What is Acquired Brain Injury?

221 Pages·2003·3.65 MB·English

by  Tower G4/3

Educating Educators
About ABI
Re s o u r c e B i n d e r
Produced by:
Brock University
- and the-
Ontario Brain Injury Association
Funded by:
Ontario Neurotrauma Foundation
Primary Investigators
Dr. Sheila Bennett
Associate Professor, Faculty of Education
Brock University, St. Catharines, ON
Tel: [phone] ext. 4584
Email: [email protected]
Dr. Dawn Good
Chair, Department of Psychology and Centre for Neuroscience
Brock University, St. Catharines, ON
Tel: [phone] ext. 3556
Email: [email protected]
John Kumpf
Executive Director
Ontario Brain Injury Association, St. Catharines, ON
Tel: [phone] ext. 222
Email: [email protected]
Thanks to:
Dawn Zinga, Research Assistant
Tracey Burnet, Research Assistant
Jane Arghittu, Research Assistant
Barbara Chambers, Proofreading Service
Jennifer Norquay, Typesetting
Special thanks to Dr. Dawn Zinga for her
collaborative contributions on this project
ISBN 0-9733658-0-3
Title: “Educating Educators About ABI: Resource Binder”
© 2003 Ontario Brain Injury Association
The Ontario Brain Injury Association and Brock University
would like to gratefully acknowledge the financial support of the
Ontario Neurotrauma Foundation.
— ii —
Preface
It is estimated that there are approximately 27,000 students who have
experienced a brain injury in the classrooms of Ontario. This manual is intended as a
resource to anyone involved in the education of a student who is living with the
effects of an acquired brain injury. It grew out of my own frustration at the lack of
resources and knowledge in the field. This became apparent when I was challenged to
teach these very special students. One of my goals when I started my new career at
the Ontario Brain Injury Association was to provide teachers with a resource that
would help them to help students living and learning with the effects of an acquired
brain injury.
In this endeavour, I’ve had the good fortune to work with Dr. Dawn Good,
Chair of the Psychology Department at Brock University, Dr. Sheila Bennett,
Associate Professor, Faculty of Education at Brock University, and a number of
extraordinary research assistants. This group has spent 3 years researching and
developing the materials that are provided here. Educators are invited to use them,
copy them and share them—free of charge. We also invite you to contact us at
OBIA, tel: [phone], or by email: [email protected], for further information.
In addition, information is available on a special web site developed in conjunction
with this project: www.abieducation.com.
Our deepest appreciation goes out to the many educators who participated in this
study and to the Ontario Neurotrauma Foundation, which funded the project.
Sincerely,
John Kumpf
Executive Director, OBIA
Primary Investigator, ONF Project
— iii —
Table of Contents
Chapter 1- Brain and Function in the
Context of Acquired Brain Injury 1
......................................
1.1 - Case Study........................................................................................... 2
1.2 - The Brain is Who You Are..................................................................... 2
1.3 - Brain Physiology and Behaviour............................................................ 3
1.4 - What is Acquired Brain Injury? ........................................................... 11
1.5 - What Happens When the Brain is Damaged?....................................... 11
1.6 - Who Does Acquired Brain Injury Affect?.............................................. 13
1.7 - Brain and Function ............................................................................ 14
Chapter 2 - Understanding ABI from a
Developmental Perspective 25
...............................................
2.1 - Myths About the Injured Brain ............................................................ 26
2.2 - Causes of Acquired Brain Injury ......................................................... 27
2.3 - Traumatic Brain Injury ....................................................................... 28
2.4 - Mild, Moderate, and Severe Injuries.................................................... 31
2.5 - Damage at Specific Stages During Child Development......................... 33
2.6 - Recovery and Long-Term Consequences............................................. 39
Chapter 3 - The Challenges of Working with ABI 41
..
3.1 - Case Study......................................................................................... 42
3.2 - Functional/Behavioural Expectations in the Classroom ....................... 43
3.3 - General Challenges in the Classroom Following ABI ............................ 44
3.4 - Cognitive Challenges Following ABI .................................................... 45
3.5 - Behavioural/Emotional Challenges Following ABI ................................ 49
3.6 - Physical Challenges Following ABI....................................................... 52
3.7 - Other Important Considerations Regarding Challenges in the Classroom............. 55
Chapter 4 - Working with ABI in the School
Setting 57
..........................................................................................
4.1 - Case Study......................................................................................... 58
4.2 - Myths and Misconceptions ................................................................. 59
4.3 - Learning Disabilities vs. Acquired Brain Injury..................................... 59
4.4 - Deciding on Appropriate Strategies .................................................... 62
4.5 - The Process for Developing Strategies ................................................ 63
4.6 - General Strategies for Educators ........................................................ 63
4.7 - Cognitive Impairments ....................................................................... 64
4.8 - Cognitive Skills and Strategies............................................................ 65
4.9 - Behavioural/Emotional Impairments................................................... 74
4.10 - Behavioural/Emotional Skills and Strategies...................................... 75
— iv —
4.11 - Physical Impairments ....................................................................... 82
4.12 - General Skills and Strategies ............................................................ 86
Chapter 5 - General Techniques for
Working with Individuals with ABI 91
................................
5.1 - Overview ........................................................................................... 92
5.2 - Redirection........................................................................................ 92
5.3 - Restructuring ..................................................................................... 95
