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Traumatic Brain Injury (updated April 2000)

What information is available on teaching students with traumatic brain injuries (TBI)?

A traumatic brain injury (TBI) is an injury to the brain caused by the head being hit by something or shaken violently. This injury can change how the person acts, moves, and thinks. A traumatic brain injury can also change how a student learns and acts in school.

The term TBI is used for head injuries that can cause changes in one or more areas, such as: thinking and reasoning, understanding words, remembering things, paying attention, solving problems, thinking abstractly, talking, behaving, walking and other physical activities, seeing and/or hearing, and learning.

When children with TBI return to school, their educational and emotional needs are often very different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes. The child's family, friends, and teachers also recall what the child was like before the injury. These other people in the child's life may have trouble changing or adjusting their expectations of the child. The following tips may assist teachers in working with these students:

  • Find out as much as you can about the child's injury and his or her present needs. Find out more about TBI.
  • Give the student more time to finish schoolwork and tests.
  • Give directions one step at a time. For tasks with many steps, it helps to give the student written directions.
  • Show the student how to perform new tasks. Give examples to go with new ideas and concepts.
  • Have consistent routines. This helps the student know what to expect. If the routine is going to change, let the student know ahead of time.
  • Check to make sure that the student has actually learned the new skill. Give the student lots of opportunities to practice the new skill.
  • Show the student how to use an assignment book and a daily schedule. This helps the student get organized.
  • Realize that the student may get tired quickly. Let the student rest as needed.
  • Reduce distractions.
  • Keep in touch with the student's parents. Share information about how the student is doing at home and at school.
  • Be flexible about expectations. Be patient. Maximize the student's chances for success.

Following are links to related Internet resources, and Internet discussion groups, as well as selected citations from the ERIC database and the search terms we used to find the citations.

You can search the ERIC database yourself on the Internet through either of the following web sites:

ERIC Citations

The full text of citations beginning with an ED number (for example, EDxxxxxx) is available:

  • In microfiche collections worldwide; to find your nearest ERIC Resource Collection, point your web browser to: http://ericae.net/derc.htm.
  • For a fee through the ERIC Document Reproduction Service (EDRS): http://edrs.com, service@edrs.com, or 1.800.443.ERIC. (no longer available)

The full text of citations beginning with an EJ number (for example, EJxxxxxx) is available for a fee from:

ERIC Search Terms Used

head injuries


neurological impairments

ED359687 EC302247
Traumatic Brain Injury: The Role of Schools in Assessment.
Carter, Susanne
Western Regional Resource Center, Eugene, OR. May 1993 45p.
Sponsoring Agency: Office of Special Education and Rehabilitative Services (ED), Washington, DC.
Contract No: HO28-A10013
EDRS Price - MF01/PC02 Plus Postage.
Language: English
Geographic Source: U.S.; Oregon
Journal Announcement: RIEDEC93
Target Audience: Practitioners; Policymakers
This monograph attempts to provide an overview of current educational issues that affect brain-injured students with special emphasis on the assessment process. An introduction notes recognition of traumatic brain injury (TBI) and its definition under the Individuals with Disabilities Education Act of 1990 as well as the increasing numbers of such students in the schools (as their survival rate increases). Typical causes and consequences of TBI at different age levels as well as categories of severity are considered in the next section. A typical recovery sequence following TBI is then discussed as are differences between TBI students and other students with disabilities. The following section stresses the importance of the school's role and educational interventions in helping such children gain reassurance that achievement is again possible. The major section on assessment addresses the following aspects: early intervention/coordination, nature of the assessment, the neuropsychological evaluation, neuropsychological assessment instruments, test observations, informal assessments/observations, assessment timing, other factors relating to assessment, and financial responsibilities. The final two sections look at implications for the recovering student and implications for school responses to recovering students.
Descriptors: Age Differences; Definitions; Early Intervention; Educational Legislation; Elementary Secondary Education; *Evaluation Methods; Federal Legislation; *Head Injuries; Informal Assessment; Measures (Individuals); *Neurological Impairments; *Neuropsychology; School Role; Student Characteristics; *Student Evaluation; Tests
Identifiers: Individuals with Disabilities Education Act

