4.2 - TBI in Children and Adolescents (Roberta DePompei) Flashcards by Keco Voco

What 3 life arenas can be affected in children with TBI?

Classroom learning

Behavior

Community participation

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What are the two types of brain injury?

Congenital

Acquired

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What are the two types of acquired brain injuries?

Traumatic

Non-traumatic

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What are the two types of traumatic brain injuries?

Closed head

Open head

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What are the four major part of the brain’s nerve cells?

Axons

Dendrites

Receptor sites

Neurotransmitters

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Why would language be believed to be neutral association?

It is the result of global linkages between nerve cell circuits

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What happens to neural pathways when we learn something new?

They rewire

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What is strategic learning?

Efficiently extracting important information

Efficiently inhibiting unimportant information (to not use up vital storage capacity)

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What kind of learning is the brain most effective at?

Abstracting meaning

Not storing detail

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How is strategic learning affected after TBI?

It impaired

The individual might have trouble summarizing, finding main idea, and interpreting statements

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What is the theory behind the learning of high capacity and low capacity individuals?

High capacity individuals are more efficient at learning only relevant information

Low capacity individuals inefficiently encode and learn irrelevant informations

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When does strategic learning begin?

What does this mean for children after TBI?

Early years

They should be provided with specific interventions early

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What 4 things drive the Under-Identification Cycles of children suffering from the effects of TBI?

Apparent Low Incidence Rate (probably not true)

Lack of Awareness of TBI-specific issues

Lack of Research Money

Lack of training

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What 5 things may prevent a child from being referred for SLP services post-TBI?

Lack of medical referral

Lack of parental recognition

Developmental bias that they will be OK

Many “look good” physically

Lack of public awareness

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What often happens to children who do not receive intervention after TBI?

They can end up in…

– Mental health systems

– Penal institutions

– Welfare rolls

– Social service agencies

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What Attention Disorders can be found in children post-TBI?

Sustaining attention

Easily fatigued

Impaired selective attention

Poor shifting of attention (gets lost in group conversations)

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What Memory Disorders can be found in children post-TBI?

Poor rote learning

Short term memory difficulties

Difficulty organizing information to store

Can’t recognize what is “important” to store

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What Planning Disorders can be found in children post-TBI?

Impaired ability to abstract

Can’t inhibit action resulting in impulsive or perseverative responses

Slowed initiation time

Can’t start to solve a problem

Can’t sequence information

Doesn’t learn from mistakes

Doesn’t know when, where or how to ask for help

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What Judgement Disorders can be found in children post-TBI?

Misinterprets actions of others

Can’t handle multiple bits of information at one time

Socially unacceptable verbal and physical behaviors

Unrealistic appraisal of self and residual strengths and weaknesses

What Processing Disorders can be found in children post-TBI?

(4)

Extreme slowness in reaction time

Slowed in psychomotor activities (talking, writing etc)

What Communication Disorders can be found in children post-TBI?

(5)

Anomia

Inefficient word retrieval

Hyperverbal

Use of peculiar words or phrases

Uninhibited choice of words

What 10 problems can occur after TBI in children?

DISORIENTATION (not appropriate to the prevailing stimuli—unable to discuss where he is)

DISORGANIZATION (fragmented and incomplete thoughts—unable to complete sentence)

CONFUSION

CONFABULATIONS (story telling; filling in information that can be partially true and partially untrue)

CIRCUMLOCUTIONS (talking around the word without saying it)

TANGENTS (getting further and further from the topic)

HYPERVERBALNESS (talking long past the point where others are interested)

STIMULUS BOUND (sticks on one part of the topic but cannot convey the intent of the entire message)

REDUCED INITIATION (can’t start the conversation but can respond if someone else begins)

REDUCED INHIBITION (once started can’t stop)

What may be seen in a child post-TBI due to impaired attention, perception, and/or memory?

(3)

Daydreaming

Bothering another student

Playing with materials from desk

What may be seen in a child post-TBI due to inflexibility, impulsivity, and/or disorganized thinking, or acting?

