How does TBI affect Children and Adolescents? by Marilyn Lash, M.S.W. and Ron Savage, Ed.D.

How does TBI affect Children and Adolescents?

By Marilyn Lash, M.S.W. and Ron Savage, Ed.D.


Lash & Associates Publishing/Training, Inc


Does a brain injury affect a child differently than an adult?

Unlike an adult, a child’s brain is still developing right up through adolescence. An injury interrupts this development.

Different parts of the brain develop at different ages or stages of a child’s maturation. Consequently, the full impact of a child’s brain injury may not become evident for many months, or even years, until the brain matures. It takes longer for the effects of a brain injury to be seen in children and the consequences can change over time.

By comparison, an adult’s brain is fully developed. This accounts for the dramatic “before and after the brain injury” changes that are so common. Unlike children, an adult has a lifetime of skills, knowledge and experience of education and work that can be used to adjust to the changes caused by the brain injury. This does not mean that it is easier for the adult who has had a brain injury; it is different because the life experience is different.

How is a child with a brain injury different from a child with a birth related disorder?

Children with birth related conditions often have diagnoses that are related to heredity, prenatal development, or delivery complications. Examples are mental retardation and cerebral palsy. The child’s development is altered or at risk from infancy. Diagnosis is often made early when the child does not progress and reach the normal developmental milestones.

By contrast, it is the ongoing “normal” brain development and functioning that is interrupted in children with brain injuries. It can occur at any age. From that point on, the child’s development may be delayed or altered because the brain has been injured and damaged.

There are two types of brain injuries. Traumatic brain injuries are the result of an external force from a trauma or blow to the head. Examples are when the child’s head hits the windshield during a car crash or strikes the floor or ground after a fall. Acquired brain injuries are caused by internal changes as the result of a stroke, tumor, or disease like meningitis or encephalitis.

Does the age at which a child has a brain injury make a difference?

Yes. The younger the child is when injured, the less developed and more vulnerable to injury is the brain. It used to be thought that younger children were more resilient and “bounced back” after a brain injury. Now, we understand that it simply takes longer for the effects to be seen. It is important to track progress and change over time as the young child’s brain develops and matures.

Does a history of a traumatic brain injury mean a child is eligible for special education?

The category of traumatic brain injury was added under the federal education act in 1991 (Individuals with Disabilities Education Act). The category is used in all states. However, the diagnosis or history of a traumatic brain injury does not automatically qualify the student for special education. It must be shown that the brain injury has affected the student’s ability to learn and function in school. Once a referral for a special education evaluation has been made, the school conducts a comprehensive assessment to determine if the effects of the brain injury and the student’s needs meet the requirements for eligibility for special education under the state’s regulations.

Does it make any difference what category or classification is used under special education, as long as the student is found eligible and receives services?

Yes. Before the change in the education law, many students with brain injuries were incorrectly described as mentally retarded, learning disabled, or emotionally disturbed. A brain injury can have unique consequences for learning, behavior, and communication. Identifying the student accurately under the classification of traumatic brain injury helps educators recognize the condition and it consequences. They can then develop educational strategies and programs that are individually designed for that student.

For more information, see:

ELVIN The Elephant Who Forgets 

By Heather Snyder and Susan Beebe, illustrator

This children’s book is about a little elephant named Elvin, who has a brain injury when a tree branch falls on his head!

Since his head injury, he can’t count his figs anymore, gets mixed up at school and doesn’t get along with his friends. A visit to the neuropsychologist helps him understand that he’s not a bad little elephant… he has a brain injury.


Arnie’s MRI

  Arnie’s MRI

by Jenny Archibald, B.A., D.C.S.

In this children’s book about treatment for a concussion, Arnie the armadillo falls off his bicycle. Because he isn’t wearing a helmet, he hurts his head and has to have a MRI. He doesn’t understand what this is so he is nervous about the examination. The story line and colorful illustrations help children understand why Arnie is a bit scared. Hospital staff address his fears about medical procedures by turning the MRI exam into an adventure. Arnie soon overcomes his fears and learns why he should always wear a bicycle helmet.  Simple language helps children understand what an MRI brain scan is so they are not afraid of medical procedures when they get hurt. This colorful story book is an excellent tool for children to learn about an MRI and how to prevent head injury and a concussion by always wearing a helmet when doing activities “that make you go fast.”

Lash Blog Permission

9 responses to “How does TBI affect Children and Adolescents? by Marilyn Lash, M.S.W. and Ron Savage, Ed.D.”

  1. I equivalent this communication. Never thought its so relaxed 🙂 sorry for my english

  2. Thanks for the great article!

  3. Lily Tyberg says:

    Great post many thanks

  4. Hi, I applaud your blog for informing people, very interesting article, keep up it coming 🙂

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  7. Cool site, love the info.

  8. Marilyn says:

    The new blog looks great – congratulaltions!

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