Writing Challenges Executive Functions of TBI Students in School

Writing Challenges Executive Functions of TBI Students in School

by Theresa Sacchi Armstrong, M.A.

Students with a brain injury or TBI often struggle in school.

Writing essays that are well developed, organized and have proper language and grammar can be especially challenging for middle and high school students after a traumatic brain injury or TBI. For children with brain injuries in lower income families or students who are second language learners, the challenges are often compounded. State writing exams continue to note lower writing scores in students of some minority groups, lower scores in boys, and students who live in poverty.

Self-regulation affects student’s school work after TBI

Self-regulation skills are essential to writing production for the student. The skills of self-regulation are part of the brain’s executive functioning system, which we know resides in the pre-frontal cortex of the brain. Children who have had a traumatic brain injury (TBI) from motor vehicle crashes or abuse most often have injuries which severely limit the functioning of the frontal lobes. Consequently, they frequently struggle with the executive functioning skills which are necessary to the production of written language tasks.

According to George McCloskey (McCloskey, Perkiins, & Van Divner, 2009), the student must be able to integrate several executive function cues in order to complete most tasks. Most complex writing tasks involve the skills of:

  • perceiving the world and thoughts
  • understanding and beginning a process to gather thoughts and put them on paper
  • focusing and sustaining attention, and
  • having the flexibility to shift attention.

It is no wonder that some children and students with brain injuries have extreme difficulties producing or completing an assigned writing project. Planning and organizing, generation and manipulation of ideas, being able to make associations between ideas, planning, shifting thoughts, flexibility, and holding information in memory when working with other ideas – these are essential skills for writing.

Teachers can help the TBI student with writing assignments in school

There are many ways to help children with their writing. But all should begin with an assessment of the child’s writing skill, the child’s feelings about their writing, and perceived competence of their skill. As educators, our main goal should be to give our students power and voice in their writing. If we are truly to help children, we must help them find their own writing process.

In the book Write to Learn (Murray, 2002), explains that the common writing process used in teaching works for most students. However, it is not the only way to complete a writing task. We need to give students with TBI the tools and technology which they need to meet their writing goals. But in addition, we also need to teach these students how to accept their own learning and working style. It is essential that we provide them with a methodology that helps them through every step of their process to build their executive functioning skills. It is these skills and abilities which will ultimately enable them to be more successful with writing throughout their lives.

Executive skills become increasing critical for students with TBI or traumatic brain injury as they develop from childhood into adolescents. The latent effects of brain trauma often become more visible in adolescents with increased cognitive challenges in school. There are several workbooks and manuals for educators, therapists and psychologists that take a detailed approach to assessing executive skills and designing interventions for students with ADHD, learning disabilities and traumatic brain injury.

About the Author

Theresa Sacchi Armstrong is Research Associate in the Graduate School of Education and Human Development at The George Washington University. For information on building schools’ capacity to serve students with brain injuries, learn about the Master’s Degree Program with Teacher Licensure email Ms. Armstrong at tjsacchi@gwu.edu.


McCloskey, G., Perkiins, L., & Van Divner, B. (2009). Assessment and Intervention for Executive Function Difficulties.New York: Routledge.

Murray, D. M. (2002). Write to Learn.Boston: Heinie.

Recommended Reading

Cognitive Rehabiliation of Executive Functions — Two Book Set

Cognitive Rehabilitation of Executive Functions
Lawrence S. Dilks, Ph.D. and Kimberly S. Hutchinson, Ph.D.

Executive Functions After Brain Injury — Tip Card

Executive Functions After Brain Injury
Lawrence S. Dilks, Ph.D. Kimberly S. Hutchinson, PhD

One response to “Writing Challenges Executive Functions of TBI Students in School”

  1. Delphine Williams Young says:

    My son is facing some of the challenges described and the school he was attending has actually sent him home as a result of his problems. I am now planning to home school until I can get funding to send him to a school that will accept him.

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