Traumatic Brain Injury(TBI)

Very Low Incidence Disabilities

TLSE 240

TBI – IDEA Definition

“Acquired injury to the brain caused by an external force that adversely affects a child’s educational performance and results in partial functional disability, psychosocial impairment or both….”

Not Covered

Brain injuries that are congenital (present at baby’s birth)

Anoxia (lack of oxygen to the brain) i.e., choking, stroke or drowning

TBI can be due to…..

Closed Injury

Open Injury

Closed Injury

Brain whipped back and forth rapidly, causing it to rub against and bounce off the rough, jagged interior of the skull.

Closed continued

Neurofibers responsible for sending messages to all parts of the body are damaged

Stresses brain stem, a relay station

Physical, emotional, and cognitive consequences

Open Injury

Insult to specific area of brain, such as gunshot wound or blow to the head

Usually only affects those functions controlled by injured parts

Characteristics

Unique to individual and injury

Can have characteristics similar to LD, MR, ED/BD, Speech Impairments, or Physical Disabilities

Areas Typically Affected

Cognition Language Memory Attention Reasoning Abstract Thinking Judgment Information

Processing Speech

Possible Physical Changes

Nothing to serious20% - Seizures; often subsideSpasticity or paralysisCoordination problemsPhysical weaknessFatigueSome strength resumes as brain heals

Physical Changes continued

HeadachesVisual/hearing

issuesChanges in

senses

Possible Cognitive Changes

ComprehensionProblem solvingConcentrationLong and short term memoryInformation processingPoor judgment

Possible Linguistic Changes

Receptive languageWritten languageAphasia (inability to use language

appropriately)Word finding issuesMost speech and expression skills

are regained

Possible Social, Behavioral, and Personality Changes

Temper outburstsEuphoriaRestlessnessAnxietyIrritability15-25% struggle with depressionPoor self-monitoring skills

Causes of TBI

Accidents ( especially motor vehicle)

Falls Violence – related

incidentsChild abuseShaken baby

syndrome

Causes continued

Sports and recreational injuriesOften mild

and go unreported

TBI – other facts

TBI is the leading cause of death and disability among children and young adults

1 TBI per 15 secondsMales 2x as likely as femalesMost prevalent 15-24 and 75 and overAlcohol is involved in half of TBI injuries

Assessment

Medical evaluationCAT Scan identifies large area of

bleeding or contusionMRI identifies smaller and subtle brain

anomaliesPET Scan measures some of the energy-

processing functions of the brain. Looks at how certain chemicals are being used by the brain

Assessment continued

Intellectual skillsAcademicsMemoryLanguageMotorPersonalityOthers

Assessment continued

Multi-disciplinary team

Often on-going to determine changes, improvements, or needs

Continued communication with neurological or medical experts

Recovery

Motor skills return firstRapid progress at first, then slower

progressSpeech and language issues

quickly recoveredHigher level skills and complex

language skills remain difficult

Educational Implications

IEP or 504 PlanVarious therapiesMemory strategiesAccommodations and

ModificationsSocial needs

Very Low Incidence Disabilities

Multiple-Severe disabilitiesDeaf blindness

Multiple - Severe

Often cognitive, sensory, and physical disabilities

Focus on functional skillsRequire supports throughout life,

usuallyGroup homesLiving longer

Deaf blindness

Often some residual hearing or vision

Need considerable supportsOften have additional disabilitiesLess frequently in general educationCommunication and functional skills