Back to School – New Challenges after Brain Injury by Marilyn Lash, MSW

September 2017

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New school, new classes, new teachers for students

I remember my mixed feelings of excitement and regret as summer vacation ended and it was time to go back to school. Whether you are a child, adolescent, or adult with a brain injury, you have some things in common.  It doesn’t matter if you’re heading off to grammar school, middle school, high school or college, you may all share some concerns and challenges.

School challenges learning

Will I…

  • fit in with classmates?
  • be able to keep up in class?
  • pass or fail?

There are questions for teachers too. Will they…

  • know anything about brain injury?
  • understand what I need?
  • help me learn?

How has a brain injury affected this student or my child?

After a brain injury, students of all ages can have a wide range of changes.  Some changes may be subtle and invisible; others may be more noticeable and dramatic. While the cognitive effects – the ability to think and learn – may be the most obvious concern for students in the classroom, it’s not as simple as that.

Students may also have difficulty with…

  • cognitive and physical fatigue
  • irritability and anger
  • behavior
  • depression
  • social skills
  • attention and memory
  • planning and organization

TBI, ADHD, LD – How are these students different?

Some of these changes can look like an attention deficit hyperactivity disorder (ADHD) and a learning disability (LD). Educators are more familiar with these conditions, but there are important differences. Most notable is the sudden onset of a disability and difficulty for a student following a brain injury. Over time, problems with attention, executive functions, higher language skills and behavior may lessen but not totally disappear.

New problems may surface as school work becomes more complex and the brain matures, particularly for children injured at a young age. Frequently, students with attention difficulties after a brain trauma have what is called a “checkerboard” pattern. This is because some attention skills are affected, while others are very impaired. This can mislead educators and families into thinking that a student is “unmotivated” or “lazy”.  Sharon Grandinette’s tip card on Brain Injury, ADHD, and LD: What’s the Difference? explains this.

Federal laws help students

The good news is that what is commonly known as the “special education law” – the Individuals with Disabilities Education Act (IDEA) contains a special category for Traumatic Brain Injury that helps identify these students, assess their educational needs, and provide individualized educational programs.

That’s not the only resource. Section 504 of the Rehabilitation Act also can help set up accommodations for students in school. This Act is also important for college students who may find help in Centers for Students with Disabilities.

A checklist to help parents, educators and therapists identify accommodations in school that support and assist a student with brain injury can be found in the tip card, “Section 504 Plan Checklist for a Student with a Brain Injury” by Janet Tyler, Ph.D. and Linda R. Wilkerson, M.S.Ed.

504 Includes College & University Students

The Section 504 Act is also important for college students who may find help in Centers for Students with Disabilities, usually located on college and university campuses.  Remember – most colleges and universities do not provide the same entitlements and supports as special education services in public schools. College students have a greater responsibility for self advocacy and negotiating accommodations for learning.

So it’s important for college students to know the federal laws, learn how to request accommodations, work with admissions offices and find tutors and supports on campus.  This information is summarized in the tip car d, Going to College: When a Student has a Brain Injury” by Goodwin and Larson.

Teaching strategies help all students

Here are just a few teaching strategies for educators from Dr. Janet Tyler on some common challenges for students with brain injuries in classrooms

Tips for improving attention/concentration…

  • Reduce distractions in student’s work area (remove extra pencils, books, etc.).
  • Divide work into smaller sections.
  • Ask student to orally summarize information just presented.

Tips for improving memory…

  • Frequently repeat information and summarize it. 
  • Teach student to use devices such as post-it notes, calendars, and assignment books as self-reminders to compensate for memory problems.
  • Categorize or chunk information to aid retention.

Tips for improving organization…

  • Give additional time for review.
  • Use a written checklist of steps for complex tasks.
  • Practice sequencing material.

Tips for improving following directions…

  • Provide oral as well as written instructions.
  • Ask student to repeat instructions back to teacher or a peer.
  • Underline or highlight significant part of directions on written assignments.

Learning is a life long process

School is more than a building. It’s a vehicle for the process of life long learning that occurs both within and outside the structure of school. Whether it’s learning academic skills or life skills, the process may be altered and affected when a student has a brain injury, but all students still share the possibility and potential for learning achievement, and success.

Resources from Lash and Associates

The resources below are filled with detailed information for students of all ages and for families, educators and clinicians.

 A Set of Educational Manuals on Students with Brain Injury addresses students in elementary, middle and high schools.

Elvin the Elephant who Forgets  Story book to help young children understand brain injury.

Tip Cards on Children and Youth with Brain Injuries

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