Traumatic

Brain Injury
By Michael Robles
What is TBI?
What is it?
● An injury to the brain resulting from a violent blow or
injury to the head
● Can affect the brain cells temporarily, or cause further
physical damage (bruising, bleeding, torn tissue)
● Symptoms may appear immediately, or days or even
weeks after the incident
● 3 main categories:
○ Mild (Concussion) - usually results from the brain bouncing
around or twisting in the skull, chemical changes in the brain, or
stretching/damaging brain cells in the brain itself
○ Moderate - usually caused by falls & firearm-related injuries
○ Severe - higher risk of leading to long-term or even lifelong health
issues
Symptoms & Challenges
● Common Symptoms
○ Dizziness (Mild)
○ Fatigue (Mild)
○ Memory/Concentration Issues (Moderate/Severe)
○ Lack/Loss of Cognitive Skills (Moderate/Severe)
○ Coma (Severe)
● Challenges in School
○ Remembering concepts and important
assignments/deadlines
○ Behavioral issues, irritability
○ Information processing
History of TBI

● Middle Ages - TBI victims would have holes drilled in their heads for physical relief
● 1600s - term “Concussion” started to be used, & symptoms began to be studied
● Kurt Goldstein - opened The Institute for Research in the After Effects of Brain Injury
○ Goldstein-Scheerer Tests of Abstract and Concrete Thought

● 1960s - investigators stopped unifying organicity and brain damage with each other
○ “Children with TBI could exhibit different sets of behavioral characteristics” (Rotatori et al. 2011)

● 1990 - IDEA defined TBI as “an acquired injury to the brain caused by an external physical
force, resulting in total or partial functional disability or psychological impairment or both,
that adversely affects a child’s educational performance.”
Case Study: “Byron”
Intro
● 14 y/o Byron suffered a moderate/severe
TBI after getting hit by a car while riding
his bike
○ He suffered skull fractures, displacement in the
cerebellum & multiple hemorrhages to the left
frontal and temporal lobes
● Once he physically rehabilitated, he took
assessments to determine how his brain
was affected
● Richard Kubina and his research team
discovered Byron was unable to write
○ So, they developed assessments to help him
relearn how to handwrite
Byron’s Assessments
● Byron sat with a therapist 1-3 days a
week and completed 3 activities:
○ drawing continuous, elongated ovals
○ drawing 4 vertical lines with a horizontal line
thru it
○ drawing connected lines at various degrees
● He had 60 seconds to complete each
activity
● Once finished, the therapist would grade
his activities
● He would then write, and the research
team would analyze the results
Results
● Even though Byron was 14 years old, the
TBI he sustained caused his brain to
“forget” how to write
● TBI’s can be frustrating for children,
especially because of how they force
them to relearn skills they had learned
years ago
● It is important to be patient with students
and support them throughout their
recovery
Classroom Accommodations
General Accommodations
● Allow additional time to complete work
and tests
● Allow extra/extended breaks for the student
● Grade Quality, NOT Quantity
○ Grade not how much of the work they completed,
but how well they did on the parts they did
complete
● Provide oral AND written instructions
● Monitor Student’s progress & check in w/
them
● Print out slide deck & other materials for
student
Neurorehabilitation
● Once student physically recovers from their TBI, they meet
with a special education team at school to determine what
accommodations they need
● The team designs initial assessments for the student to take to
see what areas they need to retrain or practice on
○ Ex: Cognitive Skills, Memory Retention, Info Processing…
● They meet with their intervention team on a regular basis
throughout their schooling to improve and retrain the skills that
suffered from the injury
● They may or may not be given an IEP, depending on the
severity of their injury
● Their teacher(s) are contacted and given information on the
student’s condition
Accommodations in My Classroom
● Seat student closer to the front
● Slow down speaking and lecturing during
lessons and when giving instructions
● Give student printouts of instructions,
powerpoints, & activities beforehand
● During discussions, modify questions for
them by focusing on memory retention
and info processing more than concept
acquisition
● Check in with student and their
intervention team frequently
Thank you!