Ruth Wilcock Executive Director Supporting Students with Concussions

 To enhance the lives of Ontarians living with the effects of ABI through education, awareness and support

OBIA’s helpline is seeing increased calls about concussions

MythFact Younger children recover better from a brain injury than adults Younger brains are MORE vulnerable to damage

 As an educator you may have a student who has had a concussion whose symptoms continue over a long period of time  You may also encounter a student who has had a moderate or even severe brain injury

 Acquisition of new knowledge  Memory  Organization  Attention and concentration  Perception  Reasoning  Problem-solving  Initiation

 Students with ABI will often return to school with previously learned knowledge relatively intact.  It may seem that the student will be ready and able to acquire new information.  For students with ABI this may not the case.

 Present new material in small chunks.  Repeat information frequently and summarize it.  When teaching new concepts include many relevant, concrete examples.  Reinforce information with a variety of visual/auditory aids.  Allow students additional time for review.

 Students with organizational difficulties as a result of a concussion/ABI may have difficulty completing such tasks as:  performing a task in sequence  keeping track of assignments  following a schedule.

 Establish and maintain daily routines.  Provide a written daily schedule for students to refer to and, if necessary, review it at the beginning of each day.  Provide an outline that is coordinated with each class lecture and have the students make notes for each session.  Keep a duplicate copy of handouts and materials for those students who misplace work.  Colour code all materials associated with each class.  Break instructions down into simple steps and have students check off each step as it is completed.

 Students with attention and concentration difficulties respond best to structured environments which allow for predictable organized and consistent routines.

 Provide consistent, predictable, regular routines.  Provide appropriate student work/study areas that limit distraction.  Set up a "quiet" area where students can focus and calm down.  Place student with ABI away from distracting areas such as the door and windows.  Monitor student seating and take note of peers to see if being in close proximity with certain students increases or decreases certain behaviours.

 Students may have difficulty thinking in abstract terms.  Students may also have difficulty understanding the subtleties of language such as metaphors and the use of humour, particularly sarcasm.

 Provide concrete examples  Check for understanding.  Be direct and aware when you are speaking in metaphors  Reduce stress in learning situations

 Difficulties in problem-solving can apply in both the academic and social realms

 Use step-by-step problem-solving methods.  Provide frequent feedback.  Model problem-solving explicitly (talk through).  Assist students in generating solutions.  Keep instructions clear and explicit.  Provide opportunities for problem-solving at an appropriate level.

Areas of difficulty may include:  Frustration  Disinhibition  Aggression  Depression  Initiation  Poor self-image  Poor social behaviour

 Redirection is a way of disengaging a person from a particular mode of behaviour  Its intent is to help an individual to shift her/his cognitive “mind set,” particularly when they cannot do so at all or easily.

 The art of redirection involves steering the person away from her/his current behaviour or thought process by engaging them in another task or train of thought, especially one that is incompatible with the current behaviour.  Redirection is frequently used when direct instruction is ineffective due to the nature of the student’s ABI.

 Active ignoring involves the continued monitoring of a person’s behaviour while deliberately not responding or reacting to it.  It is performed in such a way so that unwanted behaviours are not reinforced, therefore, decreasing in frequency  With active ignoring you allow the student to know that the behaviour is detected but that you will not react to it

 The problem with the behavioural modification model is:  Inability to understand the connection between the consequence and the behaviour  An inability to remember why she/he had consequences  An inability to generalize from one situation to another

 Antecedent-Based Approach can be more effective with a student who has an ABI.  By identifying the antecedent and modifying the environment/situation accordingly, you decrease the chance that the person will engage in the behaviour.

 Education about concussions  Working with a knowledgeable doctor  General tips and strategies

 Information and support regarding the school system including  IPRC – Identification, Placement and Review Committee  IEP – Individualized Education Program  Accommodations  Other Resources:  Guidance Counsellors  Social Workers

 OBIA assists with advocacy and/or mediation to assist with issues such as:  A lack of knowledge around brain injury/concussion  A lack of provision of appropriate accommodations  A lack of collaboration with the treating physician’s recommendations

 Education to school personnel  Assisting with recommendations for accommodations

 When impasses occur, mediate conversations between the school and family  Goal is always to find positive solutions  Always advocate for what is best for the student

 Educating Educators About ABI Manual  It addresses issues such as:  Understanding ABI from a Development Perspective  The Challenges of Working with a Student with ABI  Working with ABI in the School Setting  Techniques for Working with Individuals with ABI  Individual Program Planning/Returning to School  A Team Approach to Assessment and Planning  Role of the Parents  Free for Download at

 Guidelines for Diagnosing and Managing Pediatric Concussion  It is an evidenced based document with a specific section for schools, teachers, parents and coaches.  Available online at

 OBIA is here to support students and schools  Contact:   