Ideas that Work, office of special programs U.S. Department of Education

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Traumatic Brain Injury Resources
Adapted from NICHCY

Under IDEA, traumatic brain injury refers to an acquired brain injury that Traumatic brain injury means an acquired injury to the brain.

The Individuals with Disabilities Education Act (IDEA) defines traumatic brain injury as "being 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; psychosocial 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."

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.

The term TBI is not used for a person who is born with a brain injury. It also is not used for brain injuries that happen during birth.

The definition of TBI below comes from the Individuals with Disabilities Education Act (IDEA). The IDEA is the federal law that guides how schools provide special education and related services to children and youth with disabilities.

How Common is Traumatic Brain Injury?

More than one million children receive brain injuries each year. More than 30,000 of these children have lifelong disabilities as a result of the brain injury.

Many call this TBI the silent epidemic because often individuals don't think to report incidents that may have resulted in an injury to the brain. Children are particularly susceptible because of falls, car accidents and sport injuries. Any time a concussion is sustained, there is the possibility of traumatic brain injury.

What Are the Signs of Traumatic Brain Injury?

The signs of brain injury can be very different depending on where the brain is injured and how severely. Children with TBI may have one or more difficulties, including:

Physical disabilities:
Individuals with TBI may have problems speaking, seeing, hearing, and using their other senses. They may have headaches and feel tired a lot. They may also have trouble with skills such as writing or drawing. Their muscles may suddenly contract or tighten (this is called spasticity). They may also have seizures. Their balance and walking may also be affected. They may be partly or completely paralyzed on one side of the body, or both sides.
Difficulties with thinking:
Because the brain has been injured, it is common that the person's ability to use the brain changes. For example, children with TBI may have trouble with short-term memory (being able to remember something from one minute to the next, like what the teacher just said). They may also have trouble with their long-term memory (being able to remember information from a while ago, like facts learned last month). People with TBI may have trouble concentrating and only be able to focus their attention for a short time. They may think slowly. They may have trouble talking and listening to others. They may also have difficulty with reading and writing, planning, understanding the order in which events happen (called sequencing), and judgment.
Social, behavioral, or emotional problems:
These difficulties may include sudden changes in mood, anxiety, and depression. Children with TBI may have trouble relating to others. They may be restless and may laugh or cry a lot. They may not have much motivation or much control over their emotions.

A child with TBI may not have all of the above difficulties. Brain injuries can range from mild to severe, and so can the changes that result from the injury. This means that it's hard to predict how an individual will recover from the injury. Early and ongoing help can make a big difference in how the child recovers. This help can include physical or occupational therapy, counseling, and special education.

It's also important to know that, as the child grows and develops, parents and teachers may notice new problems. This is because, as students grow, they are expected to use their brain in new and different ways. The damage to the brain from the earlier injury can make it hard for the student to learn new skills that come with getting older. Sometimes parents and educators may not even realize that the student's difficulty comes from the earlier injury.

Tips for Parents
  • Learn about TBI. The more you know, the more you can help yourself and your child. See the list of resources and organizations at the end of this publication.
  • Work with the medical team to understand your child's injury and treatment plan. Don't be shy about asking questions. Tell them what you know or think. Make suggestions.
  • Keep track of your child's treatment. A 3-ring binder or a box can help you store this history. As your child recovers, you may meet with many doctors, nurses, and others. Write down what they say. Put any paperwork they give you in the notebook or throw it in the box. You can't remember all this! Also, if you need to share any of this paperwork with someone else, make a copy. Don't give away your original!
  • Talk to other parents whose children have TBI. There are parent groups all over the U.S. Parents can share practical advice and emotional support. Call NICHCY (1-800-695-0285) to find out how to find parent groups near you.
  • If your child was in school before the injury, plan for his or her return to school. Get in touch with the school. Ask the principal about special education services. Have the medical team share information with the school.
  • When your child returns to school, ask the school to test your child as soon as possible to identify his or her special education needs. Meet with the school and help develop a plan for your child called an Individualized Education Program (IEP).
  • Keep in touch with your child's teacher. Tell the teacher about how your child is doing at home. Ask how your child is doing in school.
Tips for Teachers
  • Find out as much as you can about the child's injury and his or her present needs. Find out more about TBI. See the list of resources and organizations at the end of this publication.
  • 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
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