. There are many different strategies that are out in the educational worldthe list above are research-based and they are the foundation. As in, all situations,borrow and utilize other sources ask other teacher, search the internet, read journals, go toseminars. Find a strategy that works and use it. Consistency is very important, once yourfind a strategy that works use it and if the student suffering from memory loss, repetitionis key.What strategies are there for Math Intervention? Mathematics is an issue across all boundaries; according to the article Using anIntelligent Tutor and Math Fluency Training to Improve Math Performance stated that:
Masters Project TBI 17 results of the Third International Mathematics and Science Study (TIMSS) involving a half-million students showed that U.S. fourth-graders perform poorly, middle school students worse and high school students are unable to compete. In the 2006 Program for International Student Assessment, US students ranked 17th out of 30 in the science assessment and 24th out of 30 in math. (p 136)Students with TBI, suffering from memory loss, and other damages, may have beengood, exceptional or poor in math may now be completely different. It has also bedetermined that “Students with LD characteristically are poor problem solvers. Theytypically lack knowledge of problem-solving processes, particularly those necessary forrepresenting problems and, therefore, need to be taught those processes explicitly andshown how to apply them when solving math word problems (Montague & Applegate,1993). Today math intervention is not just for students with disabilities. What are the best strategies for Math intervention? We know that repetition isimportant in math to develop those skills that are the basics of math. “Automatic skills,which are only acquired after considerable practice, consume little cognitive capacity andallow the possibility of performing multiple tasks relevant to the problem at handsimultaneously.” (Arroyo, Royer, Woolf, 2011, p 138). According to the article byLouie, Brodesky, Brett, Yang, Tan, & Regional Educational Laboratory Northeast &Islands (2008). Math Education Practices for Students with Disabilities and OtherStruggling Learners, there is no one method for students with disabilities, a summary ofwhat they recommended is as follows: • Graphic organizers • Computer games
Masters Project TBI 18 • Manipulative, hands on math • Peer teaching (p 8)Response to Intervention (RTI) is another strategy for Mathematics. The literature presented is from peer-reviewed, research- based documentation, aswell as government-sponsored reports. This literature was presented to demonstrate truthin the findings of this review. These results are explored and applied to the interactivewebsite project. Each of the pages of the website addresses one of the questions:What is TBI and how does it affect the brain?What strategies are there for Teachers in the area of memory loss?What strategies are there for Reading Comprehension?What strategies are there for Math Intervention?Summary The website www.effectiveteachingtbi.org will answer the above questions andwill also demonstrate for teachers an effective strategy that worked for this educator. Thepurpose of the website is to provide information and real life strategies for this growingneed.
Masters Project TBI 19 Chapter 3Introduction There is plenty of research on how TBI occurs and how it debilitates the brain, butthere are few strategies available to parents and educators, to help a child with TBI re-learn to function. Teachers need practical teaching strategies. This project provides aninteractive website to educate parents, teachers and people who suffer from TBI. Inaddition, this website gives examples of teaching strategies. The strategy is presented invideo representation.Background of project During the past year, this teacher has worked with several students in high schoolthat have suffered TBI. One student was kicked in the head by another player during asoccer game. One student attempted suicide by hanging, and suffered an Hypoxic-Anoxic Brain Injury (HAI). Each student had severe memory loss. Each student had lostmany of their basic cognitive functions. For example, one student was an excellent mathstudent and now struggled with multiplication tables. The other student, an avid writer,now struggled to write one paragraph. It is our responsibility, as special educators, to givethese students the tools they need to be successful.Components of the project There is a lot of research on what TBI is; however, as it is an injury that cannot beseen (like a broken leg) each person is affected differently, as an educator, we must find away to re-route the brain. Reading about different strategies is a great start but how doyou apply the strategies what do they look like. This is the reason this educator made this
Masters Project TBI 20website. This website gives information on the three areas of need, English LanguageArts (ELA), Mathematics, and Memory Retention. The home page on the website gives general information about TBI. Pages two,three and four of the website have actual teaching strategies for each area, ELAMathematics, and Memory Retention, and one life skill strategy. The final page has a listof websites and links (Appendix B). There is also a survey page for the informalfeedback. The students with TBI that are working with this special education teacher willdetermine the strategies used on the website “The concepts of teacher effectiveness andresearch-based instructional strategies combine to form a foundation that results inchanges in teaching.” (Fabry, 2010, p.24). Research based strategies are the onlystrategies presented on the website.Methodology and project design After many months of research and utilizing several research-based strategies, theones that were most effective for the students were chosen for the website the choice ofone strategy over another is not to recommend, but to demonstrate, possible strategies. The participants on the videos are not the students in the research of this project,but paid student actors. The videos (Youtube) describe the strategy and demonstrate thetechnique implementation. In addition, a PDF of the lesson is on the website. An informal survey of the website and the effectiveness will give these educatorideas for future videos, strategies and lessons. As stated, this is an interactive website,research will be on going, and as more information, links and strategies are used, thewebsite will be updated.
