The Challenges of Integrating Students with Brain Injuries

Experiencing a traumatic brain injury (TBI) can create new educational hurdles for a child and for that child's teachers. Many children who have suffered from brain injuries are left with changes in cognitive or behavioral challenges are either misidentified or end up completely slipping through the cracks in the system. Schools then face the three challenges of first identifying students with brain injuries, assessing them and then providing the appropriate classroom accommodation.

After anyone, child or adult, experiences the sort of head trauma that leads to TBI, there can be both immediate and long term changes in their behavior and functioning. In the short term, a child might lose consciousness from anywhere from a few minutes to much longer - or the child may just seem confused or disoriented. Some children may not be taken to the doctor at all if the immediate effects do not seem severe, or the child might be taken to the emergency room and discharged quickly. When it comes to seemingly milder incidents which do not require hospitalization, both parents and the child's school may be unaware of the potential for long term changes. Those changes may include changes in cognitive function and in behavior as the child struggles to deal with his or her new limitations.

Physical changes following TBI may include:

• Tiredness
• Lack of interest
• Headaches
• Awkwardness of movement
• Slowed reaction time
• Increased sensitivity to light or sound

Cognitive changes may include:

• Forgetfulness
• Sudden inability to retain new material
• Difficulty "finding" words
• Problems with organization
• Inattentiveness

Emotional changes:

• Moodiness
• Depression
• Anxiety

And Behavioral changes:

• Agitation
• Irritability
• Aggression
• Inability to cope with unexpected events
• Frustration over minor things

Children who exhibit these symptoms are often misidentified as having learning or emotional disabilities. The hospital may have failed to provide appropriate transitional care and never identified the child's needs to the school, and in the case of mild TBI, doctors may have failed to discuss the possibility even with parents. An estimated 15 percent of people who suffer mild TBI experience significant problems after their injury. In these cases, problems are often attributed to other causes, such as poor motivation.

Because TBI is different from other forms of emotional or learning disability, traditional approaches often fail to provide the correct insight or support for students. In the case of TBI, as opposed to learning or emotional disabilities, the disability is acquired from one or more specific events. The student will remember their old abilities, and may feel frustrated by the changes. He or she may also still be able to perform based on old learning, as in many cases individuals still retain that, but struggle with assimilating new knowledge. Not only does this create an inconsistent performance, but it can be quite frustrating to the student. Also, unlike in cases of learning disability, a student may regain some of their lost ability over time.

Armed with a better understanding of what the problem, educators can then go on to assessing and better integrating their students with TBI. Check back here on Monday for more about children and the long term effects of TBI.