1. Traumatic Brain Injury (TBI) Very Low Incidence Disabilities TLSE 240

2. TBI – IDEA Definition “Acquired injury to the brain caused by an external force that adversely affects a child’s educational performance and results in partial functional disability, psychosocial impairment or both….”

3. Not Covered Brain injuries that are congenital (present at baby’s birth) Anoxia (lack of oxygen to the brain) i.e., choking, stroke or drowning

4. TBI can be due to….. Closed Injury Open Injury

5. Closed Injury Brain whipped back and forth rapidly, causing it to rub against and bounce off the rough, jagged interior of the skull.

6. Closed continued Neurofibers responsible for sending messages to all parts of the body are damaged Stresses brain stem, a relay station Physical, emotional, and cognitive consequences

7. Open Injury Insult to specific area of brain, such as gunshot wound or blow to the head Usually only affects those functions controlled by injured parts

8. Characteristics Unique to individual and injury Can have characteristics similar to LD, MR, ED/BD, Speech Impairments, or Physical Disabilities

9. Areas Typically Affected Cognition Language Memory Attention Reasoning Abstract Thinking Judgment Information Processing Speech

10. Possible Physical Changes Nothing to serious 20% - Seizures; often subside Spasticity or paralysis Coordination problems Physical weakness Fatigue Some strength resumes as brain heals

11. Physical Changes continued Headaches Visual/hearing issues Changes in senses

12. Possible Cognitive Changes Comprehension Problem solving Concentration Long and short term memory Information processing Poor judgment

13. Possible Linguistic Changes Receptive language Written language Aphasia (inability to use language appropriately) Word finding issues Most speech and expression skills are regained

14. Possible Social, Behavioral, and Personality Changes Temper outbursts Euphoria Restlessness Anxiety Irritability 15-25% struggle with depression Poor self-monitoring skills

15. Causes of TBI Accidents ( especially motor vehicle) Falls Violence – related incidents Child abuse Shaken baby syndrome

16. Causes continued Sports and recreational injuries Often mild and go unreported

17. TBI – other facts TBI is the leading cause of death and disability among children and young adults 1 TBI per 15 seconds Males 2x as likely as females Most prevalent 15-24 and 75 and over Alcohol is involved in half of TBI injuries

18. Assessment Medical evaluation CAT Scan identifies large area of bleeding or contusion MRI identifies smaller and subtle brain anomalies PET Scan measures some of the energy- processing functions of the brain. Looks at how certain chemicals are being used by the brain

19. Assessment continued Intellectual skills Academics Memory Language Motor Personality Others

20. Assessment continued Multi-disciplinary team Often on-going to determine changes, improvements, or needs Continued communication with neurological or medical experts

21. Recovery Motor skills return first Rapid progress at first, then slower progress Speech and language issues quickly recovered Higher level skills and complex language skills remain difficult

22. Educational Implications IEP or 504 Plan Various therapies Memory strategies Accommodations and Modifications Social needs

23. Very Low Incidence Disabilities Multiple-Severe disabilities Deaf blindness

24. Multiple - Severe Often cognitive, sensory, and physical disabilities Focus on functional skills Require supports throughout life, usually Group homes Living longer

25. Deaf blindness Often some residual hearing or vision Need considerable supports Often have additional disabilities Less frequently in general education Communication and functional skills