Masters Project TBI 21Summary The strategies that were tried were research based strategies. The strategies thatwere chosen were the strategies that worked with the students. The choice was not anevaluation of which strategy was better or worse but which one worked.
Masters Project TBI 22 Chapter 4Evaluation of Project Educators need a place to get information on effective strategies, but moreimportantly to see a demonstration of what the strategy looks like. This project willprovide educators, parents, and persons with TBI the information, and strategies as wellas the modeling of those strategies. This website will provide information, papers, andlinks to other websites. The hope is that these demonstrated strategies may relievefrustration and will help to improve the student’s physical and emotional wellbeing.This web site design is a tool for multiple users. Teachers may be the main target anduser of this information but parents will seek strategies that they can use to support theirchildren with TBI. People with TBI will themselves research strategies to re-gain theirlives . The internet provides a median for this information. As an interactive websitethe continual monitoring of the information and strategies are a vital part of theevaluation of the project. The determination of this project and effectiveness of thewebsite will be the informal evaluation.Limitations to the website and plans for future expansion The largest limitation to the website is time. The website is now up and runningwww.effectiveteachingtbi.org. The videos on the website require a written consent to bevideoed as the participants are minors; however, they are not my students and are used asactors only. In addition, the use of a professional cameraperson was used and theinformation uploaded to the website.
Masters Project TBI 23 Research for this project in ongoing and as an interactive website will be updatedas needed. The design of the website is complete. The rest of the project is on goingincluding: • Determine the research strategies for each page of the website • Monthly new research strategies • Review informal evaluations from the information link-postings The future plan depends on funding and reactions to the site. This is a work inprogress and will be updated based upon research and implementation of the strategies.The site officially went up on October 12, 2012, and has had over 100 hits in less than amonth. The postings as of 10-30-2012 are as followsIn favor of the site—13 postingsSuggestions for the site-1 postingSolicitation for other things-6 postingsSpam-5 postingsConclusions As an educator, understanding the brain of a student with TBI, is likeunderstanding a road map. The student has always gotten from point A to point B bytaking a direct route. Now the brain needs to find an additional route to get to the sameplace, and that is very difficult, and frustrating. This website will assist teachers, parents,and persons with TBI, by giving them tools and information. Arroyos-Jurado, Paulsen,Ehly and Max stated it best as an educator “Not only do educators need to draw onstudent’s strengths, they also need to come up with novel approaches to teaching learning
Masters Project TBI 24strategies.” (2001,p.137). This project is based on this statement. Each of the strategiesthat are used and will be used are novel approaches for each individual person. Thisproject’s goal is to assist the student, parent and teacher to be successful in educatingthemselves and others and to assist all persons who experience TBI.
