Transcript Slide 1

BrainSTEPS
Child & Adolescent
Brain Injury
School Re-Entry Program
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Strategies
Teaching
Educators
Parents
Students
What is BrainSTEPS?
• Brain injury consulting teams available to
families and schools throughout Pennsylvania.
• Teams are extensively trained in the
educational needs of students returning to
school following brain injury.
• Teams will work with local school staff to
develop educational programs, academic
interventions, strategy implementation, and
monitoring of students.
What BrainSTEPS Can Do:
1. Conduct observations of the student
2. Communicate with the district and medical
professionals to ensure a smooth re-entry
3. Review medical, rehabilitation, & educational
reports to assist in making educational
recommendations.
What BrainSTEPS Can Do:
4. Create & provide a training for the school on
the educational impact of the student’s
specific brain injury. Educate and support
district staff & family.
5. Provide Peer Trainings, so peers understand
how brain injury has impacted their classmate.
What BrainSTEPS Can Do:
6. Consult on all aspects of the student’s
educational plan & make recommendations
to the district team.
7. Assist in transitioning a student from grade to
grade or school to school by training new
teachers
Who should be referred to BrainSTEPS?
1. A student who continues to have CONCUSSION
symptoms 2 WEEKS after injury, should be
referred to BrainSTEPS.
2. A student who sustains a more moderate to
severe brain injury should be referred prior to the
student’s return to school.
3. A student who has an older injury, but begins to
experience educational impacts as their brain
matures/develops can be referred at any time
through graduation.
www.brainsteps.net
Traumatic
Brain Injury
STATISTICS
Brain injury is a leading cause of death
and disability in children & young adults.
CDC Statistics
Average ANNUAL number of Traumatic Brain Injury
Emergency Department Visits and Hospitalizations in
the United States
474,000
Children with Traumatic Brain Injury 0-14 years of age
• Most children who sustained a TBI (91.5%) were treated
and released from the emergency department.
United States. Centers for Disease Control. Traumatic Brain Injury in the United States. 2005.
http://www.cdc.gov/ncipc/pub-res/TBI_in_US_04/TBI%20in%20the%20US_Jan_2006.pdf>.
How Common is TBI in Children in
Pennsylvania?
Each year, approximately
26,000
children in Pennsylvania sustain a
traumatic brain injury
(mild, moderate, or severe)
Source: The Brain Injury Association of Pennsylvania, 2008
Causes of Traumatic Brain Injury
Infants
Accidental Dropping
Physical Abuse
Toddlers
Falls
Vehicular Accidents
Preschoolers
Falls
Vehicular Accidents
Physical Abuse
Elementary School Children
Vehicular Accidents
Bicycle Accidents
Falls
Recreational Injuries
Adolescents
Vehicular Accidents
Sports Injuries
Assault
Causes of Acquired Brain Injury
• Post Cancer Treatment
• Toxic Substances
• Infections
• Aneurysms
• Stroke
• Anoxia (i.e. choking, respiratory / heart conditions)
Brain injury can occur
even if there is no loss
of consciousness.
A Concussion
is a Traumatic
Brain Injury!
Concussions in Pennsylvania:
Annually,
approx. 22,000 children
ages 0-21 years
suffer concussions
A Child’s Brain
• Underdeveloped – the younger the child, the less
developed is their brain
• Easily Injured – infant’s neck is weak
• New skills build on ESTABLISHED skills over time
• Brain injury interrupts skill development, and can
prevent new skills from developing
Important Developmental Stages
• Child’s stage of
development when
injury happened
• Child’s stage of
development NOW
Pre-Existing Conditions & TBI
• Children with pre-existing behavioral weaknesses
are much more likely to have a TBI.
