Traumatic Brain Injury and Education

 Traumatic Brain Injury and Education

What are some of the causes of Traumatic Brain Injury?

How do educators ensure high quality equitable education to students with TBI?  

The human brain is a complex system as it consists of many different and connected parts to make the brain function. The human brain is responsible for all human behaviors, emotions and cognition processes.  Most common causes in ages 0-4 are falls and tumbling down the stairs, motor vehicle accidents and child abuse. Working with a child with TBI is different, because the injury occurs within the context of the brain that’s in the process of developing, so the child is still healing from the injury at the same time that their brain is also developing (2018). 

Since getting back to school is a concern for most parents and children, teachers should team up with parents to develop a plan on how entry to school should happen. Author Julie Bowen states, “Because the recovery process can take several months or even years, many of these children continue to have rehabilitation needs and cognitive impairments and will return to school while still in the recovery stages.” Teachers should gather informative information from parents to determine any modification to curriculum and physical accommodations like wheelchairs, walkers or leg braces. Accommodations for any cognitive issues like attention problems or fatigue can be reduced by sitting closer to the teacher so they can pay attention or giving more frequent rest breaks.

To further accommodate and promote equitable access to learning, educators need to  Identify, acquire  and implement assistive technology that will provide equity in the classroom. When teachers prioritize the needs of all students regardless of any disabilities and create an inclusive environment, they break down the barriers and increase their students' success. As previously mentioned, the recovery process can take months or years. Rehabilitation of cognitive impairments makes learning and communication in the classroom difficult for the child. 

Examples of assistive technology for children with TBI are AAC devices. Assistive technology such as AAC devices in the classroom helps children social emotionally connect to peers and teachers, become productive and independent to participate in their education. There are other tools in assistive technology such as keyboards, switches, pointing devices that can enable the cognitively impaired child to actively interact with the assistive technology in the classroom and at home. TBI in young school aged children requires a careful  formative assessment of each child’s unique needs and examination of their abilities to select classroom interventions designed to meet those needs.

In order to promote children's equitable access, learning and participation across all learning environments an Universal Design for Learning (UDL) classroom and principles is ideal for all children. Multiple means of representation, expression, and engagement are the three guiding principles of the UDL design.  The UDL classroom pays special attention to the physical arrangement of the classroom to assist in mobility and accommodate all physical needs. Students with disabilities may have poor mobility and need accommodations for their physical needs. Free from obstacles with wide walkways for transitions make it easier for all children. Low shelves, labels bins, jumbo writing materials and touch and feel items related to classroom curriculum. To increase participation in learning, teachers should provide a variety of stimulating activities and tools to enhance learning. Use hands-on activities to supplement written material.The use of audio books furnished with nursery rhymes stimulates literacy as well as phonetic awareness.   Representing the UDL principles, teachers provide instruction concepts in multiple ways while offering multiple means of expression and provide the child with options for engagement with learning activities. It is imperative that teachers provide verbal, visual and tactile input for their students and many opportunities to engage in the curriculum through music and movement. 

In order to ensure that all children get what they need, equitable teachers should use evaluation and assessment data daily to inform learning experiences for young children with TBI and those children who are dual language learners. Informal observational assessments such as the Desired Results Developmental Profile (DRDP) measure the learning and social emotional progress of students. Teachers can use the instruments such as DRDP daily to assess and make informed decisions on how best to deliver the curriculum and meet the child cognitively where they are developed. Responding to requests may be delayed  in children with TBI and/or any child learning english. Teachers can use smaller sentences, picture cards, AAC devices and gestures for clarification. English learners may need to point or look for clues from other children to respond. While monitoring with anecdotal notes and assessing individual learning, teachers can determine the transitions and look for any fatigue issues and provide frequent breaks. Strategies such as picture/visual schedules for each time a day, warm-up activities, extra time, modeling, multimodal learning opportunities, preparing children for changes ahead of time and constant praise ensure success and individual pride within the child. Regardless of any disability the interventions that teachers provide daily to support their students with TBI are typically the same as typical children struggling with learning. 

References:

Bowen.J (2021). Classroom Interventions for Students with Traumatic Brain Injuries. https://www.brainline.org/article/classroom-interventions-students-traumatic-brain-injuries

Centers for Disease Control (2010). Retrieved from: www.cdc. gov/traumaticbraininjury/

(2018). Brain Injury in Children and Youth: A Manual for Educators. https://www.cde.state.co.us/cdesped/tbi_manual_braininjury