Accommodating student veterans w/ ptsd & TBI Tips for Campus Faculty and Staff Learning Day February 7, 2014 Robert M. Dixon, M.A. Lieutenant Colonel, U.S. Army (Retired) Student Veterans Support Counselor Germanna Community College

Purpose To increase awareness in the faculty and staff regarding Post Traumatic Stress Disorder and Traumatic Brain Injury in our Student Veterans To provide some practical ways to assist our student veterans with PTSD and TBI to succeed in the classroom

Introduction Schuyler’s story: 5:31 http://www.youtube.com/watch?v=mEVA0T7QR1E We have approximately 50-100 Schuylers here at GCC … … almost all do not consider themselves as “disabled” or “victims”

History “Battle Fatigue” “Soldier’s Heart” “PTSD” “Thousand Yard Stare” “Traumatic Neurosis” “Shell-Shock” “Nostalgia”

Causes Examples: Combat Exposure Child Sexual or Physical Abuse Terrorist Attack Sexual/Physical Assault (ex. MST – Military Sexual Trauma) Serious Accident Natural Disaster BUT Not just military veterans –anyone can develop PTSD … the effects are cumulative over a lifetime … Over 90% of returning Veterans have experienced a traumatic event in their lifetime, however, only 10-30% will develop PTSD

Definitions - PTSD Leif’s Story: 4:29 http://www.youtube.com/watch?v=T5VfEEa6zUU DSM IV 309.81 PTSD - Diagnostic Features: The development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate. The person's response to the event must involve intense fear, helplessness, or horror … The characteristic symptoms resulting from the exposure to the extreme trauma include persistent re-experiencing of the traumatic event, persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness, and persistent symptoms of increased arousal. The full symptom picture must be present for more than 1 month and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

PTSD Symptoms What are the implications in the classroom? These symptoms manifest themselves at different times … … no two veterans have the same experience!

Definitions - TBI Traumatic Brain Injury (TBI) Veterans and TBI: 7:00 Traumatic Brain Injury (TBI) A blow or jolt to the head or a penetrating head injury that disrupts the functioning of the brain In other words – concussion … TBI causes physical damage to the brain tissue and Central Nervous System. This damage may or may-not induce psychological changes as well http://www.youtube.com/watch?v=BX0SsGkVwAo&feature=player_embedded

TBI Mechanisms of Injury in Veterans

TBI Symptoms Some symptoms: Subside over time … Some never heal …

Physical & Cognitive Impacts What are the implications in the classroom?

Physical & Cognitive Impacts What are the implications in the classroom?

The Magnitude 18.5% of all returning servicemembers meet criteria for either PTSD or depression. 14% of returning servicemembers currently meet criteria for PTSD, and 14% meet criteria for depression. 19.5% reported experiencing a probable TBI during deployment. About 7% meet criteria for a mental health problem and also report a possible TBI. If these numbers are representative, then of the 1.64 million deployed to date, the study estimates that approximately 300,000 veterans who have returned from Iraq and Afghanistan are currently suffering from PTSD or major depression, and about 320,000 may have experienced TBI during deployment. All statistical information provided by the RAND Corporation, Invisible Wounds of the War study (released May 2008)

How Many Vets Affected at GCC? ~ 40 - 50 ~ 50-100 ~ 20-40 Sometimes the treatments are worse than the disease …

Counseling & Advising Considerations Broaching the subject Sensitivity to terms “disability” BUT these conditions are covered under Federal Statutes regarding disabilities and education (ADA 1990, Sec 504 of Rehab. Act 1973) Student Veteran may not be aware: Impacts to their academics/lives -- they are living a new normal Provisions and protections afforded by Federal law Stigma and concern about being perceived as “weak” Other significant adjustments (especially 1st semester) New location, new family, new freedom … health challenges Be diligent to: Course load and level Format (online vs. in-person)

Concentration & Memory Helps Permit electronic note-taking/recording Provide handouts in a timely manner Select texts available in an electronic format Close the classroom door Use Blackboard to provide materials Select audio/visual clips with quality sound (close captioning) Consider content “triggers” that may be distractors Expect questions and requests to repeat

Test-taking Helps Eliminate timed tests, use other methods to minimize distractions Use online testing Build memory joggers into the exam, allow note-cards Eliminate distractors (ex. close the door)

Alleviating Panic Attacks/Stress Allow student to take a short break or time-out when necessary Permit flexibility in attendance when possible (medical /therapy appointments) Consider possible “triggers” If possible give fair warning in advance or allow an alternative Increased sensitivity to stimuli Maintain access and discourage clutter of aisles in the room Avoid loud, sharp noises or aggressive body movements Avoid hovering Lighting Avoid touching a student or following them

Classroom Management Group dynamics and group work Flexibility with seating and class arrangement Understand the student may also have physical issues related to TBI (ex. hearing) Be careful about your questions – is anybody here a veteran? Consider introductory note-cards to help with privacy concerns Include disability statements on syllabus Use SAILS early and often Be on the lookout for symptoms and indicators Contact Counseling if you are concerned Allow standing due to being tired

Curriculum Design Use experiential learning “hooks” Add visual and or auditory stimuli to important information Connect assignments to daily life or current events Use intermediate deadlines for major parts of large assignments Highlight additional resources to assist (tutoring, counseling, online support)

Resources VA Campus Toolkit: Disability Services http://www.mentalhealth.va.gov/studentveteran/index.asp Disability Services My contact information Bob Dixon, Student Veterans Support Counselor Dickinson Building, 114E 540-834-1927 rdixon@germanna.edu