EJ532370 EC614653
Children and Adolescents with Traumatic Brain Injury: Reintegration Challenges in Educational Settings.
Clark, Elaine
Journal of Learning Disabilities, v29 n5 p549-60 Sep 1996 Special series on traumatic brain injury.
ISSN: 0022-2194
Language: English
Journal Announcement: CIJMAR97
Target Audience: Practitioners
The school reentry of students with traumatic brain injury (TBI) is discussed, focusing on federal legislation requirements, TBI characteristics, assessment methods, the range of services that need to be considered, problems affecting students' academic and social functioning, need for a school team approach, schedule for reintegration planning, the need for inservice training on head injury, and a case study.
Descriptors: Academic Achievement; Case Studies; Educational Legislation; Elementary Secondary Education; Evaluation Methods; Federal Legislation; *Head Injuries; Inservice Teacher Education; Interpersonal Competence; *Intervention; *Neurological Impairments; *Reentry Students; Rehabilitation; Student Characteristics; *Student Evaluation; Symptoms (Individual Disorders); Teamwork; *Transitional Programs

ED409673 EC305717
Integrating Community Resources.
Courtney, Linda J., Ed.
Institute for Rehabilitation and Research, Houston, TX. Sep 1994 317p.
Sponsoring Agency: Rehabilitation Services Administration (ED), Washington, DC.
Contract No: H128A00019
ISBN: 1-882855-30-2
Available From: HDI Publishers, P.O. Box 131401, Houston, TX 77219; toll-free telephone: 800-321-7037; fax: 713-681-9595 ($16.50).
EDRS Price - MF01/PC13 Plus Postage.
Language: English
Geographic Source: U.S.; Texas
Journal Announcement: RIEDEC97
This manual is designed to provide resource managers, advocates, and social service personnel with information about the integration of community services for persons with traumatic brain injury (TBI). The materials encompass the values of independence, productivity, and integration in the delivery of resources and services to persons with TBI. Each of the 12 informational sections begins with an outline of the goal and objectives of the included material. The beginning section provides an overview of TBI, followed by sections addressing the following issues: (1) attitudinal and language barriers; (2) employment issues for persons with TBI, including the implications of the Americans with Disabilities Act; (3) necessary supports for independent living for persons with TBI; (4) housing for persons with disabilities, including funding and legal issues; (5) Social Security Administration programs for persons with TBI; (6) state vocational rehabilitation agencies and their implications for persons with TBI; (7) community based services and resources for persons with TBI; (8) substance abuse issues for persons with TBI; (9) sexuality and brain injury; (10) a checklist for writing neuropsychological reports in functional terms for vocational rehabilitation; and (11) motor vehicle driving evaluation issues for persons with TBI. An appendix includes information summary sheets designed for slide presentations.
Descriptors: Adults; *Community Programs; Employment; Etiology; Evaluation Methods; *Head Injuries; Housing Needs; *Independent Living; *Integrated Services; *Neurological Impairments; Neuropsychology; Sexuality; State Agencies; Substance Abuse; Traffic Safety; *Vocational Rehabilitation; Welfare Services
Identifiers: Americans with Disabilities Act 1990; Social Security Disability Insurance; Supplemental Security Income Program

EJ534174 EC614996
How Education Should Respond to Students with Traumatic Brain Injury.
D'Amato, Rik Carl; Rothlisberg, Barbara A.
Journal of Learning Disabilities, v29 n6 p670-83 Nov 1996
ISSN: 0022-2194
Language: English
Journal Announcement: CIJAPR97
Target Audience: Practitioners
This article focuses on the educational implications of traumatic brain injury (TBI). It considers conceptual issues of TBI and discusses how assessment of this group differs from assessment of other groups. It offers an integrated intervention approach which attempts to bring order to students' life experiences, called the S.O.S. (Structure, Organization, and Strategies).
Descriptors: Classroom Techniques; Elementary Secondary Education; Evaluation Methods; *Head Injuries; Intervention; *Neurological Impairments; *Remedial Instruction; *Student Evaluation; *Student Needs; Teaching Models

