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  Traumatic Brain Injury or TBI – The IDEA Definition and How Traumatic Brain Injury Impacts School

Connor’s Story – A Child with TBI

AT 8 pounds, 5 ounces Connor was born a very healthy boy. He reached all of his typical developmental milestones on time and by the time he was 5 years old was anxiously awaiting school. Once enrolled Connor excelled, he learned to read and write with ease, he made friends quickly and by most accounts was a leader in his class. By age 8 Connor was already a role model academically, athletically and socially.

Then one day, as Connor was out riding his bike, a passing car hit him. The accident severely broke both an arm and a leg. Even worse, he suffered a traumatic brain injury when his head collided with the pavement. Connor had to spend a few weeks in the hospital while his injuries healed. While there, he re-learned how to complete certain tasks.

Now Connor is back in school. His bones have mended and he looks like every other boy in class. That, however, is part of the problem. Connor now has a hard time with word retrieval, decoding, frustration tolerance and sports. Although he looks like the same boy, he has changed.

Traumatic Brain Injury According to IDEA

Although Traumatic Brain Injury (TBI) is not an everyday topic of discussion, TBI occurs fairly frequently. In fact, according to Principal Leadership and NICHCY, one million children sustain a TBI each year. Thirty thousand of those children, in the US, suffer permanent disabilities from TBI. Given statistics like that, TBI is certainly a topic worth discussing and notable enough for the Individuals with Disabilities Education Act, or IDEA, to include in the law.

IDEA is a federally mandated law outlining how states must educate children with disabilities. There are certain criteria a child must meet in order to receive special education services and early intervention services from their Local Education Agency (LEA). IDEA recognizes 14 specific categories under which these services can be provided.  Traumatic Brain Injury is one of those 14 categories

IDEA defines TBI 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.”

Academic Implications with TBI

Since the brain defines who a person is, the effects of a brain injury are going to vary greatly from person to person. Brain injuries can range from mild to severe, and so can the changes in each person that result from the injury. This means that it’s hard to predict exactly how an individual will recover from the injury, or what they may require as a result. TBI can affect all aspects of a person’s life from mobility to personality. As in Connors case, TBI can effect how a student learns and behaves in school.

Some areas of concern for children with TBI may include:
•    thinking and reasoning (logic),
•    understanding words (receptive language),
•    memory,
•    sequencing events,
•    attention,
•    problem solving,
•    abstract reasoning,
•    talking (expressive language),
•    behavior,
•    depression,
•    gross and/or fine motor activities,
•    blurred vision and/or vision loss,
•    ringing in the ears and/or/ hearing loss
•    slower to respond or react
•    frequent headaches
•    distractions from sounds, or smells

TBI can have a significant effect on classroom performance, and can impact all areas of day to day functioning within the school setting. School professionals may observe a very different child than the one they remember prior to the accident. The mental and physical energy required to meet the daily demands of such students can be exhausting. Given that a child with TBI may have difficulty in all areas it is easy to see that a plan may need to be utilized in order for that child to succeed. The question becomes, what plan should be used?

Traumatic Brain Injury in School – creating a plan for success


Section §300.114 of IDEA refers to the Least Restrictive Environment (LRE). Simply stated LRE means that all children with disabilities must be educated to the maximum extent appropriate with their non-disabled peers. It is the school's job to ensure that all students with disabilities are educated as similarly as their non-disabled peers as possible, so long as they are successful. To ensure that success in the classroom the schools must provide appropriate supports, if need be.

A student who has experienced a TBI may be eligible for special education services or a 504 plan. Both plans are written to ensure student success. The main difference is that a team has determined that a student requiring an Individualized Education Plan (IEP) must receive specialized instruction from a specific professional, such as a special education teacher or speech and language pathologist, in order to succeed in school. A multidisciplinary or IEP team determines whether or not this instruction is necessary, as well as any other requirements that are necessary for the child to succeed. These final decisions are then written into an IEP for the child.

A student with a TBI who requires accommodations only, not specialized instruction, would qualify for a 504 plan. This plan would ensure that accommodations such as extended time during test taking, or modified worksheets would be provided for the student. The regular education teacher would provide these accommodations.

In addition to defining the 14 categories under which a student can receive special education services, IDEA 2004 requires that each IEP team consist of a parent, at least one regular education teacher of the child (if the child is, or may be, participating in the regular education environment), at least one special education teacher that works with the child (if one does work with the child), a representative of the local education agency (usually an administrator), and an individual that can interpret the instructional implications of evaluations.  Beyond that, others may be invited that are involved in the specific case.  (See state requirements for further information on this.) 

Schools can play a vital role in helping students who are dealing with TBI to succeed in both their academics and their rehabilitation. Being aware of the child’s academic and emotional needs surrounding the TBI is critical to the child’s recovery. It is important to note that, as the child grows and develops, parents and teachers may notice new or different challenges that he/she is facing. As students progress through school, they are expected to think and behave differently than they were in the younger grades. The damage that the brain endured at a younger age may make it hard for a student to acquire the skills necessary in later grades. Therefore, it is important to understand that both the IEP and 504 plans are malleable based on student need.

References

NASP
Nichy.org
Ninds.nih.org
Traumatic Brain Injury

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