What the disability is:

IDEA's Definition of "Traumatic Brain Injury"

Our nations special education law, the Individuals with Disabilities Education Act
(IDEA) defines traumatic brain injury as...
...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 childs 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; psycho-social 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. [34 Code of Federal Regulations300.7(c)(12)]
Types of TBI

Closed Head Injury

-the skull is intact and there is no penetration of the skull. Direct or
indirect force to the head can cause this type of injury. This may be
caused by rotational and/or deceleration in the case of both direct and
indirect force.

Open Head Injury

-penetration of the skull with direct injury to the head.

Diffuse Axonal Injury

-diffuse cellular injury to the brain from rapid rotational movement.
This is often seen in motor vehicle accidents or shaking injuries. The
axons are the projections of the brains nerve cells that attach to other
nerve cells. They are damaged or torn by the rapid deceleration. The
injury is from the shearing force disrupting the axons which compose
the white matter of the brain.

Contusion
-a bruise to a part of the brain. Like a bruise on the body, this is
bleeding into the tissue.

Penetrating Trauma
-any object that enters the brain. Causes direct injury by impact and
pushing skull fragments into the brain.

Secondary Injury
-swelling and release of chemicals that promote inflammation and cell
injury or death. This causes swelling in the brain which may increase

the intracranial pressure and prevent the cerebrospinal fluid from

draining out of the skull. This causes further increase in pressure and
brain damage. If this is not controlled or prevented the brain can
herniate (push through) the base of the skull and cause respiratory
failure and death. The only way to prevent the primary injury is to
prevent the trauma. The prevention of this secondary injury is the
focus of the acute medical care after injury.
Secondary Injury Includes:
Intracranial hemorrhage (bleeding inside the skull)
Brain swelling
Increased intracranial pressure (pressure inside the skull)
Brain damage associated with lack of oxygen
Infection inside the skull, common with penetrating trauma
Chemical changes leading to cell death
Increased fluid inside the skull (hydrocephalus)

Strategies that general education teachers can use to help students with
the disability:
Become fully familiar with the childs condition.
Use appropriate schedules and routines.
Help other children understand how they can help the childs growth.
Let peers work with the child on academics and social skills.
Communicate and collaborate with other professionals and parents.

Accommodations or modifications that would be applicable to the specific

disability:
Educational Support
Communication and collaboration are essential for the transition from the hospital
to the school environment.
Educational services must be tailored to a students specific needs.
Efforts should be directed at improving students general behaviors such as
problem solving, planning, and developing insight.
Use assistive technology devices to aid in communication, learning, information
processing, and recreation.

IEPs should be reviewed every 6 to 8 weeks to make adjustments based on the

growth of the students. Most students will make the most gains within the first year
of their accident and will make little progress thereafter.
Teachers should be very flexible and responsive.
Technology and Environmental Resources:
Classroom Strategies
Study guide
Pictures
Homework book or planner
Teach memory strategies
Scribe or note-taker
Modify work amounts
Provide feedback
Classroom aides
Avoid over-reactions
Routine and schedules
Simple and concrete language
Communication log or book
Behavior intervention plan
Recognition and recall
Alternative forms for expression
Peer tutors