ED346691 EC301306
Traumatic Brain Injury: An Educator's Manual. Revised Edition.
Fiegenbaum, Ed, Ed.; And Others
Oregon State Dept. of Education, Salem. Special Education Section.; Portland School District, Oreg. Special Education Dept. 1991 99p.
Available From: Oregon Department of Education, Publications Sales Clerk, 700 Pringle Parkway, S.E., Salem, OR 97310-0290 (free).
EDRS Price - MF01/PC04 Plus Postage.
Language: English
Document Type: TEACHING GUIDE (052)
Geographic Source: U.S.; Oregon
Journal Announcement: RIENOV92
Government: State
Target Audience: Practitioners; Teachers
This manual for the Portland (Oregon) Public Schools presents basic information on providing educational services to children with traumatic brain injury (TBI). Individual sections cover the following topics: the brain, central nervous system and behavior; physical, psychological and emotional implication; traumatic brain injury in children versus adults; a proposed federal definition of TBI; incidence of traumatic brain injury; rehabilitation; typical recovery sequence following TBI; school reentry; serving the student with TBI; teaching strategies summary; school psychologists and the assessment of TBI (including a table of measures sensitive to neuropsychological domains); educational needs of the student with TBI; designing the individualized educational program; modifying the education environment; modifying the elementary classroom; and modifying the secondary classroom. A glossary defines 20 terms and a resource list identifies eight national, state, or local organizational resources. Appendices include a proposed bill of rights for the brain injured, 3 different coma assessment scales, 16 references, and neurological diagrams.
Descriptors: Classroom Design; Classroom Techniques; Definitions; Educational Needs; Elementary Secondary Education; *Head Injuries; Incidence; Individualized Education Programs; Mainstreaming; *Neurological Impairments; Neurology; Neuropsychology; Rehabilitation; Student Evaluation
Identifiers: Portland School District OR

ED387965 EC304319
Home/School Support for Families and Children with Traumatic Brain Injury. Final Report.
Glang, Ann; And Others
Oregon Research Inst., Eugene. Mar 1993 248p.; For individual report components separately analyzed, see EC 304 320-323. Appendix D: "Stress Management Manual" is not included.
Sponsoring Agency: Special Education Programs (ED/OSERS), Washington, DC.
Contract No: H086P90023
EDRS Price - MF01/PC10 Plus Postage.
Language: English
Document Type: PROJECT DESCRIPTION (141)
Geographic Source: U.S.; Oregon
Journal Announcement: RIEMAR96
This final report describes the Traumatic Brain Injury (TBI) Home/School Support project, an Oregon project which attempted to decrease stress in parents caring for school-aged children with TBI and to provide support to schools serving students with TBI. During its 3 years of development, the project involved over 50 families of children, ages 5-21, who had experienced a severe traumatic brain injury. In addition, nearly 200 educators throughout Oregon received inservice training and technical assistance. The multi-faceted model on which the project was based included both school-centered and child-centered goals focusing on issues in instructional planning and community participation. The model provided for coordinated family services from the Oregon Head Injury Foundation, a community psychology clinic, a parent-run respite care organization, and a public school-based information and referral program. Results of the project indicated that a combination of coordinated school/home efforts, respite care, case management, and parent training and counseling were of significant assistance to the parents of children with TBI. This report has sections on the project's goals and objectives, conceptual framework, the model and its participants, logistical problems and modifications, findings, impact, and sources of further information. Extensive appendices include articles and book chapters: "A Comparison of Two Psychosocial Interventions for Parents of Children with Acquired Brain Injury: An Exploratory Study" (George H. S. Singer and others); "Comprehensive Family Support for Behavioral Change in Children with Traumatic Brain Injury" (Joseph M. Lucyshyn and others); "Helping Parents Negotiate the School System" (Ann Glang and others); "Tailoring Direct Instruction Techniques for Use with Elementary Students with Brain Injury" (Ann Glang and others); "Training an Interdisciplinary Team in Communication and Decision-Making Skills" (Elizabeth Cooley); "Using Direct Instruction with Brain Injured Students" (Ann Glang and others); and "'You Can't Imagine Unless You've Been There Yourself': A Report on the Concerns of Parents and Children with Acquired Brain Injury" (George H. S. Singer and Charles Nixon). A retreat planning outline, a knowledge quiz, and a teacher questionnaire are also attached.
Descriptors: Community Programs; Delivery Systems; Demonstration Programs; Elementary Secondary Education; Family Programs; *Family Relationship; *Family School Relationship; *Head Injuries; Inservice Teacher Education; *Intervention; Models; *Neurological Impairments; Respite Care; School Community Programs; *Stress Management; Stress Variables; Technical Assistance
Identifiers: Family Needs; *Oregon

