1. Traumatic Brain Injury Created by... Sue Fontaine Tina Gonzalez Sandra Rivera Jayne Stewart EEX 6107 – Dr. Lee Cross Teaching Written & Spoken Language 10/2/2009

2. Characteristics of TBI - Traumatic Brain Injury... cerebral contusions Wikipedia Physical difficulties: headaches seeing hearing other senses... ( smell, sensing hot/cold, etc.) fine motor skills (writing, drawing) spasticity (sudden muscle contraction) fatigue seizures balance paralysis Thinking/Cognition:  short-term memory loss (what was just said)  long-term memory loss (formerly known facts)  short attention span  slow processing skills  slow talking and listening  slow reading and writing  poor planning /judgment  poor sequencing Social, behavioral, or emotional:  sudden change in mood  anxiety  depression  trouble relating to others  restlessness  laughing or crying a lot  lack of motivation  lack of emotional self-control According to the IDEA (2004)...a traumatic brain injury is an acquired injury to the brain...resulting in total or partial functional disability or psycho- social impairment, or both, that adversely affects a child's educational performance.” (Sec. 300.8(c)(12)) CT scan showing Each to a varying degree dependent on the scope of the injury...what part of the brain & how badly NICHCY (2006)

3. Impact of TBI on Language and Speech Development  fluent aphasia...  Patients speak in fluent sentences and use complete grammar... however they display little meaning.  They speak in gibberish  They are usually unaware and become angry that others do not understand  non-fluent aphasia...  Patients have trouble recalling words and speaking in complete sentences.  They speak with frequent pauses and broken phrases.  Patients may be aware and become frustrated. Dysarthia... speech is slurred, slow, and garbled due to damage to the part of the brain that controls the muscles used in speech production Prosodic Dysfunction of intonation and inflection may also have difficulty with: reading, spelling, and writing taking turns maintaining a topic of conversation interpreting subtleties of conversation: body language and nonverbal signals keeping up with others in fast paced conversations Symptoms will vary depending on the extent of damage to the brain as well as the location. Language deficits can lead to miscommunication, confusion, and frustration. Aphasia... difficulty with understanding & producing spoken & written language... www.nursingceu.com/course/213/index-nceu.htmlwww.asha.org/public/speech/disorders/TBI.htm

4. Impact of TBI on Second Language Acquisition Dissociation between ability to perceive and to produce the second language. Disturbance in auditory comprehension of second language may improve with treatment. Language impairment is more severe in the second language... Impairment in naming ability – in all types of naming tasks. Therapy may provide mild improvement. Speech is characterized by...word-finding pauses...paraphasic (speech production) errors...non-fluent speech Written Language... Problems in reading and writing Poor performance in reading Abilities remain comparable to first language Single-word reading Writing in dictation

5. Intervention, Strategies, and Resources for Teachers To progress to the most independent level of language functioning possible... utilize augmentative assistive devices...letter/word/picture boards, portable computers improve their ability to define words or describe actions or events help them express their needs in simple terms If unsure, ask what was meant List directions and number the steps Avoid completing the student’s sentences Provide structured activities & predictable routine Let them know in advance of deviations in routine Integrate/relate new information with old information Avoid conversations in noisy distracting environments Use a visual cue to indicate that important information is coming Allow time to complete his/her thought processes before speaking Train students to prepare mentally when waiting for their turn to speak Simple cues may calm the struggling student trying to retrieve the correct word/s To increase comprehension, present information in the student’s preferred mode of learning...written, auditory, kinesthetic, or a combination TBI Resource Guides www.neuroskills.com/index.shtml www.braininjuryresources.org/speech.html National Resource Center for Traumatic Brain Injury http://www.neuro.pmr.vcu.edu/LINKS/support.htm The Brain Injury Ring w/ chatroom http://www.alliance.net/~jame/bir/bir.htm Perspectives Network database of support groups http://www.tbi.org/ A Kid’s Guide to Brain Injury - ages 6-14 This book can be purchased through the National Resource Center. www.fldoe.org/ese/pdf/trauma.pdfwww.neuro.pmr.vcu.edu//

6. References: IDEA. (2004). US Department of Education. Sec. 300.8(c)(12). Retrieved September 19, 2009 from http://idea.ed.gov/explore/view/ p/%2Croot%2Cregs%2C300%2CA%2C300%252E8%2Cc%2C12%2C NICHCY. (2006). Disability Fact Sheet #18. The National Dissemination Center for Children with Disabilities. Retrieved September 19, 2009 from http://www.nichcy.org/InformationResources/Documents/NICHCY%20PUBS/fs18.pdf Wikipedia. (1989). Photo of CT scan of brain showing cerebral contusions. Retrieved September 19,2009 from http://upload.wikimedia.org/wikipedia/ commons/thumb/8/89/Brain_trauma_CT.jpg/190px-Brain_trauma_CT.jpg Traumatic Brain Injury. (nd). Retrieved September 25, 2009, from http://www.asha.org/public/speech/disorders/TBI.htm Robertson, Laura. (2007). Traumatic Brain Injury Hope Through Research. Retrieved September 25, 2009, from www.nursingceu.com/courses/213/index_nceu.html Traumatic Brain Injury: National Resource Center. (2008). Virginia Commonwealth University. Retrieved from www.neuro.pmr.vcu.edu/ Understanding and teaching students with traumatic brain injury: What families and teachers need to know. (2005). Florida Department of Education: Bureau of Exceptional Education and Student Services. Retrieved from http://www.fldoe.org/ese/pdf/trauma.pdf Ibrahim, R. (2009). Selective deficit of second language: A case study of a brain damaged Arabic-Hebrew bilingual patient. Behavioral and Brain Functions. Retrieved September 28, 2009 from http://www.behavioralandbrainfunctions.com/content/5/1/17

7. Gray Matters