Traumatic Brain Injury (TBI)
Siri W. & Alison J.
Definition: The Individuals with Disabilities Education Act defines Traumatic Brain Injury as “an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. Traumatic brain injury 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. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.
Causes: Some of the major causes of brain injury include Brain hypoxia and ischemia may result from traumatic brain injury, circulatory problems such as cerebral vessel spasm or stroke, and lack of oxygenation that may occur during cardiopulmonary arrest.Lack of adequate oxygen to the brain causes cell death that can be localized or widespread. The extent of brain cell death influences the degree of neurological impairment and disability. Trauma, lack of oxygen, lack of blood flow (ischemia), infection and metabolic disorders. Liver failure, 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 disorders is widespread throughout the entire brain.
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 found
· 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
Suggested Teaching Strategies: (from nichy.org)
· Find out as much as you can about the child’s 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 student’s parents. Share information about how the student is doing at home and at school.
· Be flexible about expectations. Be patient. Maximize the student’s chances for success.
· It's 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 student's needs in their IEP.
Additional Resources:
The National Dissemination Center for Children With Disabilities, this is a comprehensive website for all disabilities. For TBI, there is information about symptoms, statistics, and help for parents and teachers.
This website is for Brain Injury Association of America. This is very useful with resources for families and caregivers, diagnosis and treatment, advocacy and more.
The Centers for Disease Control and Prevention discusses different types of TBI, statistics, causes and risk groups, prevention, and long-term outcomes.
National Institute for Neurological Disorders and Stroke gives information about diagnosis, treatment, prognosis, and organizations that can help.
This PDF is a great resource for getting information about how TBI occur, the effects that are seen in the patients, and what teachers can do to make a child with a TBI more comfortable in the classroom and able to learn.
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