ED377664 EC303593
Barriers to Serving Children with Traumatic Brain Injury in the Public Schools: Problems and Solutions.
James, Elizabeth Murdoch; Reynolds, Cecil R.
[1994 28p.; Paper presented at the Annual Convention of the National Association of School Psychologists (26th, Seattle, WA, March 4-5, 1994).
EDRS Price - MF01/PC02 Plus Postage.
Language: English
Geographic Source: U.S.; Utah
Journal Announcement: RIEMAY95
Target Audience: Practitioners
Traumatic brain injury (TBI) is a federally recognized disabling condition which involves behavioral and academic difficulties. Dysfunction varies with the type and location of injury and with the age of the child. School personnel traditionally have had little exposure to TBI, and there is great potential for problems to occur due to lack of knowledge of legal requirements, miscommunication, and territoriality issues. Assessment procedures, including tests of intelligence, academic achievement, and social/emotional functioning, are conducted by a multidisciplinary team to determine the special services that may be needed. Determination of appropriate placement should be dependent upon individual characteristics of the child. Individualized Education Program objectives should be developed initially for achievement over short periods of time, to best chart recovery of function and modify the program to suit the child's needs. Parental input should be actively sought and used when constructing objectives. Modifications in teaching style and methods, testing, behavior management techniques, length of lessons and homework assignments, and student expectations may be necessary. Suggestions are offered to help schools adjust to the TBI child, and a table lists barriers to serving children with TBI.
Descriptors: Classroom Techniques; *Educational Strategies; Elementary Secondary Education; Evaluation Methods; *Head Injuries; Individualized Education Programs; Intervention; Mainstreaming; *Neurological Impairments; Parent Participation; Student Characteristics; Student Evaluation; Student Placement; *Symptoms (Individual Disorders)

EJ534170 EC614992
Interventions for Students with Traumatic Brain Injury: Managing Behavioral Disturbances.
Kehle, Thomas J.; And Others
Journal of Learning Disabilities, v29 n6 p633-42 Nov 1996
ISSN: 0022-2194
Language: English
Journal Announcement: CIJAPR97
This article discusses behavioral sequelae common in children and adolescents following a traumatic brain injury (TBI) and the design of intervention strategies. Emphasis is on the unique needs of these students and the cognitive sequelae of TBI (such as impaired attention, reasoning, learning, and memory) that can cause further behavioral problems and interfere with interventions.
Descriptors: *Behavior Change; Behavior Patterns; *Behavior Problems; Cognitive Ability; Elementary Secondary Education; *Head Injuries; *Intervention; *Neurological Impairments; Psychological Characteristics; Student Needs

ED341172 EC300845
Traumatic Brain Injury: What the Teacher Needs To Know.
Pieper, Betty
New York State Head Injury Association, Albany. 1991 22p.; For related documents, see EC 300 846-849.
Sponsoring Agency: National Inst. on Disability and Rehabilitation Research (ED/OSERS), Washington, DC.
Contract No: HI-33A80023
EDRS Price - MF01/PC01 Plus Postage.
Language: English
Geographic Source: U.S.; New York
Journal Announcement: RIEJUN92
Government: State
Target Audience: Teachers; Practitioners
Intended for use by the classroom teacher, this guide presents teaching suggestions as well as suggested resources for teaching children with traumatic brain injuries (TBI). Emphasis is placed on working with the injured family and the importance of planning for transition and re-entry into the classroom through a continuum of settings. Teachers are encouraged to become informed about TBI because of their direct service role, the high incidence of TBI, and the recognition of TBI in public law. Common problems associated with TBI are identified and include: impaired memory, attentional deficits, visual field losses, confusion and hesitancy in word finding, and behavioral problems. Also discussed are identification of the TBI child, assessment (by a neuropsychologist and others), teaching methods which capitalize on the child's strengths, and the educational problem of deciding whether to retrain, remediate, or compensate. Descriptions are given of successful teaching strategies which may involve retraining or developing thinking processes, developing compensatory skills, coaching the thinking process, and applying behavioral principles and strategies. Three references and 13 suggested resources are included. Appendices provide information summaries, a glossary, and teaching models.
Descriptors: Cognitive Processes; Elementary Secondary Education; Family Involvement; Handicap Identification; *Head Injuries; Learning Problems; Mainstreaming; *Neurological Impairments; *Neuropsychology; Parent Teacher Cooperation; Remedial Instruction; *Student Characteristics; Student Evaluation; *Teacher Role; *Teaching Methods; Thinking Skills; Transitional Programs

