Traumatic Brain Injury (TBI)

Definition and Description

TBI occurs when an external, mechanical force causes brain damage and dysfunction. This is usually the result of a blow to the head or body.


Open Head Injury: When skull is broken, fractured, or penetrated, causing localized damage.

Closed Head Injury: An outside force impacts the head, but does not cause a break or penetration. The damage is typically widespread among the entire brain.


TBI is NOT caused by a stroke, brain tumor, or other internal brain damage present at birth, but rather an incident that initially occurred outside of the brain, like accidents, concussions, or child abuse.

Major Characteristics

Physical:
  • headaches
  • fatigue
  • imbalance
  • muscle contractions
  • paralysis

Cognitive:

  • short or long-term memory loss
  • attention deficits
  • disorganization
  • non-sequential thinking

Social/Emotional:

  • mood swings
  • anxiety
  • depression
  • restlessness
  • lack of motivation


Students with TBI might have trouble carrying out multi-step tasks or problems, become easily distracted, have difficulty with comprehension, struggle with completing assignments on time, have a hard time thinking abstractly, and resent change. Often, students with TBI become frustrated with themselves and experience a lack of motivation and feelings of unworthiness.


Prevalence:

TBI that requires special services is found among only a fraction of 1% of students, making this exceptionality incredibly uncommon. Approximately 1.5 million head emergencies are diagnosed every year in US emergency rooms, but not all of these individuals require special services (Langlois, 2007).

Living with a Traumatic Brain Injury

Instructional Practices

Since memory loss is so commonly associated with TBI, improving memory is very important and vital to helping a student with TBI succeed. Here are three strategies to support students with memory loss that can be applied in the classroom:


  1. Use of assistive devices and objects: Tape recorders, calculators, timers, alarms, labels, checklists, and planners can all help in recalling facts, dates, times, lists, etc. Memory books/boards can also be used, which can contain any information that considered relevant to a student's needs, including maps, labeled pictures, phone numbers, photographs of family and friends, life events, or anything else that a student might need to learn or re-learn.
  2. Provide hands-on learning experiences: It's no secret that humans learn better when more than one sense is stimulated. Allowing children to experience things hands-on is a good way to improve memory during lessons, as well as connecting material that is being learned to previously learned material. Lessons that stimulate multiple senses through touch, taste, and sound can often be more beneficial than just using visual and auditory senses.
  3. Implementing Self-Reminders: Teachers should help students use "self-reminders," which include Post-Its, assignment sheets, and calendars to remember important information, dates, and assignments. These reminders can be color-coded, in the form of a graphic organizer, or in a planner form. Students use these reminders to remember important material and hopefully improve memory.

Links To Strategies

Assistive Devices and Objects: Memory Book

Example of Multisensory Hands-On Activities (these activities are actually used to teach young students about TBI, but of course, any hands-on activity about any classroom topic can be implemented)

Self-Reminders for the Classroom

Home Strategies to Promote Generalization

  1. Memory Books: While these can be used at school to remember important dates, numbers, letters/the alphabet, historical events, etc, they also are very popular for at-home use. The types of memory books used at home are almost like a scrapbook of the affected person's life. There might be photographs of family members and friends, frequently-visited places, life events, likes/dislikes, etc. By showing photographs with labels, individuals with TBI can clearly see items that are important to their lives and can hopefully improve their memory.
  2. Parents should arrange their house to accommodate their child with a TBI. Labeling frequently-used objects, drawers, rooms, etc, can help a child become readjusted and familiarized with the home. In addition, this helps people with a TBI to establish organization/order to eliminate confusion. Children can become more familiar and therefore comfortable with their surroundings while still staying organized.
  3. Structure is key for those who have a TBI. Without structure, individuals with TBI can become easily confused, distraught, and embarrassed if they don't know what comes next or what to say. By providing these individuals with consistent schedules and planners, they can anticipate and prepare themselves for upcoming events. Cue cards can also be useful, which can help a person get through conversation. People with a TBI often get lost during conversation, but cue cards (also called flashcards) can help keep them on track and socially engaged. Here is a great website with cue cards and word flashcards that are made for ELL students but are also recommended for students with a TBI.


Some cue card and word flashcard examples are listed below.

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BrainLine.org

This frequently-updated website is for both those who have TBI and those who are family/friends of a person with TBI through articles that provide advice, information, and ideas that offer support.

Brain Injury Association of America

This website can help people with or people who know someone with TBI by locating nearby support groups and connecting those affected by TBI with other people who are experiencing the same thing.

Cozi Family Organizer App

This app, developed by Cozi and featured in multiple parenting magazines and television shows, allows families to sync all sorts of information on each other's phones to keep a consistent schedule. Each person's information is color-coded to optimize organization. In addition, families can see each other's scheduled events to ensure structure and cohesiveness. Individuals with a TBI can clearly see upcoming events and set reminders for the future.

References

Bonner, C. (2001). A Parents' Guide. Retrieved April 27, 2015, from http://www.brainline.org/content/2009/06/children-with-traumatic-brain-injury-a-parents-guide-_pageall.html.


Family & Caregivers. (n.d.). Retrieved April 27, 2015, from http://www.biausa.org/brain-injury-family-caregivers.htm#Manage the Home


Langlois, J. (2007, April 16). Facts About TBI in the USA. Retrieved April 20, 2015, from https://www.braintrauma.org/tbi-faqs/tbi-statistics/.


Life-Changing Mobile Apps for People with Brain Injury. (2014, January 16). Retrieved April 27, 2015, from http://www.brainline.org/content/2013/12/life-changing-iphone-and-ipad-apps-for-people-with-brain.html.


Ryan, L. (n.d.). Adapting for Special Needs Learners. Retrieved April 27, 2015, from http://mrsryansportfolio.weebly.com/adapting-for-special-needs-learners.html


Tools & Aids. (2014, March 25). Retrieved April 20, 2015, from http://www.braininjurypeervisitor.org/index.php?p=1_65_Tools-Aids.