5.4 - The “Back Door” Approach................................................................. 98
5.5 - Positive Reinforcement..................................................................... 100
5.6 - Active Ignoring................................................................................. 102
5.7 - Cueing............................................................................................. 104
5.8 - Changing the Antecedent ................................................................. 108
Chapter 6 - Individual Program Planning/Returning
to School 113
..................................................................................
6.1 - Case Study....................................................................................... 114
6.2 - Myths and Misconceptions ............................................................... 115
6.3 - Aspects of Successful Integration Back to School ............................. 116
6.4 - What is an Individual Educational Plan (IEP) and Why is it Important? ............118
6.5 - How is an IEP Written? ..................................................................... 122
6.6 - Transitions ...................................................................................... 129
6.7 - Identification and Placement of Exceptional Students ....................... 135
Chapter 7 - A Team Approach to Assessment
and Planning 139
..........................................................................
7.1 - Myths and Misconceptions................................................................ 140
7.2 - Working With Other Professionals..................................................... 141
7.3 - Personnel Available at School and School Board Level...................... 144
7.4 - Other Related Professionals.............................................................. 146
7.5 - Things to Remember When Accessing Help....................................... 147
7.6 - A Team Approach to Assessment ..................................................... 147
Chapter 8 - Role of the Parents 155
...................................
8.1 - Myths and Misconceptions................................................................ 156
8.2 - Role of the Parent ............................................................................ 157
8.3 - Words of Caution ............................................................................. 158
8.4 - General Tips for Talking With Parents................................................ 161
8.5 - Strategies for Maintaining Regular Parent-Teacher Communication.............. 162
— v —
Chapter 9 - Appendices Appendix - i
..................................
9.1 - Acronyms............................................................................Appendix - iii
9.2 - Neuropsychological Tests .....................................................Appendix - v
9.3 - Brain Injury Quiz.................................................................Appendix - vii
9.4 - Curriculum Expectations .................................................... Appendix - ix
9.5 - Glossary .............................................................................Appendix - xxxi
9.6 - Resource/Reference List.................................................. Appendix - xxxxiii
9.7 - Index.............................................................................. Appendix - xxxxix
— vi —
Resource Binder
Chapter 1
Brain and Function in the Context of
Acquired Brain Injury
1.1 Case Study
1.2 The Brain is Who You Are
1.3 Brain Physiology and Behaviour
1.4 What is Acquired Brain Injury?
1.5 What Happens When the Brain is Damaged?
1.6 Who Does Acquired Brain Injury Affect?
1.7 Brain and Function
1-1
Educating Educators About ABI
1.1 - Case Study Adam was 5 years old when he fell down the
basement stairs while hurrying to catch up with his 7-
year-old brother. He was dazed and lay motionless for a
few minutes at the bottom of the stairs, until Mom came
to help. After a few tears, Adam seemed OK and eagerly
followed Mom into the kitchen for a cookie. Later that
day he began to vomit and his mother was concerned
enough to take him to the hospital where he was initially
diagnosed with concussion.
Over the next few weeks and months, Adam’s
“personality” seemed to change. He was more obstinate
and easier to anger; he was slower than usual, even
lazy, when asked to do simple things like get ready for
school. His kindergarten teacher noticed a change in his
social behaviour with others. By the end of the year, the
school’s recommendation was for Adam to retry
kindergarten. His parents, at the suggestion of the school
team, took Adam for a full physical exam which, after a
referral to a neurologist, resulted in a CT scan. Adam
was finally diagnosed with a mild brain injury.
1.2 - The Brain is Since the brain is responsible for the most complex
Who You Are of human functions such as thinking, problem solving,
emotions, consciousness, and social behaviour, it,
essentially, controls and defines your personality or who
you are. It also controls basic bodily functions such as
breathing, eating, sleeping, moving, and the five senses
and is responsible for how we think, feel, perceive, and
act in the world—it is the organization of who we are.
Although the brain
If an external force is strong enough to either
comprises only 2% of
fracture the cranial bones, or an internal rotational
our weight, it manages
98% of our functions, force occurs due to impact causing the brain to hit or
directly or indirectly, and
scrape against the inside of the skull, the brain will tear
is highly complex in its
and/or neurons will be damaged—and we will change.
organization.
1-2
Resource Binder
1.3 - Brain The brain is made up of cells called neurons, and,
Physiology and with the spinal cord, makes up the central nervous
system (CNS).
Behaviour
At birth, we have essentially all the neurons we will
ever have for the rest of our lives. Although most neural
differentiation is accomplished by 6 months postnatally,
Damage to the brain
development continues until we are 25 years old in terms
can actually change
how a person learns, of growth in size, dendritic connections, the process of
thinks, behaves, and parsing (natural progression of neurons dying), and
interacts with other
myelination (formation of myelin on axons).
people—in essence,
it changes your
personality or who
you are.
Structure and Function of The brain is quite fragile and has a soft jelly-like
the Brain
consistency. In order to protect this fragile organ, the
body has developed three lines of defense.
1st Line of Defense - Hair and Skull
• Hair prevents excessive heat loss
• The skull provides a bony case that encapsulates
and protects the brain from external impact (note:
the inner surface of the skull is not entirely smooth,
but contains rougher areas and ridges along its
ventral portion)
1-3