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SOESD / Learning Matters / Newsletter Archive / April 2007 / March is Brain Injury Awareness Month!!!

March is Brain Injury Awareness Month!!!

Vicki Bernard

Traumatic Brain Injury (TBI) has now been designated as a “low incidence” disability to be served by Regional Programs in the state of Oregon. The educational definition of Traumatic Brain Injury is “an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance.  The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech.  The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.”  Children with TBI often have difficulties accessing and succeeding in the general curriculum and need special help to succeed in school.

Incidence:
Emergency room visits and hospitalizations as a result of TBI total 707,000 per year among children aged 0 – 19 (Langlois et al., 2004)  Approximately 30,000 experience persisting disabilities as a result of changes in cognition, behavior, physical abilities (National Pediatric Trauma Registry, 1993)

Lack of Awareness of TBI:
TBI is thought by many to be a “low incidence” disability.  However if you look at the statistics above, you’ll see that is not the case.  There is also the “myth” that, “kids will bounce back”, that the child is “fine”.  This myth is often perpetuated by the medical community.  A student’s brain injury is often “invisible.”  The student may look “fine”.  He/She may appear to be “recovered”.  The student is no longer being followed by medical personnel.  However even a mild brain injury (a sports concussion for example) can cause temporary or even long lasting impact for the student trying to access education.  There is an “under-identification for Special Education”.  Annually of the 30,000 experiencing persisting disabilities listed above, 10,000 (1 out of 3) are needing special education supports.  The cumulative total (K-12) should be 130,000, however the actual total on the federal Special Education census (2002) was 14,844.  

Impact of Brain Injury
“A brain injury is potentially one of the most devastating disabilities, with a huge range of effects due to the complexity of the brain.  The number and severity of problems resulting from a brain injury will differ from person to person because each individual’s brain injury varies in the extent and location of damage.  The extent of some of these changes may only become apparent as time progresses.”  (Headliner, Winter 2007, Vol. IX Issue 1)  Impacts may include cognitive changes, lack of insight, memory problems, poor concentration, slowed responses, poor planning and problem-solving, lack of initiative, inflexibility, impulsivity, irritability, socially inappropriate behavior, emotional lability, depression, fatigue, headaches, poor or slow processing, difficulty screening out distractions, and visual problems.  Just having one of these can greatly impact a student’s ability to learn in the classroom.  Full effects of an earlier injury may not be evident until adolescence when children are expected to demonstrate increasing competence in executive functions and reasoning.  Skills may not develop if the relevant areas of the brain have been damaged. (Alden & Taylor, 1997; Feeney & Ylvisaker, 1995; Mangeot et al, 2002; Ylvisaker & Feeney, 2002)

What can the school do?
All students that suffer a TBI may not need special education services.  However, many of them may still need support and strategies to help them in school as they recover from even a “mild” injury.  When you hear of a student in your school who is returning after an injury (from severe to mild); car accident to sports concussion, and anything in between, watch the student for changes in behavior, concentration level, ability to process, memory, etc.  Call for help BEFORE the student begins to have trouble keeping up in classes or gets suspended or expelled for behavior issues.  Call for help as soon as you know of the injury.  In the Southern Oregon Region (Jackson, Josephine, Douglas, Klamath and Lake Counties) there is an active group of TBI Consultants trained by Teaching Research Institute.  These consultants can come into any school in the region and provide consultation for any student with a TBI as a part of school services.  They can provide support, idea, and strategies to the teaching staff to help kids with TBI continue to learn in their classes.  They can provide information as to what the school may expect and how to deal with issues.  They can provide the student with ideas/strategies to help them through their school day.  If it is determined that a student with a TBI needs special education, they can help the school and the family with a smooth transition into this arena. 

What the Southern Oregon Regional TBI Consulting Team can do:
A member or members of the TBI consulting team can come into a school and provide information to teaching staff on TBI, what to expect, how to help students with this disability (in general and individually).  They can observe and work with students with TBI to determine possible program needs.  They can recommend strategies, accommodations, programs, etc. to help staff and students.  They can help conduct Functional Behavior Assessments and develop Behavior Intervention Plans.  They can inservice staff.  They can help in IEP meetings. These are just a few of the services that the TBI consulting team can do for schools and/or districts on behalf of students with TBI.

The purpose of the team is to help the child with a TBI access his education to the best of his/her ability and to help the school staff working with that student help him/her do it.

For further information or to refer a student to be helped by the consulting team, please call or email:  Vicki Bernard, M.S., Southern Oregon Regional TBI Liaison, 541/776-8551 or 541/273-6361, vicki_bernard@soesd.k12.or.us




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