Traumatic Brain Injury (TBI)

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