im good enough, im smart enough and doggone it, i know tbi judy l. dettmer 303-866-4085...
TRANSCRIPT
I’m Good Enough, I’m Smart Enough and Doggone it, I know TBI
Judy L. Dettmer
303-866-4085
School Realities:
No school person/program owns TBI:Case manager does not follow TBIProgram does not follow TBI
Myth of Rehab Center for TBI students:School IS the Rehab Center
Shades of grey!
YOU ARE THE EXPERTS!
De-mystify TBI – eligibility is binary.
But assessment and treatment of TBI is many shades of grey, red, blue, green…
TBI assessment protocol and a TBI intervention protocol – within your creative reach!
Basic premises
Proper Intervention is grounded in a Good Assessment – comprehensive, multi-layered
Focus of intervention is on teaching positive replacement behaviors and skills instead of looking at deficits
Requires active and continuous teaching on the part of adults
Not linear, not circular – it’s spiral
MONITORMONITOREvaluate Response Evaluate Response
to Interventionto Intervention
PLANPLANIdentifyIdentify Strengths, Strengths, Concerns, Concerns, & Outcomes& Outcomes
TEACHTEACHAssign & Implement a Assign & Implement a
Research-based InterventionResearch-based Intervention
ADJUST ADJUST Analyze & Interpret Analyze & Interpret
DataData
Universal Instruction & Problem Solving ModelUniversal Instruction & Problem Solving Model
Data D
riven
D
ecisi
on M
akin
g
Broad Overview of Issues & Strategies
Hallmarks of Brain Injury
Fatigue Executive Function
* Speed of Processing
* Memory
* Attention
* Organization/Planning
* Social Emotional
Strategies for Addressing Fatigue
Encourage the student to take rest breaks Be aware that medications a student is taking and
time of day they take them can contribute to fatigue Recognize signs when student is overloaded or
fatigued. Avoid presenting them with new tasks or information
School day may need to be altered or shortened to accommodate fatigue
Strategies for Addressing Speed of Processing
Give the student instructions one at a time, make them clear and concise
Provide appropriate “wait time” for the student to formulate a response to questions asked of him/her
Strategies for Addressing Speed of Processing
Eliminate timed tests
Avoid situations requiring multi-tasking
When giving instructions, check for comprehension. Have the student verbalize the instruction as well as demonstrate that he/she understands
Strategies for Addressing Memory
Regularly summarize information with the student as it is being given, especially critical in regards to new learning
Give instructions in written, verbal and visual format when possible
Call on the student with a brain injury first so that they do not forget their responses and are then able to focus on others responses
Strategies for Addressing Memory
Develop checklists/picture schedules with the student that he/she can use to help remember daily schedules, routines, etc.
Consistency and time are important, especially when introducing a new strategy
Allow the student time to put into practice what was just learned to reinforce learning/memory
Modify test format to reduce need for total memory recall, e.g. multiple choice
Strategies for Addressing Attention
Provide the student with an uncluttered environment
Eliminate as many auditory and visual distractions as possible
Eliminate as many interruptions as possible
Strategies for Addressing Attention
Assign tasks that do not require a lot of divided attention
Break task down into manageable steps based on the individual’s attention span
Provide the student with clear expectations for what he/she is supposed to accomplish during the activity time
Strategies for Addressing Organization/Planning
Assist student with cleaning out desks/locker on a routine basis
Develop checklists with the student that he/she can use to help remember daily schedule, routines etc.
Help student organize notebooks by using dividers, colored folders, portfolio containers etc.
Strategies for Addressing Organization/Planning
Help student develop and organize a “Homework Only” folder and check it with him/her at the beginning of each class
Check student’s planner at the end of the day (elementary) or each class (secondary) to ensure that they have written their homework assignments completely and accurately. Have the teacher initial the page so the parents know the planner is correct.
Strategies for Addressing Social/Emotional Concerns
Provide a framework for structure in social situations (e.g., invite a friend over for a specific period of time to do a specific activity)
Smal group settings are usually better for a student with a brain injury
Use peer buddies as mentors
Help the student identify what activities they may enjoy following a brain injury
Provide the student with direct and clear feedback
Most Importantly!
Do not assume that the student has the ability to take responsibility for the organizational aspects of his/her education
Each person with a brain injury is an individual and therefore a strategy you try with one person may not work with the next
Become familiar with the beauty of trial and error but give significant time for a strategy to take hold
Tools for Interventions
LearNet Colorado Kids with BI BrainSTARS What Works Clearing House Casel Cherry Creek School District BEG, BORROW and STEAL!
LEARNet Problem-Solving SystemMark Ylvisaker, Ph.D.
1. Clear statement of the problem in simple, everyday behavioral terms
2. Brainstorm possible explanations: Medical Cognitive Self-regulation Behavioral Emotional
LearNet
3. Systematic exploration of possible explanations
4. Planning (well thought out and evidence-based) interventions and support
Additional considerations: Collaboration Context On-going process
WWW.cokidswithbraininjury.org
Identification and Intervention Protocol Best practices for identification Best practices for assessment Best practices for interventions
Monk Video
BrainSTARS
Introduction to Brain Injury
Brain Injury and Development
Problem Solving Index
Evidence-Based or Research-Based Intervention:
What Works Clearinghouse
www.whatworksclearinghouse.org CASEL – Collaborative for Academic, Social
and Emotional Learning www.casel.org Cherry Creek School District, Colorado Wiki
www.ccsdrti.pbworks.com
CASEL 5 domains:
Self Awareness Social Awareness Self Management Relationship Skills Responsible Decision Making
Cherry Creek School District Wiki
Systematic Review of Evidence Based or Best Practices
Listing of practices endorsed by CCSD Description of area of need and
corresponding intervention
Progress-Monitor
Prioritize only 1 to 2 behaviorsWrite SMART goalsDetermine a baselineDetermine an aimlineDetermine a time-frame
Examples of behavior plans and progress-monitoring:InterventioncentralChart DogExcel
SMART GOALS
SMART Goals –
Specific
Measurable
Attainable
Realistic
Time-limited
“I do, we do, you do”
Progress-Monitoring
A Spiral
If intervention is working, wean back and insert more natural supports
If intervention is not working: evaluate, brainstorm, and adjust
If intervention works, wait and it will morph
Now Repeat After Me….
“I’m good enough,
I’m smart enough
and doggone it…
I know TBI”!
Questions?
The End!