Traumatic Brain Injury
A traumatic brain injury is defined as an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.”
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Types of Traumatic Brian Injuries:
- Closed Head Injury- the skull is intact and there is no penetration of the skull. Direct or indirect force to the head can cause this type of injury. This may be caused by rotational and/or deceleration in the case of both direct and indirect force.
- Open Head Injury- penetration of the skull with direct injury to the head.
- Diffuse Axonal Injury- diffuse cellular injury to the brain from rapid rotational movement. This is often seen in motor vehicle accidents or shaking injuries. The axons are the projections of the brains nerve cells that attach to other nerve cells. They are damaged or torn by the rapid deceleration. The injury is from the shearing force disrupting the axons which compose the white matter of the brain.
- Contusion- a bruise to a part of the brain. Like a bruise on the body, this is bleeding into the tissue.
- Penetrating Trauma- any object that enters the brain. Causes direct injury by impact and pushing skull fragments into the brain
- Secondary Injury- swelling and release of chemicals that promote inflammation and cell injury or death. This causes swelling in the brain which may increase the intracranial pressure and prevent the cerebrospinal fluid from draining out of the skull. This causes further increase in pressure and brain damage. If this is not controlled or prevented the brain can herniate (push through) the base of the skull and cause respiratory failure and death. The only way to prevent the primary injury is to prevent the trauma. The prevention of this secondary injury is the focus of the acute medical care after injury.
- Intracranial hemorrhage (bleeding inside the skull)
- Brain swelling
- Increased intracranial pressure (pressure inside the skull)
- Brain damage associated with lack of oxygen
- Infection inside the skull, common with penetrating trauma
- Chemical changes leading to cell death
- Increased fluid inside the skull (hydrocephalus)
Areas affected by a brain injury:
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Educational support:
- Communication and collaboration are essential for the transition from the hospital to the school environment.
- Educational services must be tailored to a student’s specific needs.
- Efforts should be directed at improving students’ general behaviors such as problem solving, planning, and developing insight.
- Use assistive technology devices to aid in communication, learning, information processing, and recreation.
- IEP’s should be reviewed every 6 to 8 weeks to make adjustments based on the growth of the students. Most students will make the most gains within the first year of their accident and will make little progress thereafter.
Tips for the General Education Teacher:
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Accommodations/Environmental Resources:
- Study guide
- Pictures
- Homework book or planner
- Teach memory strategies
- Scribe or note-taker
- Modify work amounts
- Provide feedback
- Classroom aides
- Avoid over-reactions
- Routine and schedules
- Simple and concrete language
- Communication log or book
- Behavior intervention plan
Technology
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