Siri Wieringa & Atison Jacobson

Traumatic Brain Injury (TBI)

Definition: The Individuals with DisabilitiesEducation Act defines Traumatic Brain Injury as

"an acquired injury to the brain caused by anexternal physical force, resulting in total or partialfunctional disability or psychosocial impairment, orboth, that adversely affects a child's educationalperformance. Traumatic brain injury applies to openor closed head injuries resulting in impairments inone or more areas, such as cognition; language;memo ry; attention; reasoning; abstract thinkitg;judgment; problem-solving; sensory, perceptual,and motor abilities; psychosocial behavior; physicalfunctions; information processing; and speech.

Traumatic brain injury does not apply to braininjuries that are congenital or degenerative, or tobrain injuries induced by birth trauma.

Common Associatecl Characteristics :

Qnpefi Sudden

enmp; One rlr more blo\rys to the headaccompanied by altered mental status,including loss of ccnsciousness

Functional Changes: Marked contrastbetween pre- and post-onset capacities:memory loss, reduced processing speed,

impaired executive functionsr Physical Disabilities: May include loss of

balanco, weakness, paralysis, visual/ sensory

changes, headachesI Emotional Difficulties: Labile mood,

depression and anxiety frequently foundSuggested Teaching Strategies: (from nichy.org)

Causes: Some of the rnaior carlses of brain injuryinclude Brain hypoxia and ischemia may resultfrom traurmatic brain injury, circulator:y problemssuch as cerebral vessel spasm or stroke, anrJ lack ofoxygenation that may ocour duringcardiopulmonary arrest. Lack of adequate oxygen tothe brain causes c,ell death that can be localized orrq/idespread. The extent of brain cell deathinlluencss the degree of neurological impairmentand clisability. 'frauma, lack of oxygetr, lack ofblood flow (ischemia), infection and metabolicdisorders. Liver :failure, low blood sugar(hypoglycemia), kidney failure, and toxic exposureto such substances as alcohol, druBS, sedarives,poisofrs, and soms heavy metals. In gelteral, braininjury associaterJ with metabolic disorders iswidespread throughout the entire brain.

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r Behavioral Difficulties: [Jnpredictable:po ssible agitation, aggres siveness,restlessness, impulsivity

o Awareness of Deficits: Limited-to-fullawareness

Skills and Knowledge: Pre-TBI learning islargely intactDifficulties with Learning: Old informationis easier to recall than newPeer llrteractions: Affected by cognitivedeficits, behavioral difnculties, reducedsocial skills

Find out as much as you can about the child's injuty and his or her present needs.

Find out more about TBI through the resources and organizations listed below. These can help you

identifu 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 writtendirections.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 leamed the new skill. Give the student lots ofopportunities 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. Modmize 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:

http :/inichcy.orgldi sabilit"rr/speci liclthi#help

The National Dissemination Center for Children With Disabilities, this is a comprehensive website for alldisabilities. For TBI, there is information about symptoms, statistics, and help for parents and teachers.

l*tp :i/biausa. f yrian. com/index.htm

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.

http : i/www.cdc. gov/traumati cbrainini ury/

The Centers for Disease Control and Prevention discusses different types of TBI, statistics, causes and riskgroups, prgvention, and long-term outcomes.

http: //wwr,v.nind s.nih. govldisorders/tbi/tbi.htm

National Institute for Neurological Disorders and Stroke gives information about diagnosis, treatment,

prognosis, and organizations that can help.

http://www.mssm.e<lu/static*tiles/MSSM/t":ileslResearch/Csntersl traumatio0le20Brain%2Olnjury%20Centrali'lBiKIDS.pdf ,'

Uoalhqlp i" Iead,w',iThis PDF ir u gr5uii.rorjr.. for geuing-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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