1. Siri Wieringa & Alison Jacobson
Traumatic Brain Injury (TBI)

2. Definition: The Individuals with Disabilities Education Act defines Traumatic Brain Injury as "an acquired
injury to the brain caused by an external physical force, resulting in total or partial functional disability or
psychosocial impairment, or both, that adversely affects a child's educational performance. Traumatic brain
injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition;
language; memory; attention reasoning; abstract thinking; judgment; problem solving; sensory, perceptual,
and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic
brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by
birth trauma.
Common Associated Characteristics:
* Onset: Sudden
* Cause: One or more blows to the head
accompanied by altered mental status,
including loss of consciousness
* Functional Changes: Marked contrast
between pre- and post-onset capacities:
memory loss, reduced processing speed,
impaired executive functions
* Physical Disabilities: May include loss of
balance, weakness, paralysis, visual/ sensory
changes, headaches
* Emotional Difficulties: Labile mood,
depression and anxiety frequently found
Suggested Teaching Strategies: (from nichy.org)
Causes: Some of the major causes of brain injury include Brain hypoxia and ischemia may result from
traumatic brain injury, circulatory problems such as cerebral vessel spasm or stroke, and lack of oxygenation
that may occur during cardiopulmonary arrest. Lack of adequate oxygen to the brain causes cell death that can
be localized or widespread. The extent of brain cell death influences the degree of neurological impairment
and disability. Trauma, lack of oxygen, lack of blood flow (ischemia), infection and metabolic disorders. Liver
failure, low blood sugar (hypoglycemia), kidney failure, and toxic exposure to such substances as alcohol,
drugs, sedatives, poisons, and some heavy metals. In general, brain injury associated with metabolic disorders
is widespread throughout the entire brain.
Behavioral Difficulties: Unpredictable:
possible agitation, aggressiveness,
restlessness, impulsivity
Awareness of Deficits: Limited-to-full
awareness
Skills and Knowledge: Pre-TBI learning is
largely intact
Difficulties with Learning: Old information
is easier to recall than new
Peer Interactions: Affected by cognitive
deficits, behavioral difficulties, reduced
social skills

3. * Find out as much as you can about the child's injury and his or her present needs.
* Find out more about TBI through the resources and organizations listed below. These can help you
identify specific techniques and strategies to support the student educationally.
* Give the student more time to finish schoolwork and tests.
* Give directions one step at a time. For tasks with many steps, it helps to give the student written
directions.
* Show the student how to perform new tasks. Give examples to go with new ideas and concepts.
* Have consistent routines. This helps the student know what to expect. If the routine is going to change,
let the student know ahead of time.
* Check to make sure that the student has actually learned the new skill. Give the student lots of
opportunities to practice the new skill.
* Show the student how to use an assignment book and a daily schedule. This helps the student get
organized.
* Realize that the student may get tired quickly. Let the student rest as needed.
* Reduce distractions.
* Keep in touch with the student's parents. Share information about how the student is doing at home and
at school.
* Be flexible about expectations. Be patient. Maximize the student's chances for success.
* It's important to remember that a student who has suffered TBI will have different educational needs
than before their injury. Because of the sudden and traumatic nature of their injury, there are emotional
and social changes to consider. There must be careful evaluation and planning to address the student's
needs in their IEP.
Additional Resources:
http ://nichcy .orgMisability/specific/tbi #help
The National Dissemination Center for Children With Disabilities, this is a comprehensive website for all
disabilities. For TBI, there is information about symptoms, statistics, and help for parents and teachers.
http://biausa.f>T:ian.com/rad.ex.htm
This website is for Brain Injury Association of America. This is very useful with resources for families and
caregivers, diagnosis and treatment, advocacy and more.
http://www.cdc.gov/traumaticbraininjury/
The Centers for Disease Control and Prevention discusses different types of TBI, statistics, causes and risk
groups, prevention, and long-term outcomes.
http://wvvw.ninds.nih.gov/disorders/tbi/tbi.htm
National Institute for Neurological Disorders and Stroke gives information about diagnosis, treatment,
prognosis, and organizations that can help.
http://wvvw.mssm.edu/staticJiles/MSS]^
BIKIDS.pdf
This PDF is a great resource for getting information about how TBI occur, the effects that are seen in the
patients, and what teachers can do to make a child with a TBI more comfortable in the classroom and able to
learn.