Traumatic Brain Injury
(TBI)
Definition: The
Individuals with Disabilities Education Act defines Traumatic Brain Injury as
“an acquired injury to the brain caused by an external physical force, resulting
in total or partial functional disability or psychosocial impairment, or both,
that adversely affects a child's educational performance. Traumatic brain injury
applies to open or closed head injuries resulting in impairments in one or more
areas, such as cognition; language; memory; attention; reasoning; abstract
thinking; judgment; problem-solving; sensory, perceptual, and motor abilities;
psychosocial behavior; physical functions; information processing; and speech.
Traumatic brain injury does not apply to brain injuries that are congenital or
degenerative, or to brain injuries induced by birth
trauma.
Causes: Some of the major causes of brain injury include Brain
hypoxia and ischemia may result from traumatic brain injury, circulatory
problems such as cerebral vessel spasm or stroke, and
lack of oxygenation that may occur during cardiopulmonary arrest. Lack of adequate oxygen to the brain causes cell death
that can be localized or widespread. The extent of brain cell death influences
the degree of neurological impairment and disability. Trauma, lack of oxygen,
lack of blood flow (ischemia), infection and metabolic disorders. Liver failure,
low blood sugar (hypoglycemia), kidney failure, and toxic exposure to such
substances as alcohol, drugs, sedatives, poisons, and some heavy metals. In
general, brain injury associated with metabolic disorders is widespread
throughout the entire brain.
Common Associated Characteristics:
· Onset:
Sudden
· Cause: One or more blows to the
head accompanied by altered mental status, including loss of
consciousness
· Functional Changes: Marked contrast between pre- and
post-onset capacities: memory loss, reduced processing speed, impaired executive
functions
· Physical Disabilities: May include loss of balance, weakness,
paralysis, visual/ sensory changes, headaches
· Emotional Difficulties: Labile mood, depression and anxiety
frequently found
· Behavioral Difficulties: Unpredictable: possible agitation,
aggressiveness, restlessness, impulsivity
· Awareness of Deficits: Limited-to-full awareness
· Skills and Knowledge: Pre-TBI learning is largely
intact
· Difficulties with
Learning: Old information
is easier to recall than new
· Peer Interactions: Affected by cognitive deficits,
behavioral difficulties, reduced social skills
Suggested
Teaching Strategies: (from nichy.org)
· Find out as much as you can about the
child’s injury and his or her present needs.
· Find out more about TBI through the
resources and organizations listed below. These can help you identify 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 written
directions.
· 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 learned the new skill. Give the student lots of opportunities 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. Maximize 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:
The National
Dissemination Center for Children With Disabilities, this is a comprehensive
website for all disabilities. For TBI,
there is information about symptoms, statistics, and help for parents and
teachers.
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.
The Centers for
Disease Control and Prevention discusses different types of TBI, statistics,
causes and risk groups, prevention, and long-term
outcomes.
National Institute
for Neurological Disorders and Stroke gives information about diagnosis,
treatment, prognosis, and organizations that can help.
This PDF is a great
resource for getting 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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