1. TRAUMATIC BRAIN INJURY: A BRIEF OVERVIEW Low Incidence Special Education Services in Minnesota Schools

2. DEFINITION OF TBI: MN RULE 3525.1348  ‘Caused by ‘External Physical Force’  Total or partial functional disability and/or psycho-social impairment  Adversely affects educational performance  Medical documentation  Consistent with Federal Definition

3. TBI CHILD COUNT: December 2013  129,646 students (birth to age 21) received special education services  454 students identified under TBI Category = 0.4% (<1%)

6. Traumatic vs. Non-traumatic Falls Physical abuse/SBS Motor vehicle accidents Recreational & sports injuries Concussion Surgical resection/tumor removal Assault Infections of the brain Cerebral vascular accidents Tumor Anoxic injury Stroke Toxins Metabolic disorders Fever

7. MN Services & Support at the Local School Level Service Providers n TBI Specialist (Educator with expertise in TBI)  Physical/Health Disabilities (P/HD) Teacher

8. Services and Support at the Local School Level  Monitoring/General Accommodations  504 Plan  Special Education Services/IEP under TBI Category

9. Services and Support at the Local School Level  Referral  Evaluation process  Qualification

10. Educational Evaluation EDUCATORS ARE ENCOURAGED TO...  Use what is available, current, & applicable  Go beyond ‘traditional testing’  Accurately define deficits

11. Potential Educational Challenges...  Intellectual/Cognitive Changes  Physical Changes  Behavioral Changes

12. Student Profile: Intellectual/Cognitive School teams are aware there may be problems with:  Memory/New Information  Processing speed  Organization/Executive Functioning  Distractibility/Inattention

13. EXAMPLE: Memory Problems Questions educators should ask:  Can student retain info from one day to the next?  Does providing a context improve learning?  Are verbal and visual memory skills equally proficient?

14. EXAMPLE: Memory Problems Questions educators should ask:  Does repetition increase learning?  Does student attempt to ‘chunk’ or organize info to aid recall?  What works better: recognition or spontaneous recall?

15. Accommodations for Memory Problems  May need to hear information multiple times AND using different modes of input (visual, auditory)  Repetition often needed  Recognition v. Recall (multiple choice v. open answer worksheets), fact cards/cue sheets for studying

16. Accommodations for Memory Problems continued  Memory aids- PDAs/smart phones with schedules & alarms, digital video and/or audio recorders  Peer note takers, electronic pens, extra copies of notes, extra texts for home  visual organizers, highlighters

17. Just one example… In addition to memory and retention deficits, accommodations, strategies & supports may also be needed for…  Processing speed  Organization/executive functioning  Distractibility/inattention  Starting/changing/maintaining activities  Problem solving & reasoning  Impulse control, judgment, decision making  Impaired motor skills For more information, see the TBI Resource Manual for MN Educators

18. Physical Changes Motor coordination Hearing and visual changes Spasticity and tremors Fatigue and weakness Headaches Slowed reactions Heightened sensitivity to light and/or noise Taste and smell Balance Mobility Speech Seizures

19. Student Profile: Emotional Depression Anxiety Poor self-esteem Appears to be unmotivated Moody

20. Student Profile: Behavioral Irritability Low frustration tolerance Sense of apathy Aggression Inflexibility

21. Factors That Can Influence Behavior neurological damage SCHOOL HOME Family pre-existing conditions/traits

22. CHALLENGES + FRUSTRATION = ACTING OUT SUSPENSION YELLING FIGHTS DETENTION

23. The Next Step: Implementing Pro-Active Behavioral Strategies Goal: Minimize the TRIGGERS Identify Antecedents Provide accommodations

24. Classroom/Environmental Considerations Stimulation Pacing Teaching style Classroom culture...All of these have a very real impact on student success!

25. Focus on Prevention: In the Home, School & Community Develop alternatives Consistent structure Predictable routines Educate Peers

26. The BIG Picture: Considerations for Schools  Return to School practices (hospital to school re-entry) for moderate and severe TBI  Increased awareness & Identification of Mild TBI/concussion  Professional development with a focus on TBI and available resources

27. The BIG Picture: Considerations for Schools continued  Traditional approaches to psycho- educational assessment often do not work with TBI population  Placement & Instruction: Mistaken assumption that TBI is like other learning/behavioral disabilities  Qualification for school services when there is no medical diagnosis

28. TBI Resources Found on Website Technical Training Materials Professional Development Opportunities Service Delivery Considerations Information & Resources for Families RESOURCES  MN Low Incidence Projects Website: www.mnlowincidenceprojects.org www.mnlowincidenceprojects.org (click on TBI)  MN Dept. of Education website: www.education.state.mn.us www.education.state.mn.us

29. ADDITIONAL ELECTRONIC RESOURCES  CBIRT Online Learning Modules for Educators http://intheclassroom.cbirt.org/ http://intheclassroom.cbirt.org/  Project Learnet www.projectlearnet.org/  Concussion Resources/CDC www.cdc.gov/features/Concussion/  Lash & Associates www.lapublishing.com/

30. Created by Deb Williamson, Statewide TBI Specialist MN Low Incidence Projects (Revised 2014)