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Traumatic Brain Injury Definition • Injury to the brain (not including conditions present at birth, birth trauma, or degenerative diseases or conditions) resulting in total or partial disability or psychosocial maladjustment that affects educational performance; may affect cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem solving, sensory or perceptual and motor disabilities, psychosocial behavior, physical functions, information processing, or speech. TBI Definition Cont. • Closed – caused by a blow to the head from an auto crash, assault, fall, etc. • Open – caused when an object (or fragment) goes through the skull and into the brain. Could be from an accident, assault, bullet, etc. TBI Categories Mild • Concussion with brief (<15 minutes) or no loss of consciousness. • Usually no complications, i.e. hematoma. • Can have normal neurological exam. • Symptoms usually improve over 1-3 months. • 75% of all brain injuries. TBI Categories Moderate • Loss of consciousness for minutes to hours. • Confusion lasts for days or weeks afterwards. TBI Categories Severe • Loss of consciousness for days, weeks, or even longer. Long Term Consequences • May affect Mental Activities – Cognitive skills, Language skills, Perceptual Skills • May affect Physical Abilities – Movement skills, Sensory skills, Maintenance/Health • May affect Psychosocial Abilities – Personality changes, Psychological states, Relationship changes TBI General Symptoms • Vision changes: blurred, double • Dizziness • Vomiting • Headache • Confusion • Dilated pupils • Lethargy • Difficulty thinking • • • • • Difficulty speaking Numbness, tingling Slow pulse, breathing Ringing in the ears Spinal fluid coming out of the ears • Loss of consciousness • Respiratory Failure • Coma Eligibility for Special Education • The student had an acquired injury to the brain following a period of normal development • Injury was caused by an external physical force • Injury caused adverse affects upon student’s educational performance Eligibility for Special Education- Areas affected • • • • • • • • Cognition Memory Reasoning Communication Problem Solving Physical Functions Psychosocial Behavior Executive Functions • • • • • Speech & Language Attention Abstract Thinking Judgment Sensory, Perceptual and Motor Abilities • Information Processing Research Based Practices • After an 8-year follow-up the following proved to be effective in supporting students with TBI – – – – – – – Daily Routine Positive Momentum Reduction of Errors Escape Communication Adult Communication Style Graphic Advance Organizers Goal-Plan-Do-Review Routine Appropriate Accommodations • The following strategies are essential for appropriate education of students with TBI: – Transition from a hospital or rehabilitation center to the school – A team approach involving regular and special educators, other special teachers, guidance counselor, administrators, and the student’s family. – An individualized education program concerned with cognitive, social/behavioral, and sensorimotor domains. Appropriate Accommodations Cont. • Educational procedures to help students solve problems in focusing and sustaining attention for long periods, remembering previously learned information, learning new things and appropriate social behavior • Emphasis on the cognitive processes in which academic skills are learned • Plans for addressing long-term needs Getting Back to School • A large problem with TBI students is getting back into school • The student sees themselves as having not changed, they just had an accident • Reintegration with their peers and in a classroom setting can be difficult and support is needed • Assessment should be done through a support team TBI Misc. Information • Causes (MN) – #1 is falls – #2 is motor vehicle crashes – #3 is external force applied to head or neck – #4 is Shaken Baby Syndrome TBI Misc. Information Cont. • 5.3 million Americans have a TBI (94,000 in MN) • In the US, a TBI occurs every 15 seconds, resulting in 5000 new TBIs per day or about 2 million a year – 50,000 of these cases result in death, annually – TBI is the leading cause of death and disability among children and young adults until age 44 TBI Misc. Information Cont. • More than 50% of all motor vehicle crashes, resulting in a TBI, involve alcohol • Each year 230,000 persons are hospitalized with a TBI and survive • Highest prevelance among males age 15-24 – Male 2X as likely to receive a TBI than females TBI Strategies • ABC Model – “A” – Antecedent – “B” – Behavior – “C” – Consequence Resources • Brain Injury Association of Minnesota – www.braininjurymn.org