1. 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.

2. 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.

3. 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.

4. TBI Categories Moderate
Loss of consciousness for minutes to hours.
Confusion lasts for days or weeks afterwards.

5. TBI Categories Severe
Loss of consciousness for days, weeks, or even longer.

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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.

12. 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

13. 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

15. 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

16. 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

17. 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

18. TBI Strategies ABC Model “A” – Antecedent “B” – Behavior
“C” – Consequence

19. Resources
Brain Injury Association of Minnesota