(2)

Speaking out

Interrupting with non relevant topic

What may be seen in a child post-TBI due to inefficient processing of information (rate, amount, & complexity)? (4)

Asking for repeats of information Acting rude Doodling on paper Bolting the classroom/work station

What may be seen in a child post-TBI due to difficulty processing abstract information?

Does not get double meanings of words, humor, puns

What may be seen in a child post-TBI due to difficulty learning new information, rules and procedures? (2)

Can’t learn a new game. Only sorts by shape, can’t convert to color

What may be seen in a child post-TBI due to inefficient retrieval of old or stored information? (2)

Poor test taker Inconsistent memory for information (recalls facts one day and not the next)

What may be seen in a child post-TBI due to ineffective problem solving and judgment? (2)

May have temper tantrums like much younger aged person Sticks to only one solution and will not change mind

What may be seen in a child post-TBI due to inappropriate or unconventional social behavior? (3)

Quick to lose temper Uses foul language at the wrong times Poor social interactions

What may be seen in a child post-TBI due to impaired “Executive” Functions? (2)

Self-awareness of strengths and weaknesses Goal-setting, planning, self-initiating, inhibiting, monitoring & evaluating either do not develop as they should or are ineffectively used

What can happen the the trajectory of a child's development when they are not assessed as they age?

They may appear to have returned to "normal" levels They may experience a decline in function as they age This may be due to their reliance on information learned pre-injury and inability to efficently learn new information

In what 2 environments should we assess a child post-TBI?

Where he/she communicates (context specific environments) One-on-one evaluation versus evaluation within environment

What 7 normed assessments measures can be use to assess cognitive function in children post-TBI?

Peabody Picture Vocabulary Woodcock Johnson: Picture Vocabulary and Sentence Memory Subtests Wisconsin Card Sort Boston Naming Test of Word Finding CELF: Concepts and Directions California Test of Verbal Learning

What are 3 informal measures that can be used to assess language in children post-TBI?

The Giant Story The Cookie Theft: Verbal and written Conversation about his interests and activities

What 6 things should we be aware of in a child's environment?

Organizational System Location in Work Area Distractions Work Materials and Equipment Performance Options Transitions

What 13 things should we be aware of in Communication Manner and Style when dealing with children post-TBI?

Average rate Organization Attentiveness Word choice Use of sarcasm, humor, puns Typical length and complexity Gestures Body Language Objects Responsiveness Ability to Provide Directions Ability to understand Patience

What 3 cognitive measures can we intervene in with children post-TBI?

Attention Memory Organization and Planning

In what 2 specific ways can we intervene in Attention with children post-TBI?

Task analysis Task completion

In what 2 specific ways can we intervene in Memory with children post-TBI?

Internal aids External aids

What are 5 Attention and Concentration Strategies that can be used with children post-TBI?

Reduce distractions in work area Divide work into smaller sections Have person summarize new information Use cue words to alert person to pay attention Develop a nonverbal cueing sys

What are 7 Memory Strategies that can be used with children post-TBI?

Repeat information often and summarize it Carry an assignment sheet for each class Use devices as self-reminders Categorize or chunk information Use special words as reminders Link new information to prior knowledge Give examples with instructions

What are 16 Organizational and Concentration Strategies that can be used with children post-TBI?

Extra time for review Written checklist of steps for complex tasks Instruction for checking each step when done Written schedule of daily routine Person to meet with at start and end of school/ work day Written cues to organize activities Practice sequencing material Outline to match lectures with note taking sections Color coded materials for each class Practice organizing activities Oral and written directions Have person repeat instructions Highlight important part of written directions Break directions down into simple steps After client does task, check work and give feedback Slow pace of instruction

How can we target Strategic Learning Skills in children post-TBI? (1+5)

Identify main idea Increasing problem solving skills Building language skills Developing self-advocacy

How should we intervene with young children post-TBI?

Play Introduce social interactions with other children and family Stimulate receptive and expressive language Start vocation transitions (turn taking, responsibilities)

Why should we involve families when treating children post-TBI?

Families are the one constant Families are the real experts