EJ464015 EC605882
Educational Considerations in Traumatic Brain Injury: The Role of the Speech- Language Pathologist.
Russell, Nancy K.
Language, Speech, and Hearing Services in Schools, v24 n2 p67-75 Apr 1993
ISSN: 0161-1461
Language: English
Journal Announcement: CIJOCT93
Target Audience: Practitioners
This article clarifies the role of the speech-language pathologist in service provision to students with traumatic brain injury (TBI). It addresses variables to be considered in service provision, cognitive deficits that interfere with speech and language function, types of speech and language deficits following TBI, and guidelines for assessing speech and language function.
Descriptors: Cognitive Ability; Elementary Secondary Education; *Head Injuries; *Language Handicaps; Language Skills; *Neurological Impairments; *Speech Evaluation; Speech Pathology; Speech Skills; *Speech Therapy; Staff Role; Student Characteristics; Student Evaluation; Therapists

ED377613 EC303540
Traumatic Brain Injury and Special Education: An Information Resource Guide.
Stevens, Alice M.
Oct 1994 43p.
EDRS Price - MF01/PC02 Plus Postage.
Language: English
Document Type: BIBLIOGRAPHY (131)
Geographic Source: U.S.; Indiana
Journal Announcement: RIEMAY95
Target Audience: Practitioners
This resource guide of annotated references on traumatic brain injury (TBI) was created to help educators locate information from such disciplines as neurology, neuropsychology, rehabilitation, and pediatric medicine. Twenty-four resources published from 1990 to 1994 are listed, with annotations. The resources include research reports/reviews, edited books, conference presentations, textbooks, and journal articles. A conclusion points out that the integration of the medical, rehabilitation, and educational perspectives is necessary for the TBI student to function at the highest level possible. The conclusion encourages special educators to use single case research designs to contribute to knowledge of TBI students in the school setting. Appendices list characteristics of TBI student which affect school functioning, Rancho Los Amigos levels of cognitive functioning, names and addresses of 10 resource organizations, and data about the literature search that was conducted to identify the 24 resources.
Descriptors: Educational Strategies; Elementary Secondary Education; *Head Injuries; *Intervention; *Neurological Impairments; *Rehabilitation; *Special Education

EJ491160 EC609690
Collaborative Intervention in Schools after Traumatic Brain Injury.
Szekeres, Shirley F.; Meserve, Nancy F.
Topics in Language Disorders, v15 n1 p21-36 Nov 1994
Theme Issue: Collaboration in Assessment and Intervention after TBI.
ISSN: 0271-8294
Language: English
Journal Announcement: CIJFEB95
This article discusses principles and procedures of collaborative intervention in delivering educational services for children with traumatic brain injury (TBI). The article presents examples of metacognitive-communicative intervention that can be carried out through collaboration across the school day and describes episodes of collaborative intervention implemented by speech language pathologists, teachers, families, and children.
Descriptors: Cooperation; Cooperative Planning; Delivery Systems; Elementary Secondary Education; *Head Injuries; *Intervention; Metacognition; *Neurological Impairments; *Speech Language Pathology; *Teamwork
Identifiers: *Collaborative Teaching; *Traumatic Brain Injury

