Working with Students with

Traumatic/Acquired Brain (TBI/ABI)

Impairment

Traumatic Brain Injury/Acquired Brain Injury

• Incidence– CDC reports that brain injuries are

the leading cause of death and lifelong disability in children, adolescents, and young adults• 1.5 million survive a brain injury per

year

• 230,000 are hospitalized each year due to a brain injury

• 50,000 die each year from brain injuries

Incidence

• CDC estimates that 5.2 million persons in U.S. live with a lifelong TBI/ABI

• Most common cause – motor vehicle accidents, violence, recreational accidents

Definition

• Persons with TBI/ABI have sustained a permanent injury to one or more areas of the brain from either external or internal events or both

• Called many things: closed head injury, acquired brain injury, traumatic brain injury, and head trauma

Definition

• Traumatic brain injuries are the result of an external force to the brain

• Acquired brain injuries are the result of internal complications such as an aneurysm or stroke

TBI/ABI - Cognitive

Functional Limitations• Lowered achievement in one or more

areas of learning

• Impaired comprehension

• Gaps in prior learning

TBI/ABI - CognitiveFunctional Limitations• Disrupted learning pattern

• Slow thought processing

• Reduced attention span

• Geographic or temporal disorientation

TBI/ABI - CognitiveFunctional Limitations

• Difficulty understanding cause and effect

• Difficulty with the ability to execute complex coordinated movements

TBI/ABI - CognitiveFunctional Limitations• Lack of awareness of impairments and

needs• Inability to prioritize thoughts or

determine the main idea• Difficulty following a sequence or

schedule

TBI/ABI - Physical & Sensory

Functional Limitations• Fatigue or decreased stamina

• Unsteady gait

• Limited upper and lower extremity ambulation

TBI/ABI - Physical & Sensory

Functional Limitations• Sensory impairments

(visual/hearing)

• Cranial-facial injuries

TBI/ABI - Physical & Sensory

Functional Limitations• Quadriplegia and other mobility

impairments• Impaired motor skills• Chronic pain• Seizures

TBI/ABI - Physical & Sensory

Functional Limitations• Slurred speech and other speech

impairments• Hormonal changes• Metabolic disturbances

TBI/ABI – Psychosocial

Functional Limitations• Loneliness• Isolation• Depression and other possible

psychiatric issues (mental disorder due to a general medical condition)

• Less open to change

TBI/ABI – PsychosocialFunctional Limitations

• Loss of self-esteem and confidence

• A sense of disconnection from peers

• Impulsivity, poor anger control, poor social skills

TBI/ABI – PsychosocialFunctional Limitations

• A sense of having lost their old selves and not liking the new person they have become

• Inability to handle stress

TBI/ABI – PsychosocialFunctional Limitations

• Frustration adjusting to and balancing the multiple demands of postsecondary study and independence

TBI/ABI Case Study - ACatherine is a 22-year old freshman

in your program. She sustained a brain injury as a result of a car crash at age 18, just after graduating from high school. She has spent the last three years in hospitals and rehabilitation programs. During her first semester, Catherine took a reduced course load of two academic classes and an elective, swimming. She met weekly with her tutors and did fairly well in all classes.

She also began dating for the first time since her accident, and during winter break went to several parties.

Now in her second semester, Catherine’s confidence has grown because of the assistance she has received from the SSS program. However, because of her new level of confidence, she refuses any help, saying she wants to be independent and “make it on her own”. Unfortunately she is failing all her classes and is beginning to feel depressed.

TBI/ABI Case Study - B

Eric is a 17-year old junior in high school where he plays football on the varsity team. During the homecoming game, just before Thanksgiving, he was tackled and sustained a closed head injury. He was admitted to the nearby hospital just for observation, but remained out of school for the rest of the semester due to headaches and fatigue. His doctor instructed him not to play football the following season.

Eric returned to school in January and remains popular in his classes and at parties. However, Eric rarely turns in any of his class work, and the work he does complete is inadequate. His tutors note that when they talk to Eric that his speech is becoming slurred. They have also noticed that he walks with a limp and that his eyes appear unfocused. Eric’s tutors have become very concerned and have reported their growing concerns to you.

Discussion• Case studies

• Suggestions for strategy

• Questions?