Understanding Students with Traumatic Brain Injury

Defining 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 F2LE&feature=related F2LE&feature=related

Prevalence of TBI In fall 2006, 23,967 students (0.4% of students in special education) Other prevalence data indicate the effects to 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 a females – Highest risk groups: birth to four years of age and years of age – 10% are severe, 10% moderate and 80% mild

Characteristics 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

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

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 checklist – 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 medication – Remember to perform a new task – Marking when to start or end a task Using technology; visual assistants; PDA’s; pagers/digital beepers, electronic watchers; There is an App for that!

Planning for UDL Instructional Pacing – Appropriate instructional pacing – Frequent student responses – Adequate processing time – Monitoring responses – Frequent feedback

Early Childhood Students Collaborate teaming – Partner to achieve a shared goal – Believe that all team members have unique and needed expertise and skills, and value each person’s contribution – Distribute leadership through the team Five components of collaborative teaming – Building team structure – Learning teamwork skills – Taking team action – Teaching collaboratively – Improving communication and handling conflict

Elementary and Middle School Students 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

Secondary and Transition Services 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

Measure student progress Analytical rubrics – Like directly to specific content and student achievement standards – Focus on only one dimension of student performance (i.e., legibility versus content knowledge) – There should be enough points in the scale to adequately judge, but no so many as to confuse the issue – Focus on specific outcomes rather than a process – Provide students with information about the rubrics and examples of high quality performance

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