Traumatic Brain Injury Definition Injury to the brain (not including conditions present at birth, birth trauma, or degenerative diseases or conditions) resulting in total or partial disability or psychosocial maladjustment that affects educational performance; may affect cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem solving, sensory or perceptual and motor disabilities, psychosocial behavior, physical functions, information processing, or speech.

TBI Definition Cont. Closed – caused by a blow to the head from an auto crash, assault, fall, etc. Open – caused when an object (or fragment) goes through the skull and into the brain. Could be from an accident, assault, bullet, etc.

TBI Categories Mild Concussion with brief (<15 minutes) or no loss of consciousness. Usually no complications, i.e. hematoma. Can have normal neurological exam. Symptoms usually improve over 1-3 months. 75% of all brain injuries.

TBI Categories Moderate Loss of consciousness for minutes to hours. Confusion lasts for days or weeks afterwards.

TBI Categories Severe Loss of consciousness for days, weeks, or even longer.

Long Term Consequences May affect Mental Activities Cognitive skills, Language skills, Perceptual Skills May affect Physical Abilities Movement skills, Sensory skills, Maintenance/Health May affect Psychosocial Abilities Personality changes, Psychological states, Relationship changes

TBI General Symptoms Vision changes: blurred, double Dizziness Vomiting Headache Confusion Dilated pupils Lethargy Difficulty thinking Difficulty speaking Numbness, tingling Slow pulse, breathing Ringing in the ears Spinal fluid coming out of the ears Loss of consciousness Respiratory Failure Coma

Eligibility for Special Education The student had an acquired injury to the brain following a period of normal development Injury was caused by an external physical force Injury caused adverse affects upon student’s educational performance

Eligibility for Special Education- Areas affected Cognition Memory Reasoning Communication Problem Solving Physical Functions Psychosocial Behavior Executive Functions Speech & Language Attention Abstract Thinking Judgment Sensory, Perceptual and Motor Abilities Information Processing

Research Based Practices After an 8-year follow-up the following proved to be effective in supporting students with TBI Daily Routine Positive Momentum Reduction of Errors Escape Communication Adult Communication Style Graphic Advance Organizers Goal-Plan-Do-Review Routine

Appropriate Accommodations The following strategies are essential for appropriate education of students with TBI: Transition from a hospital or rehabilitation center to the school A team approach involving regular and special educators, other special teachers, guidance counselor, administrators, and the student’s family. An individualized education program concerned with cognitive, social/behavioral, and sensorimotor domains.

Appropriate Accommodations Cont. Educational procedures to help students solve problems in focusing and sustaining attention for long periods, remembering previously learned information, learning new things and appropriate social behavior Emphasis on the cognitive processes in which academic skills are learned Plans for addressing long-term needs

Getting Back to School A large problem with TBI students is getting back into school The student sees themselves as having not changed, they just had an accident Reintegration with their peers and in a classroom setting can be difficult and support is needed Assessment should be done through a support team

TBI Misc. Information Causes (MN) #1 is falls #2 is motor vehicle crashes #3 is external force applied to head or neck #4 is Shaken Baby Syndrome

TBI Misc. Information Cont. 5.3 million Americans have a TBI (94,000 in MN) In the US, a TBI occurs every 15 seconds, resulting in 5000 new TBIs per day or about 2 million a year 50,000 of these cases result in death, annually TBI is the leading cause of death and disability among children and young adults until age 44

TBI Misc. Information Cont. More than 50% of all motor vehicle crashes, resulting in a TBI, involve alcohol Each year 230,000 persons are hospitalized with a TBI and survive Highest prevelance among males age 15-24 Male 2X as likely to receive a TBI than females

TBI Strategies ABC Model “A” – Antecedent “B” – Behavior “C” – Consequence

Resources Brain Injury Association of Minnesota www.braininjurymn.org