TRAUMATIC BRAIN INJURY

Amanda Sowinski

What is a Traumatic Brain Injury (TBI)?

A TBI is a complex injury that is acquired and effects the individual drastically. There are several types of TBI's ranges in severity, symptoms and characteristics. A TBI's general definition is "due to a concussion or head injury that may be visible or not; symptoms may appear right away, where others come about days or weeks later". Traumatic brain injuries are much different than any other injury on the individuals body because it effects the persons self, personality and basic functioning.


The major characteristics of TBI include:

- headaches

- dizziness/ fatigue

- visual/hearing impairments

- memory loss (short term or long term)

- difficulty conversing and staying on task

- little to no attention span

- personality changes (depression, anxiety, mood swings)

- nausea/ vomiting

- stimulation sensitivity

- trouble sleeping/ sleeping too much


There are four major deficits that those who suffer from a TBI usually struggle with: communication, cognitive, behavior/emotional and physical deficits.


Prevalence Rates:

- 50% of TBI are due to automobile accidents, bicycling and vehicle-pediatrician accidents

- 25% are due to falls

- 20% are due to violence

- According to CDC, the total number of TBI's have been rising slowly throughout the last decade; emergency visits have also risen, however deaths per TBI has lowered. The spike of increase was larger for men than women. Children 0-4 years old hold the highest rates of suffering from a TBI, twice as high as the next group (15-24 year olds).


Students that suffer a TBI during schooling usually cannot go back to school while they are in and out of the hospital and rehabilitating. Once they come back to the school environment, they are faced with characteristics from their TBI that greatly effect their learning abilities. Some include cognitive problems such as memory loss, academic skills loss, sensory problems, lack of social skills, inappropriate behavior, speech and language deficits and over all physical barriers.


The link provided goes into further detail about how different lobes are effected by a TBI https://www.youtube.com/watch?v=wlYiDxNcMdc&list=PLpSX-9TqRAn8mdRORaAL8cOJAdd7eb-ZF&index=7

Instructional Practices

One of the most prevalent cognitive deficits students suffer from due to their TBI is memory loss and the inability to retain information in class. This greatly effect their academic learning and may cause the student to drop out or have behavioral problems.


There are several in-class accommodations and strategies

- MEMORY BOOKS

- Using a memory book is extremely effective in the classroom setting. When a student learns a concept in the beginning of the week, they can write down notes, or have the teacher write their notes down, so later that week when they need to remember those notes for a quiz or homework, they can pull out their memory book and use their notes. This helps students be less overwhelmed and comforted by their memory book

- ORAL AND WRITTEN EXPLICIT INSTRUCTION

- By giving explicit instruction orally and written, the student can take advantage of whichever type of instruction fit his/her needs; if it would be easier for the student to learn from the teacher orally, they can listen to the teacher, however if that seems too much of a stimulation, or distraction, the student can be given written explicit instructions. This will help the student from over-stressing about getting their work done.

- RECORDING LESSON VIA AUDIO RECORDER (assistive technology)

- When students with a TBI have a more difficult time processing lessons and concepts, recording the lessons via an audio recorder gives the students the opportunity to learn at their own pace. By recording the lesson, they can listen to it as many times as they need. This helps students from falling behind, and with the use of extra time on tests and assignments, they can be less stressed and more confident in themselves among their peers.


The following links provide additional information for teachers to utilize in their classroom to making their students with a disability like TBI less of an academic struggle:

1. http://www.brainline.org/content/2008/07/classroom-interventions-students-traumatic-brain-injuries_pageall.html

2. http://ese.dadeschools.net/tbi/2classroom.html

3. http://www.brainline.org/content/2011/04/using-external-aids-to-compensate-for-memory-and-organizational-problems-post-tbi.html

Home Strategies

Since it is so incredibly important for students who have suffered from a TBI to have repetition and consistency, using school accommodations at home (while they will be slightly modified) is very helpful in their rehabilitation process.

