Understanding Students with Traumatic Brain Injury

Defining Traumatic Brain Injury

• Traumatic brain injury (TBI) is an acquired injury caused by external physical force

• Two types of TBI:– Closed head injury– Open head injury

• Does not include congenital, infections, degenerative, or birth trauma

• http://www.youtube.com/watch?v=AmAML1-F2LE&feature=related

Prevalence of TBI• In fall 2006, 23,967 students (0.4% of students 6-

21 in special education)• Other prevalence data indicate the effects to TBI– 1.1 million Emergency department visits each year– 235,000 hospitalizations– 50,000 deaths– Males are approximately 1.5 times as likely to sustain

a TBI as a females– Highest risk groups: birth to four years of age and 15-

19 years of age– 10% are severe, 10% moderate and 80% mild

Characteristics

• Characteristics will vary according to:– Site and extent of injury– Length of time student was in a coma– Student’s maturational stage at the time of injury

• Possible changes due to TBI:– Physical– Cognitive– Linguistic– Behavioral, emotional, and social

Phineas Gage

• http://www.youtube.com/watch?v=X4fGlny5cPg

Determining the Causes

• Accidents– Most are motor vehicle– Falls– Assaults• Firearm (2/3 are suicide attempts)• Child abuse

– Shaken-baby syndrome

– Sports and recreational injuries

Determining the Presence

• Evaluation must be comprehensive and ongoing

• Glasgow Outcomes Scale classifies injuries into broad groups:– Death– Persistent vegetative state– Severe disability– Moderate disability– Good recovery

Determining the Nature of Specially Designed Instruction and Services

• Students with TBI need frequent evaluation and re-evaluation

• Classroom observation checklist– Memory– Attention and concentration– Executive functioning– Self-awareness– Language

Partnering for Special Education and Related Services

• For successful hospital to school transitions:– Involve educators during hospital stay– Keep school personnel updated on student

medical progress– Make the time for homebound instruction as

short as possible– Frequently monitor the student’s progress after

re-entry– Assign someone to be the point person for

coordinating the transition

Determining Supplementary Aids and Services

• Teaching memory aids, including:– Following a routine schedule– Keeping appointments that are not routine – Taking medication– Remember to perform a new task– Marking when to start or end a task

• Using technology; visual assistants; PDA’s; pagers/digital beepers, electronic watchers; There is an App for that!

Planning for UDL

• Instructional Pacing– Appropriate instructional pacing– Frequent student responses– Adequate processing time– Monitoring responses– Frequent feedback

Early Childhood Students

• Collaborate teaming– Partner to achieve a shared goal– Believe that all team members have unique and needed

expertise and skills, and value each person’s contribution– Distribute leadership through the team

• Five components of collaborative teaming– Building team structure– Learning teamwork skills– Taking team action– Teaching collaboratively– Improving communication and handling conflict

Elementary and Middle School Students

• Cooperative learning strategies– Positive interdependence– Individual accountability

• Several ways to structure cooperative learning groups for group success– Group size– Detailing each student’s individual task– Peers holding one another accountable

Secondary and Transition Services• Problem-solving– Problem identification– Problem explication or definition– Solution generation

• Decision making– Identify relevant alternatives or options– Identify consequences of alternatives– Identify probability of each consequence– Determine the importance placed on each value or

alternative– Integrate values and consequences to select preferred

option

Measure student progress

• Analytical rubrics– Like directly to specific content and student

achievement standards– Focus on only one dimension of student performance

(i.e., legibility versus content knowledge)– There should be enough points in the scale to

adequately judge, but no so many as to confuse the issue

– Focus on specific outcomes rather than a process– Provide students with information about the rubrics

and examples of high quality performance

Measuring Student Progress

• Progress in addressing other educational needs– Perceptual-motor skills coordinate visual and

sensory input with motor activities– Bender-Gestalt Visual Motor– Collaboration with other professionals

• Making accommodations for assessment– Test item construction– The use of a scribe