Traumatic Brain Injury 101 Signs Symptoms and Eligibility

Traumatic Brain Injury 101: Signs, Symptoms, and Eligibility PRESENTED BY: DAVID BRIGGS, ED. S. , NCSP

Goals for Today By the end of this presentation, you should be more familiar with and better able to identify: What is a Traumatic Brain Injury (TBI). How eligibility is determined in the State of Wyoming. Rule out factors. Comorbid disorders Most common causes. Warning signs of a TBI. Intervention and accommodation ideas.

A Traumatic Brain Injury is…. An acquired injury to the brain caused by an external physical force That results 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 (1) 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.

A look at TBI

TBI Eligibility Criteria Eligibility is established through: A comprehensive evaluation The initial evaluation shall be conducted by qualified professionals as determined appropriate by the school district or public agency. The initial evaluation process shall be comprehensive and address all areas of suspected disability. Documentation from a physician, within the previous twelve (12) months, that the child has sustained a brain trauma (e. g. , skull fracture, contusions, and/or bullet wound, etc. ) resulting in the onset of an impairment Documentation that the Traumatic Brain Injury adversely affects the child's educational performance in one (1) or more of the following areas: cognitive ability, social behavior, use of adaptive skills, physical ability, vision, hearing, or ability to communicate.

TBI-Rule Out Factors Traumatic Brain Injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.

TBI- Common Comorbid Conditions Children with a lifetime TBI history were more likely to have the following comorbid conditions compared to children without a TBI: • Depression-10. 9% vs 3. 2% • Anxiety-13. 2% vs 4. 3% • Epilepsy or seizure disorder- 7. 9% vs 1. 0% • Vision problems- 6. 7% vs 1. 6% • Attention-deficit/hyperactivity disorder- 20. 5% vs 8. 5% • Bone, joint, or muscle problem- 4. 2% vs 2. 8%

TBI-Warning Signs Talk to your doctor if you notice any of the following symptoms following head trauma: Headache that gets worse and does not go away. Weakness, numbness, or decreased coordination. Repeated vomiting or nausea. Slurred speech. Look very drowsy or cannot wake up. Have one pupil (the black part in the middle of the eye) larger than the other. Have convulsions or seizures. Cannot recognize people or places. Are getting more and more confused, restless, or agitated.

TBI-Warning Signs Cont’d Have unusual behavior. Lose consciousness. Will not stop crying and are inconsolable. Will not nurse or eat. Keep in mind…some of these symptoms may appear right away. Others may not be noticed for days or months after the injury, or until the person resumes their everyday life. Sometimes, people do not recognize or admit that they are having problems. Others may not understand their problems and how the symptoms they are experiencing impact their daily activities.

TBI-Warning Signs

TBI- Typical Causes TBI is most often caused by:

TBI- Intervention Ideas Academic Intervention Services (ex. - reading, writing, and math) Behavior Management Plans Speech-language pathology and audiology services Physical and occupational therapy (ex. - sensory processing, gross/fine motor deficits, etc. ) Psychological/Counseling services (ex. - executive functioning skills, behavior support, social skills, anger management, etc. ) School health services and school nurse services (ex. - medicine management, place to rest, etc. ) Social work services in schools Transitional and Rehabilitative Services Vocational Counseling

TBI- Accommodation Ideas Classroom Accommodations: Allow additional time to complete in-class assignments Allow for extra or extended breaks Provide student with instructor’s notes or help student obtain quality notes from other students Allow student to audio record lectures for later playback Provide both oral and written instructions; clarify instructions For lectures, provide student with an outline or study guide when available Allow use of a portable computer with spelling and grammar checks for assignments and note-taking In grading work, reduce emphasis on spelling and grammatical errors unless it is the purpose of the assignment Permit referencing a dictionary or thesaurus for assignments Provide preferential seating at or near the front of the classroom Reduce quantity of work required, in favor of quality. Avoid placing student in high pressure situations (e. g. , short time frames, extensive volume of work; highly competitive) Exempt student from reading aloud in front of classmates because of impaired reading skills.

TBI- Accommodation Ideas Test Accommodations: Ø Allow additional time to complete tests. Ø Provide for completion of tests in a quiet, individual environment with the goal of minimizing distractions. Ø Administer long examinations in a series of shorter segments with breaks allowed between sections. Ø Allow oral examinations and assist student in having responses scribed, as needed. Ø Assess knowledge using multiple-choice instead of open-ended questions. Ø Allow student to clarify and explain responses on exams (and assignments). Ø Permit student to keep a sheet with mathematic formulas for reference, unless memorizing the formulas is required. Ø Permit student’s use of a calculator. Ø Permit the student to utilize a dictionary and thesaurus in writing test responses. Ø If two exams are scheduled on the same day, allow student to reschedule one for another day.

TBI- Accommodation Ideas Accommodations to improve concentration include: • Have student sit near teacher in the classroom. • Keep distractions to a minimum. • Use peer note-takers. • Allow student to use a tape recorder. • Provide assignments in writing. • Teach in small groups. • Schedule classes when student’s attention is best. • Focus student’s attention with verbal and nonverbal cues. • Allow student to have frequent breaks. Methods to improve memory include: • Have student use a daily organizer to aid memory. • Give multiple-choice tests. • Have student use flash cards to help recall information. • Encourage use of highlighters. • Utilize student’s best learning mode – visual or auditory. • Provide repetition of instruction. • Ask student to repeat information to confirm comprehension

TBI- Accommodation Ideas Processing accommodations include: Ø Review peer’s notes or taped materials to add missed information. Ø Allow additional time for in-class assignments. Ø Reduce amount of homework. Ø Allow more time for student to respond. Accommodations and teaching strategies for traumatic brain injury to improve executive function include: Ø Have student return homework in a specific place. Ø Display classroom schedule. Ø Review daily routines with student. Ø Encourage student to use daily organizer when giving assignments. Ø Encourage student to outline assignments. Ø Break projects into steps.

Questions? Contact: Davidbriggs@boces 5. org