Instructional Strategies for Secondary Students with TBIRandy Thomas
Marathon vs. SprintBuilding success with a student who has a TBI takes consistent, focused, hard work.It is very difficult for the student.It is very rewarding for the student and the teacher.Successes may require you to look back over a semester or a year to clearly recognize.Coaches dont expect a kids in casts to run; their injuries prevent them being capable.
OverviewEveryday InstructionExecutive FunctioningMemoryAttention and FocusBehavior
Follow principles of good instructionAre often beneficial to entire groupTarget the Key ConceptsReview those key concepts regularly Are highly specific to the individual needs of the studentAssess key concepts: pre, formative, & summative
4 Facts on Long-Term changes:No 2 students will be alike.
Changes are unlikely to disappear fully over time; the students recovery will most likely only be partial.
Negative consequences may not be seen immediately but only emerge when developmental demands reveal deficits and problems.
An injured brain is less likely to meet the increasingly complex tasks all children face as they get older.
Hibbard, M., Gordan, W., Martin, T., Raskin, B., Brown, M. (2001) Students with Traumatic Brain Injury: Identification, Assessment and Classification, Assessment and Classroom Accommodations : NYC, NY
Effective Teaching Model1. Task analysis break the task down to steps with clear beginning and ending point.2. Use Direct-instruction to prevent the acquisition of errors in newly developed practices. Examples and non-examples are beneficial. Paint a clear picture of expectations.3. Frequent assessments: Baseline and regular formative assessments
4. Frequent reviews combining visual and verbal ques.5. High rates of correct, practice trials: 5 trials is not enough, 30-50 practices with mass practices initially followed by consistent reinforcement practices.6. Metacognitive strategy training: Self-evaluation of ones own performance. Effective Teaching Model
Executive FunctionsThose mental capacities necessary for formulating goals, planning how to achieve them, and carrying out the plans effectively. (Leak, 1982)
Dysexecutive SyndromeImpulsivenessPoor social judgmentDifficulty interpreting others behaviorPerseverationPoorly regulated attentionDisorganizedIneffective planning
Decreased flexibilitySlowed processesLimited divergent thinkingConcrete thinkingLimited problem solving Weak self-monitoringReduced attention
Self-regulation (Self-talk or Social Stories)
A repeated phrase or narrative to help guide the student through a specific task Student Planner:
Examples of External AidsA student may take 15 minutes trying to start but perceive that it has only been 1 or 2 minutes.
Time ManagementKitchen or digital timershttp://www.online-stopwatch.com/Day planners
Task SpecificChecklist (homework, materials, readiness routines)Color coding/labelingSet up all classroom binders exactly the same
Homework Helper 1. Pull out homework list (planneretc.) 2. Make homework list in priority order 3. Start working now! Start my timer. a. Find book, worksheet, & pencil. b. Read directions. c. Ask for help only if you need it. 4. Turn in completed work!Great Job! Keep working hard!
Examples of Metacognitive StrategiesSelf-monitoring of AttentionMonitoring progress and/or success during an activityStep-by-step task-specific checklist can be used to support difficult tasksMay include error checking and motivation on the checklistsStudent self rates success during and after task and documents successful strategies
The On-task Traffic Light!!Red LightStop!! Am I doing what I am supposed to be doing?Yellow LightLook! What should I be doing instead?Green LightGo!! Choose a new direction and move forward!
Examples of Environmental Modification-Physical Set upSeating have the same seating in all classrooms if possiblei.e. front right side.Sound management ear plugs or head setDistraction management no irrelevant items
The more that a students environment is standardized across classrooms, the easier it is to focus on instruction in each class.
Examples of Environmental Modification-Physical Set upStructure task in step-by-step format.Give one portion of a task at a time.Single step instructionsRoutinize tasks.Put time estimates at the top of the paper.Assign a peer buddy.
Natural SupportModify instruction style to accommodate individual student.
Facilitate a supportive social environment. School counselors are a great resource to engage classmates in creating a supportive climate.
Work towards common expectations and practices between home and school.
Combination ApproachesExternal Aid + Metacognitive PracticeDigital timer combined with self-talk Natural Supports + External AidClassroom/school-wide culture and assignment completion systemEnvironmental Modification + Metacognitive Task accommodation and self-advocating for helpModel how to self-advocate & allow practice
Short term memory is broken.Try carrying water using a tea strainer to better understand their frustration. You look at the board, say in your head what you need to write down, look down at your paper.what was that again?Provide the aids necessary to compensate.Lecture notesCompleted graphic organizers
Attention and Focus
Students remember the beginning and end of a lesson.
Chunking limits the forgotten middle.
Break up the lesson with physical activities.Sensory diet
Crossing the midline engages both sides of the brain and causes both sides to communicate.
High CapabilityLow Motivation
Needs encouragementLow CapabilityLow Motivation
Needs instruction and encouragementHigh capabilityHigh motivation
Needs autonomyLow capabilityHigh motivation
Behavior is communication; am I listening to understand?What is being communicated?I dont know what Im supposed to be doing.I dont know how to do the work.I count using my fingers and cant remember my multiplication facts, and you want me to do what?I dont want to look like an idiot; Id rather just be in trouble.
There are Two PlansPlan AOh, lets just sporadically provide individualized instructions and make on-the-fly adjustments and hope it works.Plan BObserve behavior, think through intervention options, systematically apply the most feasible option, evaluate to determine effectiveness, make purposeful modifications.
SummaryEveryday Instruction Effective teaching modelExecutive Functioning Select the most needed target. Memory Provide aids as needed. Attention and Focus Chunking and physical activityBehavior What is this kid saying?
*A clean kitchen looks like this. The visual is essential for them to replicate what you expect.*Select the most needed area of improvement and target that one area using the type of tool illustrated on the next slide. *Model how to use this with the student, share it with the parents/guardian, and provide opportunities to practice. The first social story used requires the greatest amount of training. *Current 8th grade male student who recently talked about his progress since the beginning of 7th grade related to motivation and quality of work.*Secret signal: If I tap on your desk, you need to use your traffic light process.*Supportive social environment Students with TBI behave in ways that can push other students away or leave them isolated. The staff may have to engineer classmate support. *The time has started, I have to start now.*Do a demonstration of a volunteer trying to use the strainer to transfer water. **The purpose of this model is to get teachers to recognize that different people need different aids in order to be successful. This is about treating students equitably. Kids with broken legs leave class early but that does not mean that everyone gets to leave early. *