traumatic brain injury By Michelle Kemper GOALS IDENTIFY
traumatic brain injury By Michelle Kemper
GOALS IDENTIFY WHAT traumatic brain injury (TBI) IS HOW MIGHT TBI DIFFER FROM OTHER DISABILITIES OR BEHAVIORAL ISSUES SUGGESTED CLASSROOM INTERVENTIONS WHAT TEACHERS NEED TO KNOW INFORMATION REFERENCES
What is it? “A bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. ” (Center for Disease Control and Prevention) Injury ranges from mild to severe Majority of injuries are concussions or mild TBIs Not ALL impacts to the head are TBIs CDC considers TBI a serious public health problem TBI Video (Nucleus Medical Media): http: //www. youtube. com/watch? v=55 u 5 Ivx 31 og
Interesting TBI Facts (Center for Disease Control and Prevention) Leading causes include: Ø Ø Falls (50% children 0 -14 yrs. ) Traffic Accidents Struck by/Against Events (25% children 0 -14 yrs. ) Assaults (2. 9% children 0 -14 yrs. ) Higher for males than females (in general) Highest age groups at risk 0 -4 yrs. and 15 -19 yrs. 75% Concussions or mild TBI Individuals who experience TBI have 3 X increased risk of re-injury 1. 7 million TBIs each year (MS, Spinal Cord Inj, HIV/AIDs, and Breast Cancer combined)
What happens when a student has a TBI? Immediate changes (may include): Confusion or disorientation Loss of consciousness (minutes, hours, days) Evaluated by doctor/hospital May or may not be reported to school (depending on severity)
What happens when a student has a TBI? Long-Term (Possible Changes Over Time) Physical: Cognitive: • Tired/Sleep Issues • Lack of interest • Headaches • Weakness/Dizziness • Coordination/Motor Function • Slow reactions • Light/Noise Sensitivity • Forgetfulness/Foggy • Struggles w/new material • Word-finding difficulties • Organization problems • Inattentive • Concentration difficulties • Easily distracted Emotional: Behavioral: • Moodiness • Unstable emotions • Depression • Anxiety • Irritability • Aggressiveness • Easily Frustrated/Angered • Issues w/unexpected events • Social Withdrawal
HOW TBI DIFFERS FROM LD/ED Distinguishing Characteristics Functioning at higher level prior to injury Marked medical changes (balance, weakness, paralysis, visual, . ) Recovery of some functions (slowly, quickly, unpredictably) Perform inconsistently Short-term memory issues Previous learning intact, may have difficulty learning something new Full or partial awareness of capabilities and loss (especially in older children) Agitated, restless, impulsive, New problems with peers, behavioral difficulties, lack of understanding issues *
SIMULATIONS (As time permits) Visual-Motor Function Apraxia – loss of ability to carry out familiar, purposeful movements without motor or sensory impairment. Examples: Feeding yourself, brushing teeth, writing notes, taking a test Speed/Processing Function Examples: Cannot keep up, trouble concentrating, frustrated
Classroom Management 1. Teaching methods and strategies used with learning and emotional disabilities can also be used with traumatic brain injuries. 2. Accommodations used for students with TBI can likewise benefit all of the students. 3. There is not one teaching program that applies to every student with a brain injury; therefore, each student’s plan will need to be adapted to their specific needs.
Post TBI Strategies & Interventions I Attention/Concentr ation Minimize Distractions (eg. Seating) Technology Options Peer Notes Small Groups Adjust Schedules Verbal/Non-verbal Cues Breaks Information Processing Slower pace Extended time (eg. tests, assignments) Workload adjustment Repetition Color-coding Written assignments Record instructions (Examples)
Post TBI Strategies & Interventions II Memory Executive Functioning Written Instruct/Assign Recording Information M/C Test Formats Highlighted Information Emphasis on learning mode (visual/auditory) Organizer Repetition to comprehend Memory notebook Rehearse routines Organization systems Break large tasks into smaller steps Display schedules Color-coding Designated locations (eg. for homework) Practice sequencing material (Examples)
Personal Stories (Examples, as time permits) Jessica’s Story Strategy differences may exist for TBI students and students with other disabilities. Julie’s Story Injuries may not be recognized due to poor transition between hospitals, parents, and schools. Yvette’s Story A teacher’s willingness to adapt can be critical to success!