Masters Project TBI 25 ReferencesAlferink, L. A., & Farmer-Dougan, V. (2010). Brain-(not) Based Education: Dangers of Misunderstanding and Misapplication of Neuroscience Research. Exceptionality, 18(1), 42-52. doi:10.1080/09362830903462573Anderson, R. C. (1991). The notion of schemata and the educational enterprise: General discussion of the conference. In Anderson, Richard C., R. J., Spiro & W. E. Montague (eds). (1984). Schooling and the acquisition of knowledge. Hillsdale, NJ:Arroyos-Jurado, E, Paulsen, J., Ehly, S. Max, J. Traumatic brain injury in children and adolescents: Acedemic and intellectual outcome following Injury, (2006), 14(3), 125-140Arroyo, I., Royer, J. M., & Woolf, B. P. (2011). Using an Intelligent Tutor and Math Fluency Training to Improve Math Performance. 21(1-2), 135-152Einhorn, (1992), TEACHING Exceptional Children, Vol. 34, No. 4, pp. 62-67.Fabry, D. L. (2010). Combining Research-based Effective Teacher Characteristics with Effective Instructional Strategies to Influence Pedagogy. Journal Of Research In Innovative Teaching, 3(1), 24-32.Hibbard, M.,Gordan,W., Martin, T., Raskin,B., Brown, M.(2001). Students with Traumatic Brain Injury: Identification, assessment and classroom accommodations (1-17)Julie Louise Gerberding, M.D, to Congress on Mild Traumatic Brain Injury in the United States: Steps to Prevent a Serious Public Health Problem (2003) 1-44
Masters Project TBI 26Krach, L. E., Gormley Jr., M. E., & Ward, M. (2009). Chapter 10: Traumatic Brain Injury. In Pediatric Rehabilitation: Principles & Practice (pp. 231-260). Demos Medical Publishing, LLC.Langlois, Jean, Traumatic Bran Injury in the United States: Assessing Outcomes in Children, Montague, M., Enders, C., & Dietz, S. (2011). Learning Disability Quarterly, 34(4), 262-272. doi:10.1177/0731948711421762Langlois, J. A., Rutland-Brown, W., & Thomas, K. E. (2005). The incidence of traumatic brain injury among children in the United States: differences by race. The Journal of Head Trauma Rehabilitation, 20(3), 229-238.Lawrencerlbaum Craik, F.I.M., and R.S. Lockhart. (1972). Levels of processing: A framework for memory research. Journal of Verbal Learning and Verbal Behavior 11, 671–684.Lifshitz, H., Shtein, S., Weiss, I., & Svisrsky, N. (2011). Explicit memory among individuals with mild and moderate intellectual disability: educational implications. European Journal of Special Needs Education, 26(1), 113-124. doi:10.1080/08856257.2011.543536Louie, J., Brodesky, A., Brett, J., Yang, L., Tan, Y., & Regional Educational Laboratory Northeast & Islands, (2008). Math Education Practices for Students with Disabilities and Other Struggling Learners: Case Studies of Six Schools in Two Northeast and Islands Region States. Issues & Answers. REL 2008-No. 053. Regional Educational Laboratory Northeast & Islands,
Masters Project TBI 27Montague, M., Applegate, B., & Marquard. K. (1993). Cognitive strategy instruction and mathematical problem-solving performance of students with learning disabilities. Learning Disabilities Research and Practice, 29, 251-261.Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged <=19 years --- United States, 2001--2009. (2011). MMWR: Morbidity & Mortality Weekly Report, Courville, 1945; Gentry,Godersky, & Thompson, 1988; Hadley et al.,1988, 601337-1342.Othman, Y. (2010). Application of metacognition strategies and awareness when reading texts. International Journal of Learning, 17(3), 457-471.Pavawalla, S. P., Schmitter-Edgecombe, M., & Smith, R. E. (2012). Prospective memory after moderate-to-severe traumatic brain injury: A multinomial modeling approach. Neuropsychology, 26(1), 91-101. doi:10.1037/a0025866Pieper, (1991) Traumatic Brain Injury: What the Teacher needs to Know HI-33A80023 , 1-22Polito, M., Thompson, J. G., & DeFina, P. A. (2010). A review of the International Brain Research Foundation novel approach to mild traumatic brain injury presented at the International Conference on Behavioral Health and Traumatic Brain Injury. Journal of The American Academy of Nurse Practitioners, 22(9), 504-509. doi:10.1111/j.1745-7599.2010.00540.xhttp://www.caregiver.org/caregiver/jsp/print_friendly.jsp?nodeid=1822 retrived on4/14/2012http://www.brainandspinalcord.org/traumatic-brain-injury-types/anoxic-brain- injury/index.html retrived on 4/12/2012http://www.netc.org/focus/strategies/ retrieved on 3/20/2012
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