A few home accommodations modified from school accommodations include:

1. MEMORY BOOKS

- Memory books modified for home use are very important for parents to utilize. A memory book to help their child process their days can help them establish routine and familiarity. For example, if their child has notes and pictures in their memory book of them helping their parent to do laundry, they can possibly do that chore once again with the use of their memory book

2. PLAY MEMORY GAMES

- By playing memory games, the child can work on their memory schools. By connecting written labels to visual images, they will have an easier time making connections both at home and in school. They should be given time to make their final decisions during the game; they should also be praised by their parents to help them grow self-esteem

3. ROUTINE MAPS

- Sometimes it is difficult for a child with a TBI to stay on task and pay attention to what they need to accomplish during the day. They may need to have a visual routine map posted in their home to help the child keep track of what they need to accomplish that day. For example, the routine map can have written instruction of 3 specific things they need to have done by the end of the day (clean their room by 12 PM, play memory game by 3 PM and call their grandmother by 7 PM). The routine "map" has written instruction along with visual aids to help them make the connection.


The link provided explains the necessity of repetition in home accommodations that parents can utilize in personalizing their at home strategies with their child: http://www.brainline.org/content/2009/06/children-with-traumatic-brain-injury-a-parents-guide-_pageall.html

Additional Resources!

The following resources can be utilized by students, teachers and parents alike. While rehabilitation and accommodations for classroom and home use are very important for a student with a TBI, emotional and self-esteem needs for all who are involved is just as important.

1. http://www.projectlearnet.org/for_parents.html

- This website is great for teacher, clinician, parent and student use. It provides resources for everyone involved, a documentary, transition guide, etc. Please check out this site!! It's full of fantastic and useful info.

2. http://www.brainline.org/content/2008/10/student-brain-injury-achieving-goals-higher-education_pageall.html

- This site provides opportunities and resources for high education and further careers for students suffering from a brain injury. Parents and teachers can utilize this site and it's resources to help encourage their student to keep working hard and to not give up!


The following APP is associated with TBI and can be downloaded onto a mobile technological device for school and home use:

1. http://www.brainline.org/content/2013/12/life-changing-iphone-and-ipad-apps-for-people-with-brain.html

- This website provides a chart full of APPs for use to help with memory, communication, behavior, anxiety, stress, organization and life-skills. This can make a huge difference in a students life who is suffering from a TBI.


REFERENCES:

Brain Injury Association of America, Causes of Brain Injury. www.biausa.org


Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on

mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention; 2003.


Glang, A., Todis, B., Thomas, C. W., Hood, D., Bedell, G., & Cockrell, J. (2008). Return to school following childhood TBI:

Who gets services?. Neurorehabilitation, 23(6), 477-486


LeBlanc, J., de Guise, E., Champoux, M., Couturier, C., Lamoureux, J., Marcoux, J., & ... Feyz, M. (2014). Early

conversational discourse abilities following traumatic brain injury: An acute predictive study. Brain Injury, 28(7), 951-958. doi:10.3109/02699052.2014.888760


Lump, D. (2014). MANAGING PATIENTS WITH SEVERE traumatic brain injury. Nursing, 44(3), 30-38 9p.

doi:10.1097/01.NURSE.0000443311.50737.a8


National Institute of Neurological Disorders and Stroke. Traumatic brain injury: hope through research. Bethesda (MD):

National Institutes of Health; 2002 Feb. NIH Publication No.: 02-158.


Ponsford, J., Cameron, P., Fitzgerald, M., Grant, M., Mikocka-Walus, A., & Schönberger, M. (2012).

Predictors of postconcussive symptoms 3 months after mild traumatic brain injury. Neuropsychology, 26(3), 304-313. doi:10.1037/a0027888


Smith, D., & Tyler, N. (2014). Introduction to contemporary special education: New horizons. Boston: Pearson Education.


Traumatic Brain Injury A to Z - Interactive Brain. (n.d.). Retrieved December 6, 2015, from

https://www.traumaticbraininjuryatoz.org/interactive-brain