• Effects of TBI will compound and add to preexisting learning, behavioral or psychological
problems, such as:
»Dyslexia
»ADHD
»Paranoia
»Depression
Effects of Brain Injury
on Children
Examples of Physical Effects
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Headaches
Changes in speech & language
Stamina/weakness
Difficulty with balance
Seizures
Sensory changes
Taste
Smell
Hearing
Vision
Cognitive Effects
Executive Function Challenges:
– Attend or concentrate
– Initiate, organize, or complete tasks
– Sequence, generalize, or plan
– Flexibility of thinking, reasoning, or problem solving
– Working memory
Cognitive Effects
Metacognitive Challenges:
– Abstract thinking
– Information processing (slowed speed)
– Judgment or perception
– Long-term or short-term memory
Cognitive Effects
Related Challenges:
– Confabulation
– Ability to acquire or retain new information
– Inconsistent and unpredictable learning rate
Social, Emotional,Behavioral Issues
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Distractibility
Impulsivity
Irritability
Aggression
Motivation & Initiation
Depression
Lack of Social Judgment
Denial/Lack of Self-Awareness
Rigidity/Inflexibility
Low Frustration Tolerance
Instructional Strategies to Consider
• Classroom rules & expectations should be well
structured and explicitly taught
• Instruction should contain repetition & feedback
• Avoid multi-step instructions if possible
From: TBI Inservice Training Module, Janet Siantz Tyler, PhD., Kansas Dept. of Education, TBI Project
Instructional Strategies to Consider
• Supplement verbal instructions with writing and
modeling
• Provide ample time to process, complete tasks,
and respond
• Assist the student in keeping his/her materials
and schedule organized
From: TBI Inservice Training Module, Janet Siantz Tyler, PhD., Kansas Dept. of Education, TBI Project
Instructional Strategies to Consider
• Teach compensatory strategies for test-taking,
note-taking, reading materials, etc.
• Try external aids such as lists, diaries, computers,
calculators
• Videotape the student’s progress in class to
provide feedback and show progress
From: TBI Inservice Training Module, Janet Siantz Tyler, PhD., Kansas Dept. of Education, TBI Project
Modifications to Consider
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Consider scheduling adjustments, i.e. breaks,
study hall, eliminating non-core classes, etc.
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Assist the student in changing classes
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Introduce student gradually, i.e. small group
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Need for supervision
Consider ESY, homebound services, instruction in
the home, or tutoring for summer months
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From: TBI Inservice Training Module, Janet Siantz Tyler, PhD., Kansas Dept. of Education, TBI Project
BrainSTEPS Partnerships in our Region
– Discharge Info from:
• Children’s Hospital Pittsburgh
• Children’s Institute Pittsburgh
Pennsylvania’s BrainSTEPS Program
is Considered a National Model for
Brain Injury School Re-Entry!
BrainSTEPS received the
Award of Excellence for
Programs & Services
December 2008,
from the national
Brain Injury Association of America
For More Information on the
BrainSTEPS Program
Contact:
Jamie Moder, MHPE, CHES
Adapted Recreational Education Consultant
Allegheny Intermediate Unit
412-394-5822
[email protected]
Brenda Eagan Brown, M.S.Ed., CBIS
BrainSTEPS Program Coordinator
Brain Injury School Re-Entry Program
Brain Injury Association of Pennsylvania
724-944-6542
[email protected]
www.brainsteps.net
REFERENCES
Chapman SB. Neurocognitive stall: a paradox in long term recovery
from pediatric brain injury. Brain Injury Professional, 3(4): 10-13, 2007.
Kennedy, M. & Krause, M., University of Minnesota, Symposium on
Disability Studies & Inclusive Education, July 23, 2010 ppt
presentation
Savage RC. The Child’s Brain – Injury and Development, Lash and
Associates Publishing, Wake Forest, NC, 1999.
Savage, Ronald C. “The utilization of allostatic load theory to predict
long term deficits in children/adolescents with TBI” presented at
North American Brain Injury Society conference. October, 2007.
www.nabis.org.
Todis B. & Glang, A. (2008). Redefining success: Results of a qualitative
study of post-secondary transition outcomes for youth with traumatic
brain injury. Journal of Head Trauma Rehabilitation, 23(4), 252-263.
http://www.ncbi.nlm.nih.gov/pubmed/18650769