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Traumatic Brain InjuryAndMultiple DisabilitiesChapter 12Mackenzie Miller1Traumatic Brain Injury According to IDEA 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, psychological behavior, physical functions, information processing and

speech.* Different types of brain injury have varying degrees of seriousness & potential harm.2Types of Brain InjurySkull fractures linear fracture is a crack in the skull detectable by an X-ray.Since the skull is pushing against the brain & often is associated with significant brain damage.

Contusion- a bruise in part of the brain, the degree of damage will depend on how extensive the bruise is. Symptoms may worsen days after the incident.

Hematoma- a blood clot. -epidural hematoma- between skull and outer covering of brain. -subdural hematoma- directly on brain and is usually more serious of the two.

Concussion- can cause loss of consciousness or amnesia. Caused by slight injury of nerve fibers in the brain.

Diffuse axonal injury (DAI)- similar to but more sever than concussions. Nerve fibers (axons) injured by violent motions (car accident).

3TBI- Seeing conditions in the ClassroomRemembering- may fail to remember assignments or require a great deal of practice to remember tasks, activities or procedures.Carry out Cognitive Tasks- may be able to do math computations but might not be able to reason adequately to solve word problems. Problem Solving- student may have a problem but cant work out a solution to compensate for the problem. Information Processing- student becomes frustrated when given several bits of information or directions in a short period of time.Communicating- difficulty either expressing thoughts or understanding others who are speaking. 4Severity of TBI is determined by the duration and severity of the coma that follows the injury.

coma- loss of consciousness sometimes occurs after a head injury, can last hours, days even monthsCategorizedMinorModerateSevere

As the person is prompted to respond, their ability is rated using the Glasgow coma scale and based on the overall rating, the severity of the trauma is evaluated. 5Causes of TBIDuring Childhood:Falls from heightsSports/rec. related injuriesAutomobile/ other vehicle accidentsChild abuse or any type of assaultMost likely to occur:When a child is under 5.When a child reaches adolescence.ForcesImpact- force to the head that causes skull to fracture, bruise parts of brain, or cause bleeding in the skull.Inertial- rapid and severe motion thats violent enough to damage nerve fibers and blood vessels6After a TBI therapists provide rehab to:

Counter conditions that can occur from immobilization and neurological dysfunction. Help the person regain abilities or teach them to adapt if they lost any functions.Help offset the effect of any form of chronic disability on learning or development.Primitive Reflexes- reflexes that occur in infants but disappear as they grow older.Include:Asymmetric tonic neck reflexTonic labyrinthine reflexPositive support reflexEffective Practices for Students with TBIUse multimodal approach

Teach compensatory strategies and structure choices.

Begin instruction with review or overview of previous materials.

Provide written or visual outline of the material.

Emphasize main points of the topic & explain key ideas.

Frequent feedback on performance and behavior.

Encourage questions.

Break down larger assignments into smaller ones.

Ask students on what will help them learn better.

Use open-ended and multiple choice questions.

Use illustrations, diagrams or other visuals.

Provide additional verbal or visual cues.Prevalence of TBITBIs to children between birth and 14 yrs result in: 2,700 deaths37,000 hospitalizations435,000 ER visits

1 of 25 children are medically treated for head injuriesOf this group 1 of 500 suffers TBI.

Most resent date from U.S Dept. of EducationA little over 23,00 students between 6 & 21 were classified as having TBI.Which represents only about 0.04% of the school-age population.9Multiple Disabilities According to IDEA concomitant impairments ( MR-blindness, MR-orthopedic impairment) the combination of which causes such severe educational needs that they cant be accommodated in special education programs solely for one of the impairments.

Term doesnt include deaf-blindness Classification TermsMonoplegia: only one limb is effected.Diplegia: lower limbs are severely effected; trunk & upper limbs to a lesser extent.Paraplegia: only the legs are effected.

Quadriplegia: major involvement of all four limbs, as well as neck and the trunk.( often classified according to the nature of their physical disabilities & other health impairments)10Causes of Multiple DisabilitiesPrenatal (before)Prenatal (genetic conditions, chromosomal anomalies, maternal infections)Recessive genetic condition- condition only inherited if both parents have the condition or if both parents are carriers. Dominant genetic condition- condition inherited only if one parent has condition. 11Causes of Multiple DisabilitiesThalidomide- drug dev. In 1950s to reduce morning sickness, shown to have lead to impaired limb development.Meningitis- bacterial or viral infection of spinal cord and the fluid that surrounds the brainViral or bacterial maternal infections = little effect on mother can be serious to child.(Rubella, cytomegalovirus, herpes, syphilis and toxoplasmosis) Perinatal (around time of) Postnatal (after birth)12Cerebral Palsy (CP)- neurologically based condition.

Forms of CPspasticity- muscle stiffness. athetosis- unwanted or involuntary movement. ataxia- lack of balance and uncoordinated movementConditions seen in individuals with multiple disabilitiesEpilepsy- seizuresTYPES: tonic-cronic seizures partial seizures ( psychomotor or temporal lobe seizures) absence seizures- (petit mal seizures)13Prevalence of Multiple Disabilities Students with Multiple Disabilities = 132,000.0.23% of school-age population.Some students who have multiple disabilities may be found in other disability categories (intellectual disabilities or physical disabilities).14Multiple Disabilities On a regular basis some students with multiple disabilities will have nutrition problems such as :

AnemiaDehydrationSkin irritation and pressure soresRespiratory infectionsAsthmaEar infectionsContractures15Educational EvaluationsFocus on four questions:

- What is the students current ability in key areas including academics, social development, and physical and health needs?

What general curriculum goals are appropriate for the student, and to what extent and in what ways can the student participate in the general curriculum?

What additional areas of instruction must be addressed?

What related services and supports will be required to provide the student with an appropriate education?

16Effective Practices for Students with Multiple DisabilitiesPreschool Programs

Family-centered approach- approach to treatment or intervention that considers and addresses the strengths and needs of an individuals family as wellas those of the individual.

Developmentally appropriate practices- instructional activities that are individually and age-appropriate and reflect a childs social and cultural milieu.

School ProgramsInclusive schools and classrooms

Paraeducators and peers

Adapting the general curriculum

Functional and personal skills instruction

Systematic instructional procedures

partially participate in activities harder to do due to disability.

Collaboration of physical, occupational, & speech- language therapy.

Opportunity to gain as much independence as possible.ActivityCover your left eye and read the following passage. Don't pamper damp scamp tramps that camp under ramp lamps.

A dozen double damask dinner napkins.

Draw drowsy ducks and drakes.

Now cover your right eye and have your partner cover your ears And read the following passage.Mr. See owned a saw.And Mr. Soar owned a seesaw.Now See's saw sawed Soar's seesawBefore Soar saw See,Which made Soar sore.Had Soar seen See's sawBefore See sawed Soar's seesaw,See's saw would not have sawedSoar's seesaw.So See's saw sawed Soar's seesaw.But it was sad to see Soar so soreJust because See's saw sawedSoar's seesaw!

http://www.traumaticbraininjury.com/index.htmlResourceshttp://injury-law.freeadvice.com/injury-law/brain-injury.htmhttp://projectidealonline.org/multipleDisabilities.php