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Teaching Techniques and Traumatic Brain Injuries

Students who have sustained a traumatic brain injury (TBI) return to the school setting with a range
of cognitive, psychosocial, and physical deficits that can significantly affect their academic
functioning. Children who have had a TBI may show a wide range of newly acquired deficits or
alterations in cognition, physical mobility, self-care skills, and communication skills as well as changes
in emotional and behavioral regulation, which
may significantly affect school. The may
have a hard time dealing with people giving
them attention, goal setting, initiating, and
inhibiting behavior. They may also have
problems with organization—planning,
prioritizing, analyzing tasks, and completing a
sequence of activities. Cognitive
impairments can include memory problems,
slowed information processing, and language
disturbances.

Academic scheduling must be flexible and customized to fit student’s changing needs. Class
enrollment and expectations should be based on students’ current, rather than previous, academic
performances. Don’t push students quickly through classes and require them to make up missed
assignments, students should be allowed additional time to relearn concepts and regain skills.

If the student struggles with attention or is easily over stimulated, or has emotional disturbances,
the classroom environment should be quiet and simplified. Noise and activity levels should be
controlled, and unnecessary distracters and sensory stimulation should be kept to a minimum if
possible. This may require seating the student near the teacher or by an appropriate peer to help
keep them on task, removing extra materials so they don’t get distracted, and dividing work or task
lengths into smaller sections so they do not get over whelmed. Students may use earplugs to reduce
external noise. Students may need a designated space in which to rest or take time out from
stimulation and be allowed to have “down time.

Classroom structure should also include a predictable and consistent routine. Students with
challenging behaviors are more likely to engage in appropriate, on-task behaviors when presented
with a positive, well-understood daily routine. Providing a written schedule or posting a visual chart
of the daily routine will help reduce confusion. Students may need simplified instructions, written or
picture checklists of task steps, maps, or strategically placed signs to carry out tasks. It is
important to involve the student in reviewing the schedule at the beginning of the day or period and
verbally review the steps. Transition times and out-of-classroom activities should be preplanned and
structured to reduce stimulation and emotional distress. Using auditory or visual cues to signal
changes in the routine and giving the student warning is also helpful.