EJ445808 EC603123
Traumatic Brain Injury: An Overview of School Re-Entry.
Tucker, Bonnie Foster; Colson, Steven E.
Intervention in School and Clinic, v27 n4 p198-206 Mar 1992
ISSN: 0001-396X
Language: English
Journal Announcement: CIJOCT92
Target Audience: Practitioners
This article presents a definition of traumatic brain injury (TBI); describes problem behavioral characteristics of students post-TBI and some possible solutions; examines academic, social, emotional, and cognitive factors; and outlines interventions to assist teachers in working constructively with TBI students.
Descriptors: Behavior Change; Behavior Problems; Classroom Techniques; Elementary Secondary Education; *Head Injuries; Influences; *Intervention; *Neurological Impairments; Reentry Students; *Student Characteristics

ED373475 EC303243
Traumatic Brain Injury: When Children Return to School.
Williams, Dennis [1994 27p.; For a related document, see EC 303 244.
EDRS Price - MF01/PC02 Plus Postage.
Language: English
Geographic Source: U.S.; Washington
Journal Announcement: RIEJAN95
Target Audience: Practitioners; Counselors
This guide addresses issues concerned with the reintegration of students with traumatic brain injuries (TBI) into the classroom. It first provides a definition of TBI and identifies characteristics of students with TBI. The guide then discusses cognitive consequences of TBI, with emphasis on deficits of executive function, attention, and memory. Seven guidelines for classroom management of students with executive function deficits follow. A common timetable for regaining attentional skills is offered and goes from "ability to focus attention at all" through "ability to sustain attention" and finally "ability to divide attention." The variety of disturbances of memory processes is discussed as is the relationship between metamemory and working memory. One section provides specific recommendations for school re-entry such as establishment of a school team and avoidance of certain words and phrases in describing the TBI child. The role of the school psychologist in assessment of TBI children is addressed, and specific tests and subtests are recommended. Guidelines are offered for managing behavior problems (such as agitated behavior and inappropriate sexual behavior), cognitive disturbances, and problems of attention and control. The final section considers the use of compensatory systems and accommodative techniques to manage organizational and memory deficits.
Descriptors: *Attention Control; Attention Span; *Behavior Change; Behavior Problems; *Classroom Techniques; *Cognitive Processes; Definitions; Elementary Secondary Education; *Head Injuries; Intervention; Memory; Metacognition; *Neurological Impairments; Rehabilitation; Student Characteristics; Symptoms (Individual Disorders)
Identifiers: *Behavior Management

ED373520 EC303289
Educator Guidelines for Serving Students with Traumatic Brain Injuries. Revised Edition.
Utah State Office of Education, Salt Lake City. Special Education Services Unit.; Utah State Univ., Logan. Mountain Plains Regional Resource Center. Aug 1993 99p.
Sponsoring Agency: Special Education Programs (ED/OSERS), Washington, DC.
Contract No: HO28A30009
EDRS Price - MF01/PC04 Plus Postage.
Language: English
Geographic Source: U.S.; Utah
Journal Announcement: RIEJAN95
Government: State
Target Audience: Practitioners
These guidelines were developed for serving students with traumatic brain injury (TBI) in school settings. An introduction reviews the frequency of TBI, range of severity, and legal responsibility for special education services. Guidelines are offered for creating prevention and awareness programs and for implementing staff development. A section on service options discusses identification, re-entry into regular education, special education evaluation, and an Individualized Education Program for students diagnosed with TBI. Procedures for providing student transportation are outlined. Sample forms are offered, such as a re-entry preplanning worksheet, medication procedures, training requirements of staff, and suggestions for classroom accommodations. A resources list provides information on Utah and national agencies and support groups, books and articles, and videos. A glossary and list of acronyms are also presented.
Descriptors: Elementary Secondary Education; *Guidelines; *Head Injuries; Incidence; *Intervention; Legal Responsibility; *Neurological Impairments; Records (Forms); Staff Development; *Student Evaluation; Transportation
Identifiers: Utah

The following book on traumatic brain injury can be obtained from your local book store or public library, or directly from the publisher: Children with Traumatic Brain Injury: A Parents' Guide: A Parents' Guide. Edited by Lisa Schoenbrodt. Available from: Woodbine House, 6510 Bells Mill Road, Bethesda, MD 20817-1636. 800.843.7323. http://www.woodbinehouse.com

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