1. 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

2. 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

3. Introduction Schuyler’s story: 5:31
We have approximately Schuylers here at GCC …
… almost all do not consider themselves as “disabled” or “victims”

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

5. 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

6. Definitions - PTSD Leif’s Story: 4:29
DSM IV 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.

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

8. 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

9. TBI Mechanisms of Injury in Veterans

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

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

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

13. 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)

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

15. 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)

16. 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

17. 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)

18. 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

19. 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

20. 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)

21. Resources VA Campus Toolkit: Disability Services
Disability Services
My contact information
Bob Dixon, Student Veterans Support Counselor
Dickinson Building, 114E