Presentation on theme: "Instructional Strategies for Secondary Students with TBI"— Presentation transcript:
1Instructional Strategies for Secondary Students with TBI Randy Thomas
2Marathon vs. SprintBuilding success with a student who has a TBI takes consistent, focused, hard work.It is very difficult for the student.It is very rewarding for the student and the teacher.Successes may require you to look back over a semester or a year to clearly recognize.Coaches don’t expect a kids in casts to run; their injuries prevent them being capable.
3OverviewEveryday InstructionExecutive FunctioningMemoryAttention and FocusBehavior
4Everyday Instruction Follow principles of good instruction Are often beneficial to entire groupTarget the Key ConceptsReview those key concepts regularlyAre highly specific to the individual needs of the studentAssess key concepts: pre, formative, & summative
54 Facts on Long-Term changes: No 2 students will be alike.Changes are unlikely to disappear fully over time; the student’s recovery will most likely only be partial.Negative consequences may not be seen immediately but only emerge when developmental demands reveal deficits and problems.An injured brain is less likely to meet the increasingly complex tasks all children face as they get older.Hibbard, M., Gordan, W., Martin, T., Raskin, B., Brown, M. (2001) Students with Traumatic Brain Injury: Identification, Assessment and Classification, Assessment and Classroom Accommodations : NYC, NY
6Effective Teaching Model 1. Task analysis – break the task down to steps with clear beginning and ending point. 2. Use Direct-instruction to prevent the acquisition of errors in newly developed practices. Examples and non-examples are beneficial. Paint a clear picture of expectations. 3. Frequent assessments: Baseline and regular formative assessmentsA clean kitchen looks like this. The visual is essential for them to replicate what you expect.
7Effective Teaching Model 4. Frequent reviews combining visual and verbal ques.5. High rates of correct, practice trials: 5 trials is not enough, practices with mass practices initially followed by consistent reinforcement practices.6. Metacognitive strategy training: Self-evaluation of one’s own performance.
8Executive Functions. Those mental capacities necessary Executive Functions Those mental capacities necessary for formulating goals, planning how to achieve them, and carrying out the plans effectively. (Leak, 1982)Select the most needed area of improvement and target that one area using the type of tool illustrated on the next slide.
9Dysexecutive Syndrome ImpulsivenessPoor social judgmentDifficulty interpreting other’s behaviorPerseverationPoorly regulated attentionDisorganizedIneffective planningDecreased flexibilitySlowed processesLimited divergent thinkingConcrete thinkingLimited problem solvingWeak self-monitoringReduced attention
10Metacognitive Strategies Self-regulation (“Self-talk” or Social Stories) A repeated phrase or narrative to help guide the student through a specific task – Student Planner:Model how to use this with the student, share it with the parents/guardian, and provide opportunities to practice. The first social story used requires the greatest amount of training.
11I need to write my home work in my planner. Today is Monday, find the Monday column.This is math class; find the row for math on Monday.Look at the “homework” section on the marker board.Copy the homework neatly on Monday/Math.Have my teacher (or study buddy) check it for me.Carol Gray
12Examples of External Aids A student may take 15 minutes trying to start but perceive that it has only been 1 or 2 minutes.Time ManagementKitchen or digital timersDay plannersTask SpecificChecklist (homework, materials, readiness routines)Color coding/labelingSet up all classroom binders exactly the same
13Great Job! Keep working hard! Homework Helper1. Pull out homework list (planner…etc.)2. Make homework list in priority order3. Start working now! Start my timer.a. Find book, worksheet, & pencil.b. Read directions.c. Ask for help only if you need it.4. Turn in completed work!Great Job! Keep working hard!
14Examples of Metacognitive Strategies Self-monitoring of AttentionMonitoring progress and/or success during an activityStep-by-step task-specific checklist can be used to support difficult tasksMay include error checking and motivation on the checklistsStudent self rates success during and after task and documents successful strategiesCurrent 8th grade male student who recently talked about his progress since the beginning of 7th grade related to motivation and quality of work.
15The On-task Traffic Light!! Red LightStop!! Am I doing what I am supposed to be doing?Yellow LightLook! What should I be doing instead?Green LightGo!! Choose a new direction and move forward!Secret signal: If I tap on your desk, you need to use your traffic light process.
16Examples of Environmental Modification-Physical Set up Seating – have the same seating in all classrooms if possible…i.e. front right side.Sound management – ear plugs or head setDistraction management – no irrelevant itemsThe more that a student’s environment is standardized across classrooms, the easier it is to focus on instruction in each class.
17Examples of Environmental Modification-Physical Set up Structure task in step-by-step format.Give one portion of a task at a time.Single step instructionsRoutinize tasks.Put time estimates at the top of the paper.Assign a peer buddy.
18Natural SupportModify instruction style to accommodate individual student.Facilitate a supportive social environment.School counselors are a great resource to engage classmates in creating a supportive climate.Work towards common expectations and practices between home and school.Supportive social environment – Students with TBI behave in ways that can push other students away or leave them isolated. The staff may have to engineer classmate support.
19Combination Approaches External Aid + Metacognitive PracticeDigital timer combined with self-talkNatural Supports + External AidClassroom/school-wide culture and assignment completion systemEnvironmental Modification + MetacognitiveTask accommodation and self-advocating for helpModel how to self-advocate & allow practice“The time has started, I have to start now.”
20Memory Short term memory is broken. Try carrying water using a tea strainer to better understand their frustration.You look at the board, say in your head what you need to write down, look down at your paper….what was that again?Provide the aids necessary to compensate.Lecture notesCompleted graphic organizersDo a demonstration of a volunteer trying to use the strainer to transfer water.
21Attention and FocusStudents remember the beginning and end of a lesson.Chunking limits the forgotten middle.Break up the lesson with physical activities.Sensory dietCrossing the midline engages both sides of the brain and causes both sides to communicate.
22Situational Teachers Motivation Capability What does each person need today for that specific task?MotivationCapabilityHigh CapabilityLow MotivationNeeds encouragementLow CapabilityNeeds instruction and encouragementHigh capabilityHigh motivationNeeds autonomyLow capabilityNeeds instructionThe purpose of this model is to get teachers to recognize that different people need different aids in order to be successful. This is about treating students equitably. Kids with broken legs leave class early but that does not mean that everyone gets to leave early.
23Behavior Behavior is communication; am I listening to understand? What is being communicated?I don’t know what I’m supposed to be doing.I don’t know how to do the work.I count using my fingers and can’t remember my multiplication facts, and you want me to do what?I don’t want to look like an idiot; I’d rather just be in trouble.
24There are Two Plans Plan A Plan B Oh, let’s just sporadically provide individualized instructions and make on-the-fly adjustments and hope it works.Plan BObserve behavior, think through intervention options, systematically apply the most feasible option, evaluate to determine effectiveness, make purposeful modifications.
25Summary Everyday Instruction – Effective teaching model Executive Functioning – Select the most needed target.Memory – Provide aids as needed.Attention and Focus – Chunking and physical activityBehavior – What is this kid saying?