Chapter 13 Understanding Students with Traumatic Brain Injury

 Traumatic brain injury (TBI) is an acquired injury caused by external physical force  Two types of TBI:  Closed head injury  Open head injury  Does not include congenital, infections, degenerative, or birth trauma Defining Traumatic Brain Injury

 In fall 2006, 23,967 students (.04% of students in special education)  Other prevalence data indicate the effects of TBI  1.1 million Emergency department visits each year  235,000 hospitalizations  50,000 deaths  Males are approximately 1.5 times as likely to sustain a TBI as females  Highest risk groups: birth to four years of age and years of age  10% are severe, 10% moderate, and 80% mild Prevalence of TBI

 Characteristics will vary according to:  Site and extent of injury  Length of time student was in a coma  Student’s maturational stage at the time of injury  Possible changes due to TBI:  Physical  Cognitive  Linguistic  Behavioral, emotional, and social Characteristics

 Accidents  Most are motor vehicle  Falls  Assaults  Firearm (2/3 are suicide attempts)  Child abuse  Shaken-baby syndrome  Sports and recreational injuries Determining the Causes

Determining the Presence  Evaluation must be comprehensive and ongoing  Glasgow Outcomes Scale: classifies injuries into broad groups:  Death  Persistent vegetative state  Severe disability  Moderate disability  Good recovery

Determining the Nature of Specially Designed Instruction and Services  Students with TBI need frequent evaluation and re-evaluation  Classroom observation checklists (Figure 13–5)  Memory  Attention and Concentration  Executive Functioning  Self-Awareness  Language

Partnering for Special Education and Related Services  For successful hospital to school transitions:  Involve educators during hospital stay  Keep school personnel updated on student medical progress  Make the time for homebound instruction as short as possible  Frequently monitor the student’s progress after re- entry  Assign someone to be the point person for coordinating the transition

Determining Supplementary Aids and Services  Teaching memory aids, including:  Following a routine schedule  Keeping appointments that are not routine  Taking medications  Remembering to perform a new task  Marking when to start or end a task  Using technology: visual assistants, PDA’s, pagers/digital beepers, electronic watches

 Instructional Pacing  Appropriate instructional pacing  Frequent student responses  Adequate processing time  Monitoring responses  Frequent feedback Planning for Universal Design for Learning

 Cooperative learning strategies  Positive interdependence  Individual accountability  Several ways to structure cooperative learning groups for group success  Group size  Detailing each student’s individual task  Peers holding one another accountable Elementary and Middle School Students

 Problem-solving  Problem identification  Problem explication or definition  Solution generation  Decision Making  Identify relevant alternatives or options  Identify consequences of alternatives  Identify probability of each consequence  Determine the importance placed on each value or alternative  Integrate values and consequences to select preferred option Secondary and Transition Students

 Progress in addressing other educational needs  Perceptual-motor skills coordinate visual and sensory input with motor activities  Bender-Gestalt Visual Motor  Collaborations with other professionals  Making accommodations for assessment  Test item construction  The use of a scribe Measuring Students’ Progress