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Understanding Students with Traumatic Brain Injury. Defining Traumatic Brain Injury. Traumatic brain injury (TBI) is an acquired injury caused by external physical force Two types of TBI: Closed head injury Open head injury
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Defining Traumatic Brain Injury • Traumatic brain injury (TBI) is an acquired injury caused by external physical force • Two types of TBI: • Closed head injury • Open head injury • Does not include congenital, infections, degenerative, or birth trauma • http://www.youtube.com/watch?v=AmAML1-F2LE&feature=related
Prevalence of TBI • In fall 2006, 23,967 students (0.4% of students 6-21 in special education) • Other prevalence data indicate the effects to TBI • 1.1 million Emergency department visits each year • 235,000 hospitalizations • 50,000 deaths • Males are approximately 1.5 times as likely to sustain a TBI as a females • Highest risk groups: birth to four years of age and 15-19 years of age • 10% are severe, 10% moderate and 80% mild
Characteristics • Characteristics will vary according to: • Site and extent of injury • Length of time student was in a coma • Student’s maturational stage at the time of injury • Possible changes due to TBI: • Physical • Cognitive • Linguistic • Behavioral, emotional, and social
Phineas Gage • http://www.youtube.com/watch?v=X4fGlny5cPg
Determining the Causes • Accidents • Most are motor vehicle • Falls • Assaults • Firearm (2/3 are suicide attempts) • Child abuse • Shaken-baby syndrome • Sports and recreational injuries
Determining the Presence • Evaluation must be comprehensive and ongoing • Glasgow Outcomes Scale classifies injuries into broad groups: • Death • Persistent vegetative state • Severe disability • Moderate disability • Good recovery
Determining the Nature of Specially Designed Instruction and Services • Students with TBI need frequent evaluation and re-evaluation • Classroom observation checklist • Memory • Attention and concentration • Executive functioning • Self-awareness • Language
Partnering for Special Education and Related Services • For successful hospital to school transitions: • Involve educators during hospital stay • Keep school personnel updated on student medical progress • Make the time for homebound instruction as short as possible • Frequently monitor the student’s progress after re-entry • Assign someone to be the point person for coordinating the transition
Determining Supplementary Aids and Services • Teaching memory aids, including: • Following a routine schedule • Keeping appointments that are not routine • Taking medication • Remember to perform a new task • Marking when to start or end a task • Using technology; visual assistants; PDA’s; pagers/digital beepers, electronic watchers; There is an App for that!
Planning for UDL • Instructional Pacing • Appropriate instructional pacing • Frequent student responses • Adequate processing time • Monitoring responses • Frequent feedback
Early Childhood Students • Collaborate teaming • Partner to achieve a shared goal • Believe that all team members have unique and needed expertise and skills, and value each person’s contribution • Distribute leadership through the team • Five components of collaborative teaming • Building team structure • Learning teamwork skills • Taking team action • Teaching collaboratively • Improving communication and handling conflict
Elementary and Middle School Students • Cooperative learning strategies • Positive interdependence • Individual accountability • Several ways to structure cooperative learning groups for group success • Group size • Detailing each student’s individual task • Peers holding one another accountable
Secondary and Transition Services • Problem-solving • Problem identification • Problem explication or definition • Solution generation • Decision making • Identify relevant alternatives or options • Identify consequences of alternatives • Identify probability of each consequence • Determine the importance placed on each value or alternative • Integrate values and consequences to select preferred option
Measure student progress • Analytical rubrics • Like directly to specific content and student achievement standards • Focus on only one dimension of student performance (i.e., legibility versus content knowledge) • There should be enough points in the scale to adequately judge, but no so many as to confuse the issue • Focus on specific outcomes rather than a process • Provide students with information about the rubrics and examples of high quality performance
Measuring Student Progress • Progress in addressing other educational needs • Perceptual-motor skills coordinate visual and sensory input with motor activities • Bender-Gestalt Visual Motor • Collaboration with other professionals • Making accommodations for assessment • Test item construction • The use of a scribe