Chapter 13

Very Low-Incidence

Disabilities

Rosa M. VelaEdu 203

College of Southern Nevada

Traumatic Brain Injury

Prior to the 1960’s, most children whose brains were seriously damaged died soon after the trauma. Changes in emergency treatment, imaging technology, and surgical and pharmaceutical treatments now help save children’s lives. However, it often takes intensive special education services and accommodations for the problems resulting from the accident to be resolved.

Click on the link below to see a short video of a child who recovered from traumatic brain injury (TBI)

http://youtu.be/LuxuKVKem78

Traumatic Brain Injury

The IDEA ‘04 definition for TBI was introduced in 1990 when TBI became a separate special education category.

TBI is not * a condition present at birth or * caused by a stroke, brain tumor, or other internally caused brain damage.

TBI is * due to a concussion or head injury,

possibly from an accident or child abuse,* not always apparent or visible, and* may or may not result in loss of

consciousness

Characteristics of TBI

According to the National Institute of Neurological Disorders and Stroke TBI ranges in severity from mild to severe. They can last for a very short time or years. In some cases the effects disappear, but in some other cases it will result in lifelong problems.

These symptoms are: dizziness, headache, selective attention problems, irritability, anxiety, blurred vision, insomnia, fatigue, motor difficulties, language problems, behavior problems, or cognitive and memory problems.

Frequent Characteristics of Students with TBI

Physical Cognitive Social/Emotional

Educational

Headaches Short-term memory problems

Mood swings Difficulty with multistep tasks

Fatigue Long-term memory problems

Anxiety Requires consistent schedule and routine

Muscle contractions

Attention deficits Depression Needs distractions reduced

Imbalance Disorganization Restlessness Requires shortened assignments

Paralysis Nonsequential thinking

Lack of motivation

Must have lots of opportunities for practice of new skills

Prevalence

According to the federal government, 23,864 students, ages 6 through 21, receive special education services because of TBI (OSEP, 2008a).

Almost two-thirds of these students learn alongside classmates without disabilities, some with support from resource programs, for most of the school day (OSEP, 2008a).

CausesHalf are caused by transportation accidents such as car accidents, motorcycle accidents, and bicycle accidents. 20% percent are due to violence such as child abuse or firearms.Small percentage is due to sports injuries.

TBI is common among older children, teenage boys who are engaged in high risk behaviors.

For young children TBI is usually caused by child abuse, shaken baby syndrome where an infant is shaken so hard that it causes brain injury.

PreventionTraumatic Brain Injury (TBI)

Can be prevented or injuries minimized. Wearing helmets when riding a bike or skateboarding, not driving moving vehicles while intoxicated or under the influence of drugs and avoiding high-risk behaviors can prevent tragic accidents. Quick and immediate medical attention is important to prevent further damage.

Educational Considerations for Students with Low-Incidence Disabilities

There is no single answer to how best to educate thesestudents. Many students have complex coexisting conditionsthat result in unique, and highly individualized educationalresponses.

AssessmentBecause of universal infant screenings, better medical

technology,and more informed pediatricians, more and more instances ofdisabilities are identified when these individuals are infants ortoddlers. Their delays in development become obvious when theydo not walk or talk on time, toddlers are identified so they canreceive important intervention services during early childhood.Unless the disability occurs later for example a head injury afterbirth.

Educational Considerations for Students with Low-Incidence DisabilitiesEarly Identification Many infants are identified and receive critical earlyintervention services in their first few years of life. Familiesbenefit from these services because they learn how to interactin special ways with their baby with severe disabilities.

PrereferralSometimes it is educators who must confirm families worstfears: (The bicycle accident several weeks ago caused morethan a broken leg; it may have also caused brain injury) Schoolpersonnel play a critical role in bringing important services tostudents with TBI.

