Rosa M. Vela Edu 203 College of Southern Nevada. Chapter 13 Very Low-Incidence Disabilities. Traumatic Brain Injury.
Prior to the 1960’s, most children whose brains were seriously damaged died soon after the trauma. Changes in emergency treatment, imaging technology, and surgical and pharmaceutical treatments now help save children’s lives. However, it often takes intensive special education services and accommodations for the problems resulting from the accident to be resolved.
Click on the link below to see a short video of a child who recovered from traumatic brain injury (TBI)
The IDEA ‘04 definition for TBI was introduced in 1990 when TBI became a separate special education category.
TBI is not
* a condition present at birth or
* caused by a stroke, brain tumor, or
other internally caused brain damage.
* due to a concussion or head injury, possibly from an accident or child
* not always apparent or visible, and
* may or may not result in loss of consciousness
According to the National Institute of Neurological Disorders and Stroke TBI ranges in severity from mild to severe. They can last for a very short time or years. In some cases the effects disappear, but in some other cases it will result in lifelong problems.
These symptoms are:
dizziness, headache, selective attention problems, irritability, anxiety, blurred vision, insomnia, fatigue, motor difficulties, language problems, behavior problems, or cognitive and memory problems.
According to the federal government, 23,864 students, ages 6 through 21, receive special education services because of TBI (OSEP, 2008a).
Almost two-thirds of these students learn alongside classmates without disabilities, some with support from resource programs, for most of the school day (OSEP, 2008a).
Half are caused by transportation accidents such as car accidents, motorcycle accidents, and bicycle accidents.
20% percent are due to violence such as child abuse or firearms.
Small percentage is due to sports injuries.
TBI is common among older children, teenage boys who are engaged in high risk behaviors.
For young children TBI is usually caused by child abuse, shaken baby syndrome where an infant is shaken so hard that it causes brain injury.
Traumatic Brain Injury (TBI)
Can be prevented or injuries minimized. Wearing helmets when riding a bike or skateboarding, not driving moving vehicles while intoxicated or under the influence of drugs and avoiding high-risk behaviors can prevent tragic accidents.
Quick and immediate medical attention is important to prevent further damage.
There is no single answer to how best to educate these
students. Many students have complex coexisting conditions
that result in unique, and highly individualized educational
Because of universal infant screenings, better medical technology,
and more informed pediatricians, more and more instances of
disabilities are identified when these individuals are infants or
toddlers. Their delays in development become obvious when they
do not walk or talk on time, toddlers are identified so they can
receive important intervention services during early childhood.
Unless the disability occurs later for example a head injury after
Many infants are identified and receive critical early
intervention services in their first few years of life. Families
benefit from these services because they learn how to interact
in special ways with their baby with severe disabilities.
Sometimes it is educators who must confirm families worst
fears: (The bicycle accident several weeks ago caused more
than a broken leg; it may have also caused brain injury) School
personnel play a critical role in bringing important services to
students with TBI.
Students with multiple and coexisting disabilities many of them are identified at birth.
Universal Infant screening procedures bring babies with hearing and vision problems to the
attention of service providers during the critical months after birth. The situation for
students with TBI is different because sometimes they don’t get identified right after their
injury because they show no visible signs (cuts, bruises) of brain injury. This often creates
challenges for the injured person because the outside world cannot see the wounds from a
TBI and have difficulty understanding the nature of the injury. Many cases go undiagnosed
this is often called the silent epidemic.
Evaluation: Alternate Assessments—The “1% Kids”
IDEA ‘04 and the No Child Left Behind Act require all students—those with and without
disabilities—be included in the national accountability system. Students not participating
fully in the general education curriculum, the government allows each state to use
alternate assessments—another form of testing and evaluation of learning gains. Such
students are given these alternate assessments on alternate achievement standards. These
standards might reflect achievement expectations of those participating in the general
education curriculum but with fewer objectives or different expectations.
Parents and extended family members are often at the heart of
early intervention services, making a difference in the lives of their
children. It is important that infants and toddlers with extensive
needs because of their disabilities receive extra help learning,
growing, and getting prepared for life and their school years. The
early intervention services is possible through IDEA ‘04. It’s
important for professionals , families, and policymakers to agree
about what to expect from these services. Below are five outcomes
for families participating in services supported by IDEA ’04 agreed
Students with low-incidence disabilities should
be considered a unique member of a diverse
group of learners, all of whom exhibit
different learning styles and characteristics.
Access to the General Education Curriculum
Students with low-incidence disabilities do not
have access to the general education as their
primary objective, they will be striving to
meet a curriculum such as independent living.
TBI students have the highest participation
rate in general education. Students with deaf-
blindness has a low participation rate. The
lowest however is students with multiple
Modifications to the instructional program/classroom
routine can make such a difference and help achieve
maximum benefits for students with low-incidence
Example: A student with TBI who spends only half a day at school benefits greatly when the classroom schedule is adjusted so instruction on important academic tasks happens during the morning.
Functional curriculum is instruction in natural settings
relating to life (person’s daily needs) and vocational skills.
This type of practice is not appropriate for every student
with low incidence disabilities, the IEP team decides. TBI
students find that organizing strategies, such as graphic
organizers and story maps help them focus, visualize
information, and put structure to their learning efforts.
Data-Based Practices (continued)
After the age of 14, the labor laws allow
students to work in the community.
Important skills needed in daily life must
be taught in natural or real settings to
become useful, this is community-based
Instruction (CBI). This practice improves
these individuals’ inclusion in daily life
and employment when they are adults.
Has helped individuals with
Augmentative and alternative
communication devices (ACC) allows for
communication and participation not
otherwise possible for many individuals with
multiple-severe disabilities. Also this type of
device has helped students who are unable to
communicate with others through oral
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