Understanding Students Understanding Students with Traumatic Brain with Traumatic Brain InjuryInjuryED 222 Spring 2011

Defining Traumatic Brain Defining Traumatic Brain InjuryInjury• 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

• http://www.youtube.com/watch?v=AmAML1-F2LE&feature=related

Prevalence of TBIPrevalence of TBI• In fall 2006, 23,967 students (0.4% of

students 6-21 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 15-19 years of age– 10% are severe, 10% moderate and 80% mild

CharacteristicsCharacteristics• 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

Phineas GagePhineas Gagehttp://www.youtube.com/watch?v

=X4fGlny5cPg

Determining the CausesDetermining the CausesAccidents

◦Most are motor vehicle◦Falls◦Assaults

Firearm (2/3 are suicide attempts) Child abuse

Shaken-baby syndrome

◦Sports and recreational injuries

Determining the PresenceDetermining 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 Determining the Nature of Specially Designed Specially Designed Instruction and ServicesInstruction and ServicesStudents with TBI need frequent

evaluation and re-evaluationClassroom observation checklist

◦Memory◦Attention and concentration◦Executive functioning◦Self-awareness◦Language

Partnering for Special Partnering for Special Education and Related Education and Related ServicesServices• 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 Determining Supplementary Aids and ServicesAids 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 UDLPlanning for UDLInstructional Pacing

◦Appropriate instructional pacing◦Frequent student responses◦Adequate processing time◦Monitoring responses◦Frequent feedback