What Teachers Should Know Be aware of possible TBI. Importance of Assessment: While interventions for other disabilities may be the same for TBIs, it will not focus and identify the cognitive impairments. Identification is essential to their success. Annually follow-up: Students that have had a TBI need to be tracked for additional problems or progress. TBI Classified as ED: Many times students labeled as ED have been found to have had a TBI (20% in one study); behavior is misunderstood and cognitive deficits are missed.
What Teachers Should Know How can you support these students? Analyze and work with the student Do not rush or challenge Consistency in strategies Understand the emotional challenges, talk to the student. Older students may appear to “not care” but it is a common problem with memory deficits. Watch for social issues, peers may need to be educated
What Teachers Should Know Remember! Many students with TBIs may fail in school due to unrecognized injury, or due to “mild” mis-diagnosis. (15% have significant injury) Early TBI may be academically normal but experience significant issues with new demands of middle or high school. With older students, previously learned material may remain intact, while learning new information may be compromised.
The End ED 584 - November 2013
References Bowen, J. (2004). Classroom Interventions for Students with Traumatic Brain Injuries. Retrieved November 2013, from Brainline. org (brainline kids): http: //www. brainline. org/content/2008/07/classroom-interventions-students-traumatic-brain-injuries_pageall. html Dawson, P. , Devine, A. , Gioia, G. A. , Jones, V. , Dohrn, E. , Dunn, C. , et al. (n. d. ). TBI Compared to ED, LD, ADHD& Autism. Retrieved November 2013, from CBIRT: http: //media. cbirt. org/uploads/medialibrary/2010/10/TBI_Compared_to_ED_ADHD_LD_ASD_FINAL. pdf De. Pompei, R. , & Blosser, J. (2003). TBI Compared to Other Disabilities. Retrieved November 2013, from CBIRT: http: //media. cbirt. org/uploads/ medialibrary/2010/10/TBI_vs_Autism_LD_ED_ADHD. pdf Hibbard, M. , Gordon, W. A. , Martin, T. , Raskin, B. , & Brown, M. (2001). Students With Traumatic Brain Injury: Identification, Assessment and Classroom Accommodations. Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury, Department of Rehabilitation Medicine. New York: Mount Sinai School of Medicine. Injury Prevention & Control: Traumatic Brain Injury; What are the Leading Causes of TBI? (n. d. ). Retrieved November 2013, from Centers for Disease Control and Prevention: http: //www. cdc. gov/Traumatic. Brain. Injury/ Lash, M. (2000). Teaching Strategies for Students with Brain Injuries. Retrieved November 2013, from Brain Injury Association of America: http: // www. biausa. org Learning Difficulties and Strategies to Assist Students with Traumatic Brain Injury. (2011, November). Retrieved November 2013, from Duke Health Organization: http: //www. dukehealth. org/services/speech_and_audiology/care_guides/speech_pathology_resources/traumatic-braininjury/pediatric-traumatic-brain-injury-resources/learning-difficulties-and-strategies-to-assist-students-with-traumatic-brain-injury
References (Continued) New Start Program: Center for Community Participation. (2004, September). Learning About Brain Injury: An Activity Manual For Elementary School Students. Retrieved November 2013, from Colorado State University: http: //www. colostate. edu/Dept/CCP/Programsfolder/ Disability%20 Awareness%20 Curriculum%20 final%209 -04. pdf Nucleus Medical Media. (2012, March 14). Concussion, Traumatic Brain Injury (TBI). Retrieved November 2013, from You. Tube: http: // www. youtube. com/watch? v=55 u 5 Ivx 31 og Resources: Traumatic Brain Injury. (n. d. ). Retrieved November 2013, from National Association of Special Education Teachers (NASET): http: // www. naset. org/traumaticbraininj 2. 0. html#c 9611 Traumatic Brain Injury Basics. (n. d. ). Retrieved November 2013, from brainline. org: http: //www. brainline. org/landing_pages/Basics. html University of Oregon. (n. d. ). Service Providers. (I. a. Office of Research, Producer) Retrieved November 2013, from The Center on Brain Injury Research and Training (CBIRT): http: //cbirt. org/resources/service-providers/
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