Traumatic Brain Injury

Question 0

Prevalence

Answer 0

Most common causes of death in childhood
• Low numbers served under IDEA (<50,000)
o Why
• Almost 80 % of causes of TBI is mild
• Most TBI à temporary effects?
• Most TBI leads to only temporary symptoms so its controversial
• Most children perform fine after a year
• Families notice continuous differences
• Over estimate how good their memory was before
• 504 plans
• Only require accommodations at school
• A lot easier for parents to get
• Other IDEA categories
• Not counted under the number of TBI patients
• Filed under something else

Question 1

TBI under IDEA

Answer 1

• Acquired injury to the brain due to “external physical force”
• Resulting in impairment (educational and other)
o Has to be caused by physical force and has to impact you educationally

Question 2

Types of TBI

Answer 2

Open (penetrating) head injury
o Focal deficits
• Localized to one particular function because there was one particular part of the brain that was damaged
• Closed head injury (far more common)
o Diffuse deficits
• All over the place, don’t know specific spot that was damaged
• No damage in one particular place
• But impairment throughout the brain
o Axonal shearing (severing of connections)
• There is a tear which causes impairment throughout the brain

Question 3

Severity of TBI

Answer 3

• Mild (mTBI) (concussion)
• Moderate TBI
• Severe TBI
o Higher the score for the GCS the lower the severity
• Severity rating based on
o Length of Loss of Consciousness
o Length of Posttraumatic Amnesia
o Glasgow Coma Scale Score (GCS)
• Questions you ask to determine the severity of the TBI

Question 4

Mechanisms of Damage

Answer 4

• Contusions (“Brain bruises”)
o Brain can hit the skull which can then cause contusions
• Hemorrhage à Hematoma
o Any sort of bleeding which can lead to a accumulation of blood in the brain which is a hematoma
• Puts pressure on the brain areas since the blood is pushing the brain
• Anoxia
o A lack of oxygen to the brain
o If damaged the person will forget to breath
• Increase intracranial pressure
o In closed head injury’s
o Brain can swell which can cause pressure on certain parts of the brain

Question 5

Consequences of TBI

Answer 5

• Medical/sensory/motor
o Headache – most common
o Nausea first few days
o Over sensitivity to light
o Trouble processing
• Cognitive/academic
o Working memory
o Processing speed
o Executive function
• Social/emotional/behavioral
o Personality change
o Behavior can be unpredictable from day to day

Question 6

Educational Strategies

Answer 6

• Highly individualized
• Delayed school re-entry
• Scheduling of instruction with frequent breaks
• Resource room for organization
o Helping organize yourself
o Often helps them with organization
• Decrease need for multitasking
o Provide students with notes
• Test accommodations
o Given extra time or separate room