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Im Good Enough, Im Smart Enough and Doggone it, I know TBI Judy L. Dettmer 303-866-4085 judy.dettmer@state.co.us
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School Realities: No school person/program owns TBI: Case manager does not follow TBI Program does not follow TBI Myth of Rehab Center for TBI students: School IS the Rehab Center
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Shades of grey! YOU ARE THE EXPERTS! De-mystify TBI – eligibility is binary. But assessment and treatment of TBI is many shades of grey, red, blue, green… TBI assessment protocol and a TBI intervention protocol – within your creative reach!
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Basic premises Proper Intervention is grounded in a Good Assessment – comprehensive, multi-layered Focus of intervention is on teaching positive replacement behaviors and skills instead of looking at deficits Requires active and continuous teaching on the part of adults Not linear, not circular – its spiral
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MONITOR Evaluate Response to Intervention PLANIdentify Strengths, Strengths,Concerns, & Outcomes TEACH Assign & Implement a Research-based Intervention ADJUST Analyze & Interpret Data Universal Instruction & Problem Solving Model Data Driven Decision Making
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Broad Overview of Issues & Strategies
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Hallmarks of Brain Injury Fatigue Executive Function * Speed of Processing * Memory * Attention * Organization/Planning * Social Emotional
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Strategies for Addressing Fatigue Encourage the student to take rest breaks Be aware that medications a student is taking and time of day they take them can contribute to fatigue Recognize signs when student is overloaded or fatigued. Avoid presenting them with new tasks or information School day may need to be altered or shortened to accommodate fatigue
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Strategies for Addressing Speed of Processing Give the student instructions one at a time, make them clear and concise Provide appropriate wait time for the student to formulate a response to questions asked of him/her
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Strategies for Addressing Speed of Processing Eliminate timed tests Avoid situations requiring multi-tasking When giving instructions, check for comprehension. Have the student verbalize the instruction as well as demonstrate that he/she understands
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Strategies for Addressing Memory Regularly summarize information with the student as it is being given, especially critical in regards to new learning Give instructions in written, verbal and visual format when possible Call on the student with a brain injury first so that they do not forget their responses and are then able to focus on others responses
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Strategies for Addressing Memory Develop checklists/picture schedules with the student that he/she can use to help remember daily schedules, routines, etc. Consistency and time are important, especially when introducing a new strategy Allow the student time to put into practice what was just learned to reinforce learning/memory Modify test format to reduce need for total memory recall, e.g. multiple choice
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Strategies for Addressing Attention Provide the student with an uncluttered environment Eliminate as many auditory and visual distractions as possible Eliminate as many interruptions as possible
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Strategies for Addressing Attention Assign tasks that do not require a lot of divided attention Break task down into manageable steps based on the individuals attention span Provide the student with clear expectations for what he/she is supposed to accomplish during the activity time
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Strategies for Addressing Organization/Planning Assist student with cleaning out desks/locker on a routine basis Develop checklists with the student that he/she can use to help remember daily schedule, routines etc. Help student organize notebooks by using dividers, colored folders, portfolio containers etc.
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Strategies for Addressing Organization/Planning Help student develop and organize a Homework Only folder and check it with him/her at the beginning of each class Check students planner at the end of the day (elementary) or each class (secondary) to ensure that they have written their homework assignments completely and accurately. Have the teacher initial the page so the parents know the planner is correct.
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Strategies for Addressing Social/Emotional Concerns Provide a framework for structure in social situations (e.g., invite a friend over for a specific period of time to do a specific activity) Smal group settings are usually better for a student with a brain injury Use peer buddies as mentors Help the student identify what activities they may enjoy following a brain injury Provide the student with direct and clear feedback
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Most Importantly! Do not assume that the student has the ability to take responsibility for the organizational aspects of his/her education Each person with a brain injury is an individual and therefore a strategy you try with one person may not work with the next Become familiar with the beauty of trial and error but give significant time for a strategy to take hold
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Tools for Interventions LearNet Colorado Kids with BI BrainSTARS What Works Clearing House Casel Cherry Creek School District BEG, BORROW and STEAL!
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LEARNet Problem-Solving System Mark Ylvisaker, Ph.D. 1. Clear statement of the problem in simple, everyday behavioral terms 2. Brainstorm possible explanations: Medical Cognitive Self-regulation Behavioral Emotional
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LearNet 3. Systematic exploration of possible explanations 4. Planning (well thought out and evidence- based) interventions and support Additional considerations: Collaboration Context On-going process
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WWW.cokidswithbraininjury.org Identification and Intervention Protocol Best practices for identification Best practices for assessment Best practices for interventions
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Monk Video
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BrainSTARS Introduction to Brain Injury Brain Injury and Development Problem Solving Index
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Evidence-Based or Research- Based Intervention: What Works Clearinghouse www.whatworksclearinghouse.org CASEL – Collaborative for Academic, Social and Emotional Learning www.casel.orgwww.casel.org Cherry Creek School District, Colorado Wiki www.ccsdrti.pbworks.com
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CASEL 5 domains: Self Awareness Social Awareness Self Management Relationship Skills Responsible Decision Making
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Cherry Creek School District Wiki Systematic Review of Evidence Based or Best Practices Listing of practices endorsed by CCSD Description of area of need and corresponding intervention
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Progress-Monitor Prioritize only 1 to 2 behaviors Write SMART goals Determine a baseline Determine an aimline Determine a time-frame Examples of behavior plans and progress-monitoring: Interventioncentral Chart Dog Excel
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SMART GOALS SMART Goals – Specific Measurable Attainable Realistic Time-limited I do, we do, you do
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Progress-Monitoring A Spiral If intervention is working, wean back and insert more natural supports If intervention is not working: evaluate, brainstorm, and adjust If intervention works, wait and it will morph
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Now Repeat After Me…. Im good enough, Im smart enough and doggone it… I know TBI!
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Questions? TheEnd!
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