I’m Good Enough, I’m Smart Enough and Doggone it, I know TBI

1. I’m Good Enough, I’m Smart Enough and Doggone it, I know TBI Judy L. Dettmer 303-866-4085 judy.dettmer@state.co.us

2. School Realities: No school person/program owns TBI: Case manager does not follow TBI Program does not follow TBI Myth of Rehab Center for TBI students: School IS the Rehab Center

3. 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!

5. 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

6. ADJUST Analyze & Interpret Data PLAN Identify Strengths, Concerns, & Outcomes MONITOR Evaluate Response to Intervention TEACH Assign & Implement a Research-based Intervention Universal Instruction & Problem Solving Model Data Driven Decision Making

7. Broad Overview of Issues & Strategies

8. Hallmarks of Brain Injury • Fatigue • Executive Function * Speed of Processing * Memory * Attention * Organization/Planning * Social Emotional

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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.

17. 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 theplanner is correct.

18. 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

19. 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

20. Tools for Interventions • LearNet • Colorado Kids with BI • BrainSTARS • What Works Clearing House • Casel • Cherry Creek School District • BEG, BORROW and STEAL!

21. LEARNet Problem-Solving SystemMark Ylvisaker, Ph.D. • Clear statement of the problem in simple, everyday behavioral terms • Brainstorm possible explanations: • Medical • Cognitive • Self-regulation • Behavioral • Emotional

22. 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

23. WWW.cokidswithbraininjury.org • Identification and Intervention Protocol • Best practices for identification • Best practices for assessment • Best practices for interventions

24. Monk Video

25. BrainSTARS • Introduction to Brain Injury • Brain Injury and Development • Problem Solving Index

26. 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

29. CASEL 5 domains: • Self Awareness • Social Awareness • Self Management • Relationship Skills • Responsible Decision Making

31. 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

32. Progress-Monitor Prioritize only 1 to 2 behaviors Write SMART goals Determine a baseline Determine an aimline Determine a time-frame Examples of behavior plans and progress-monitoring: Interventioncentral Chart Dog Excel

33. SMART GOALS SMART Goals – Specific Measurable Attainable Realistic Time-limited “I do, we do, you do”

34. 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

35. Now Repeat After Me…. “I’m good enough, I’m smart enough and doggone it… I know TBI”!

36. Questions? The End!