Educational Considerations for Students with Low-Incidence Disabilities

IdentificationStudents with multiple and coexisting disabilities many of them are identified at birth.Universal Infant screening procedures bring babies with hearing and vision problems to theattention of service providers during the critical months after birth. The situation forstudents with TBI is different because sometimes they don’t get identified right after theirinjury because they show no visible signs (cuts, bruises) of brain injury. This often createschallenges for the injured person because the outside world cannot see the wounds from aTBI and have difficulty understanding the nature of the injury. Many cases go undiagnosedthis is often called the silent epidemic.

Evaluation: Alternate Assessments—The “1% Kids”IDEA ‘04 and the No Child Left Behind Act require all students—those with and withoutdisabilities—be included in the national accountability system. Students not participatingfully in the general education curriculum, the government allows each state to usealternate assessments—another form of testing and evaluation of learning gains. Suchstudents are given these alternate assessments on alternate achievement standards.

Thesestandards might reflect achievement expectations of those participating in the generaleducation curriculum but with fewer objectives or different expectations.

Early Intervention

Parents and extended family members are often at the heart ofearly intervention services, making a difference in the lives of theirchildren. It is important that infants and toddlers with extensiveneeds because of their disabilities receive extra help learning,growing, and getting prepared for life and their school years. Theearly intervention services is possible through IDEA ‘04. It’simportant for professionals , families, and policymakers to agreeabout what to expect from these services. Below are five outcomesfor families participating in services supported by IDEA ’04 agreedupon. understand their child’s strengths, abilities, and special needs know their rights and advocate effectively for their children help their child develop and learn have support systems access desired services, programs, and activities in their

community.

Teaching Students with Low-Incidence Disabilities

Students with low-incidence disabilities shouldbe considered a unique member of a diversegroup of learners, all of whom exhibitdifferent learning styles and characteristics.

Access to the General Education Curriculum

Students with low-incidence disabilities do nothave access to the general education as theirprimary objective, they will be striving tomeet a curriculum such as independent living.TBI students have the highest participationrate in general education. Students with deaf-blindness has a low participation rate. Thelowest however is students with multipledisabilities.

Teaching Students with Low-Incidence Disabilities

Instructional AccommodationsModifications to the instructional program/classroomroutine can make such a difference and help achievemaximum benefits for students with low-incidencedisabilities.

Example: A student with TBI who spends only half a day at school benefits greatly when the classroom schedule is adjusted so instruction on important academic tasks happens during the morning.

Data-Based PracticesFunctional curriculum is instruction in natural settingsrelating to life (person’s daily needs) and vocational

skills.This type of practice is not appropriate for every studentwith low incidence disabilities, the IEP team decides. TBIstudents find that organizing strategies, such as graphicorganizers and story maps help them focus, visualizeinformation, and put structure to their learning efforts.

Teaching Students with Low-Incidence Disabilities

Data-Based Practices (continued)

After the age of 14, the labor laws allow

students to work in the community.Important skills needed in daily life

mustbe taught in natural or real settings tobecome useful, this is community-

basedInstruction (CBI). This practice

improvesthese individuals’ inclusion in daily lifeand employment when they are adults.

Teaching Students with Low-Incidence Disabilities

Technology Has helped individuals withdisabilities communicate more effectively increase their levels of independence control their environments have greater mobility gain access to information

Augmentative and alternativecommunication devices (ACC) allows forcommunication and participation nototherwise possible for many individuals withmultiple-severe disabilities. Also this type ofdevice has helped students who are unable

tocommunicate with others through oralspeech.

ReferencesHealth writings. (2007-2010). Retrieved fromhttp://www.health-writings.com/head-trauma-support-project/

Preparing for Thanksgiving Travel: 3. (October 29, 2009). Retrieved from

http://wereviewyousave.com/page/6/

1st in Unique Gifts. (2011).Retrieved from http://www.1st-in-unique-gifts.com/2008/09/arai-motorcylehelmets

Smith, E. E., & Tyler, N. C. (2009). Introduction to special education,

making a difference. Pearson College