PSN Issue
What is
Traumatic Brain Injury?
A traumatic brain injury
(TBI) is an injury to the brain caused by the head being hit by something or
shaken violently. (The exact definition of TBI, according to special education
law, is given below.) This injury can change how the person acts, moves, and
thinks. A traumatic brain injury can also change how a student learns and acts
in school. The term TBI is used for head injuries that can cause changes in one
or more areas, such as:
- thinking and reasoning,
- understanding words,
- remembering things,
- paying attention,
- solving problems,
- thinking abstractly,
- talking,
- behaving,
- walking and other physical
activities,
- seeing and/or hearing, and
- learning.
The term TBI is not used for a person who is born with a brain injury. It also
is not used for brain injuries that happen during birth.
The definition of TBI below comes from the Individuals with Disabilities
Education Act (IDEA). The IDEA is the federal law that guides how schools
provide special education and related services to children and youth with
disabilities.
IDEA's Definition
of "Traumatic Brain Injury"
Our nation’s special education law, the Individuals with
Disabilities Education Act (IDEA) 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. The term 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; psycho-social behavior; physical functions;
information processing; and speech. The term does not apply to brain injuries
that are congenital or degenerative, or to brain injuries induced by birth
trauma.” [34 Code of Federal Regulations
§300.8(c)(12)]
How Common is Traumatic Brain
Injury?
More than one million children receive brain injuries each
year. More than 30,000 of these children have lifelong disabilities as a result
of the brain injury.
What Are the
Signs of Traumatic Brain Injury?
The signs of brain injury can be very different
depending on where the brain is injured and how severely. Children with TBI may
have one or more difficulties, including:
- Physical disabilities: Individuals with TBI
may have problems speaking, seeing, hearing, and using their other senses.
They may have headaches and feel tired a lot. They may also have trouble
with skills such as writing or drawing. Their muscles may suddenly
contract or tighten (this is called spasticity). They may also have
seizures. Their balance and walking may also be affected. They may be
partly or completely paralyzed on one side of the body, or both sides.
- Difficulties with thinking: Because the brain has
been injured, it is common that the person’s ability to use the brain
changes. For example, children with TBI may have trouble with short-term
memory (being able to remember something from one minute to the next, like
what the teacher just said). They may also have trouble with their
long-term memory (being able to remember information from a while ago, like
facts learned last month). People with TBI may have trouble concentrating
and only be able to focus their attention for a short time. They may think
slowly. They may have trouble talking and listening to others. They may
also have difficulty with reading and writing, planning, understanding the
order in which events happen (called sequencing), and judgment.
- Social, behavioral, or emotional problems: These difficulties
may include sudden changes in mood, anxiety, and depression. Children with
TBI may have trouble relating to others. They may be restless and may
laugh or cry a lot. They may not have much motivation or much control over
their emotions.
A child with TBI may not have all of the
above difficulties. Brain injuries can range from mild to severe, and so
can the changes that result from the injury. This means that it’s hard to
predict how an individual will recover from the injury. Early and ongoing help
can make a big difference in how the child recovers. This help can include
physical or occupational therapy, counseling, and special education.
It’s also important to know that, as the child grows and develops, parents and
teachers may notice new problems. This is because, as students grow, they are
expected to use their brain in new and different ways. The damage to the brain
from the earlier injury can make it hard for the student to learn new skills
that come with getting older. Sometimes parents and educators may not even
realize that the student’s difficulty comes from the earlier injury.
What About
School?
Although TBI is very common, many medical and
education professionals may not realize that some difficulties can be caused by
a childhood brain injury. Often, students with TBI are thought to have a
learning disability, emotional disturbance, or mental retardation. As a result,
they don’t receive the type of educational help and support they really need.
When children with TBI return to school, their educational and emotional needs
are often very different than before the injury. Their disability has happened
suddenly and traumatically. They can often remember how they were before the
brain injury. This can bring on many emotional and social changes. The child’s
family, friends, and teachers also recall what the child was like before the injury.
These other people in the child’s life may have trouble changing or adjusting
their expectations of the child.
Therefore, it is extremely important to plan carefully for the child’s return
to school. Parents will want to find out ahead of time about special education
services at the school. This information is usually available from the school’s
principal or special education teacher. The school will need to evaluate the
child thoroughly. This evaluation will let the school and parents know what the
student’s educational needs are. The school and parents will then develop an
Individualized Education Program (IEP) that addresses those educational needs.
It’s important to remember that the IEP is a flexible plan. It can be changed
as the parents, the school, and the student learn more about what the student
needs at school.
- Learn about TBI. The
more you know, the more you can help yourself and your child. See the list
of resources and organizations at the end of this publication.
- Work with the medical
team to understand your child’s injury and treatment plan. Don’t be shy
about asking questions. Tell them what you know or think. Make
suggestions.
- Keep track of your
child’s treatment. A 3-ring binder or a box can help you store this history.
As your child recovers, you may meet with many doctors, nurses, and
others. Write down what they say. Put any paperwork they give you in the
notebook or throw it in the box. You can’t remember all this! Also, if you
need to share any of this paperwork with someone else, make a copy. Don’t
give away your original!
- Talk to other parents
whose children have TBI. There are parent groups all over the U.S. Parents
can share practical advice and emotional support. Call NICHCY
(1-800-695-0285) or find resources in your state, online at
(www.nichcy.org/states.htm) to locate parent groups near you.
- If your child was in
school before the injury, plan for his or her return to school. Get in
touch with the school. Ask the principal about special education services.
Have the medical team share information with the school.
- When your child
returns to school, ask the school to test your child as soon as possible
to identify his or her special education needs. Meet with the school and
help develop a plan for your child called an Individualized Education
Program (IEP).
- Keep in touch with
your child’s teacher. Tell the teacher about how your child is doing at
home. Ask how your child is doing in school.
- Find out as much as
you can about the child’s injury and his or her present needs. Find out
more about TBI. See the list of resources and organizations at the end of
this publication.
- 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.
Information provided by National Dissemination Center for Children with
Disabilities
Disclaimer: All information on this site is of a general nature and is furnished for knowledge and understanding only.