Wounded Warriors Service for Those Who Served

1. Presented by the Disability Services Staff Tomma Lee Furst, Kym Kleinsmith Stephanie Giddens and Terry Rowles November 2 & 3, 2011 Wounded Warriors Service for Those Who Served

2. Did you know? • The number of disabled veterans has jumped 25% from 2001, to 2.9 million veterans today. • From 2009 to 2011 there was a 40% increase in veterans ( including disabled veterans) using the GI Bill • Conclusion: Disabled veterans will be on college campuses in increasing numbers

3. Types of Injuries • Amputations • Burns • Post Traumatic Stress Disorder • Traumatic Brain Injury Soldiers have as much as a 40% chance of acquiring PTSD and TBI by the end of their service. PTSD and TBI are becoming the signature wounds of the Iraq and Afghanistan wars.

4. What is PTSD?Post Traumatic Stress Disorder PTSD IS….. • a psychological health injury that can develop in response to exposure to an extreme traumatic event. • a condition that changes the body’s response to stress and affects the stress hormones and chemicals that carry information between the neurotransmitters in the brain.

5. Symptoms of PTSD • “Reliving” the event disrupts day-to-day living • Flashback episodes • Repeated upsetting memories • Repeated nightmares • Strong, uncomfortable reactions to situations that remind you of the event. For example, a door slamming may create a flashback that is related to the sound of gunfire.

6. Symptoms of PTSD (Continued) • Avoidance • Emotional “numbness” or feeling as though you don’t care about anything. • Related medical conditions • Alcohol/drug abuse • Depression • Panic attacks

7. PTSD and Student Issues • Loud noises – door slamming or book dropping may trigger flashbacks or trembling. • Discussion may activate disturbing feelings • Concentration levels are altered • Executive function issues – completing assignments and projects • Group projects – Student may profile as being difficult or “hot headed”

8. PTSD and Student Issues (Continued) • Depression – unable to function on a day-to- day basis • Marital/Family Issues Individuals may experience one or more of the PTSD reactions and PTSD may surface in all areas of the individual’s life.

9. Strategies to Accommodate Students with PTSD • Extend testing time to address concentration issues • Promote time management strategies for handling assignments, large and small. • Study skills strategies – learn how to chunk materials in completing larger projects. • Understanding that on occasion the student may suddenly leave the classroom to reorient.

10. Strategies to Accommodate Students (Continued) • Make time to discuss concerns and be supportive of student issues. • Do not modify coursework or assignments to “give the student a break” • Introduce “hot topics” with some discussion guidelines that are fair, but allow freedom of speech within the class setting. • Refer to the Disability Staff for follow up for appropriate academic accommodations.

11. Traumatic Brain Injury (TBI) External Physical Force Traumatic Brain Injury Open Head Injury Closed Head Injury

12. What Happens to the Brain in Closed Head Injury? • Brain rotates on axis causing stretching and tearing of axons. • Stretching and tearing of vessels results in a hematoma. • Brain strikes skull causing contusion or bruising.

13. Cognitive Effects of TBI • Decreased attention • Decreased information processing • Cognitive Fatigue • Changes in Memory • Decreased Language and Speech Skills • Decreased Executive Function Skills

14. Emotional Effects of TBI • Increased irritability/anger • Emotional responses intensified • Flattened affect • Increased anxiety • Depression

15. Effects on Information Processing and Memory • Poor performance on timed tasks. • Loss of ability to maintain performance after a relatively short time period. • Difficulty managing plans and tasks – confusion when attempting to multi-task. • Recalling routines and learning new routines. • Remembering to follow through.

16. Effects on Insight and Awareness • Inability to recognize deficits and the potential impact on one’s life. • Inability to use knowledge of limitations to alter subsequent behavior. • Inability to anticipate the impact of their behavior on others. • Behavior not directed toward goals • Difficulty deciding the “next step” –action plan

17. Strategies to Accommodate Students with TBI • Establish a realistic time management schedule with the student. • Work with student to maintain a consistent routine for in-class and out-of-class work. • Extended testing time to process information • Note taker in lecture classes • Notes/PowerPoint provided on ANGEL • Use of tape recorders to reinforce material • Chunk assignments into smaller units

18. Strategies (Continued) • Be aware of the possibility of cognitive fatigue and encourage student to reduce course load. • Assist student with organization of material, use of colors, planners, etc. • Provide concrete evidence of progress and give feedback to the student. • Make objectives, goals and requirements of the course clear to the individual.

19. Listen, Observe, and be Patient! • Listen to the student. Respond to student concerns or refer the student for additional support through Disability Services. • Observe any obvious stressors in class that would warrant referral to support services on campus or to Disability Services. • BE PATIENT! – Our Veterans on campus are trying to pull their lives back together and their disability concerns are a result of serving.

20. Thank you for Attending! Sources: U.S. Department of Veteran Affairs: www.va.gov Defense and Veterans Brain Injury Center: www.dvbic.org Brain Injury Association of PA: www.piapa.org Brainline: www.brainline.org National Institute of Neurological Disorders and Stroke: www.ninds.nih.gov All PowerPoint presentation information will be accessible on the Disability Services website. If you have questions please do not hesitate to contact the Disability Services staff located in the Center for Academic Success, Berks Hall room 209.