Traumatic Brain Injury
A very low incidence disability
The Major specification for TBI set out by IDEA is that the disability is the result of a head injury received after birth, and NOT caused by a stroke, brain tumor, or other internal brain damage present at birth. Usually, injuries connected to TBI disabilities are due to concussion, accidents, or child abuse.
Federal Government definition specifies that TBI means "an acquired injury to the brain caused by external physical force, resulting in total or partial functional disability or psychosocial impairment, or both"
The Impairment must be adversely affecting a child’s educational performance in order to be eligible for special education services.
People and Situations: Sam's Story
Together, Multiple-severe Disabilities, Deaf-blindness, and TBI have a combined prevalence rate of 0.25% of all students. Separately, they each include only a fraction of 1%
Very few students receive services due to TBI: 0.04% are included in this category, BUT unlike other disabilities, many students with TBI receive special education for a limited period of time during a recovery from their accident. Some with TBI sustain life-long symptoms, but others can return to their lives before the injury after a period of recovery
TBI has the highest rate of inclusion in general education classrooms (48% for more than 79% of the school day)
TBI often presents characteristics similar to Learning disabilities or ADHD.
TBI symptoms may or may not be apparent to others, but can result in dizziness, headaches, selective attention problems, behavior problems, anxiety, fatigue, motor difficulties, blurred vision, and cognitive or memory issues.
TBI symptoms range in severity from mild to severe
Characteristics that interfere with learning
- Muscle contractions
- Stiffness/ Pain
- Short-term memory loss
- Long term memory problems
- Nonsequential thinking
- Language impairments
- Mood swings
- Depression/withdrawal caused by what they remember they used to be able to do
- Lack of motivation
- Multistep/ multitasking difficulties
- Requires consistent schedule and routine
- Easily distracted
- Difficulty obtaining new skills
Teaching Strategies for TBI
- Teachers should remove distractions and divide work into smaller sections or "chunk" information- this increases the abilities of the student to get through an entire task because it makes it seems like several, shorter tasks. Classroom modifications to go along with this could be flexible scheduling, multiple sessions for one lesson, and frequent breaks
- In order to aid with short-term memory, teachers should frequently repeat information during direct instruction and ask student to summarize directions after they are given. Classroom accommodations to aid in this could be simplified or paraphrased directions, prompting, and the use of self-reminders such as post-it notes and calenders
- The ability to mentally organize information AND to organize materials for strategic learning is often affected with TBI, so the use of graphic organizers or diagrams help to make connections and see relationships among facts is a good teaching strategy to help with that.
Home strateties for TBI
- A memory board is a poster with pictures that show the student's favorite things such as soda, snacks, nail polish, best friends, colors, animals, etc. The memory board is a great generalizing tool to help the student regain their personality and perhaps stimulate memories of who they were prior to the injury, if these things had been lost cognitively. It also serves as a visual aid and graphic organizer of these points that they can work on creating with help from others, just as they would with academic information
Follow a Daily Schedule of Routines and Tasks
- Students with TBI often respond well to highly structured environments, and that includes the home life as well. Create a large calender with a "social story" on it that reveals exactly when the student should wake up, brush teeth, have breakfast, catch the bus, etc. so that they can self-monitor their progress throughout the day and are always aware of where they are supposed to be and when.
Create an Explicit Environment through Labeling
- Color coding the student's personal items such as their notebooks, toothbrush, cell phone, etc. is an easy way for the student to recognize the items they need to get through the day. You can also label the cabinets in the kitchen, the drawers in their bedroom, etc. to aid in the identification of the location of these things
"How to Recover: Comebacks from Traumatic Brain Injury" is just one of many other TBI-related blogs out there. It follows Mike Wilkinson, who sustained a severe diffuse TBI in a bicycle vs van collision in 2005. I feel that especially for the student living with TBI, blogs like this one are extremely helpful in remaining positive and avoiding slipping into depression and withdrawal because they are others' real day-to-day stories about struggles, triumphs, and little wins. Reading about how others are dealing with TBI can be very important in looking towards the future and towards recovery.
Accommodations/Modifications. (2002, September 11). Retrieved April 28, 2015, from https://www.naset.org/traumaticbraininj2.0.html#c9621
BrainLine Homepage. (n.d.). Retrieved April 20, 2015, from http://www.brainline.org
Hibbard, M., Gordon, W., Martin, T., Raskin, B., & Brown, M. (2001). STUDENTS WITH TRAUMATIC BRAIN INJURY: IDENTIFICATION, ASSESSMENT AND CLASSROOM ACCOMMODATIONS. http://icahn.mssm.edu/static_files/MSSM/Files/Research/Centers/Traumatic%20Brain%20Injury%20Central/TBIKIDS.pdf
It's Done! App for iPhone/iPad & Android. (n.d.). Retrieved April 28, 2015, from http://www.itsdoneapp.com/
Lash, M. (n.d.). Teaching Strategies for Students with Brain Injuries. TBI Challenge!, 4(2).
Tools & Aids | The Brain Injury Peer Visitor Association. (2014, March 25). Retrieved April 28, 2015, from http://www.braininjurypeervisitor.org/index.php?p=1_65_Tools-Aids#memoryboards
Wilkinson, M. (2013, August 11). How to Recover: Comebacks from Traumatic Brain Injury. Retrieved April 28, 2015, from http://howtorecover.blogspot.com