1. Characteristics of Brain Injuries: Mild to Severe While the severity of brain injury can be categorized as mild, moderate or severe, even brain injuries that are considered “mild” can have cognitive, social / behavioral, and physical manifestations

2. Important Things to Remember The most important things to remember! • A person with a brain injury is a person first. • No brain injuries are exactly the same. • The effects of a brain injury are complex and vary greatly from person to person. • The effects of a brain injury may not manifest immediately following the incident • The effects of a brain injury depend on which part of the brain is injured.

3. Factors that affect skills following a Brain Injury • Age at time of brain injury • The area of the brain that was injured • Severity of brain injury • Duration of coma • Time lapse since injury occurred • Intellectual ability prior to injury • Personality prior to injury • Willing to participate in recovery plan • Environmental / family conditions

4. Mild Brain Injury - Concussion Definition • A concussion is a temporary loss of normal brain function.

5. School Nurse’s Role • Document which children have had a concussion AND let the classroom teachers know who those children are. • Inform teachers / coaching staff on the signs and symptoms of concussion. • Work closely with family / staff to monitor children who have had a recent concussion. • Help keep track of old and new injuries. • Passing on your knowledge to: coaches, teachers and families.

6. Memory Problem Solving Decision Making Organization Planning Sequencing Judgment Persistence Thinking Differences Self-perception Perception Inflexibility Processing speed Cognitive Manifestations

7. Processing Speed: Colorsquickly state the COLORS you see PinkGreenOrange BlueYellow Blue Red Orange Black Yellow RedYellow BlackBlueGreen OrangeOrangeRed YellowBlackYellow

8. Processing Speed: Textquickly read the WORDS that you see PinkGreenOrange BlueYellow Blue Red Orange Black Yellow RedYellow BlackBlueGreen OrangeOrangeRed YellowBlackYellow

9. Stroop Effect • Speed of Processing theory: the interference occurs because words are read faster than colors are named. • Selective Attention Theory: the interference occurs because naming colors requires more attention than reading words.

10. Do You Have a Strange Mind? Cna yuo raed tihs? Fi yuo cna raed tihs yuo hvae a sgtrane mnid too.

11. The rset can be a taotl mses and yuo can sitll raed it whotuit a pboerlm. Wehn yuo becmoe an eicffneit raeder, the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Azanmig huh?

12. I cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I wsa rdanieg. The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it dseno’t mtartr waht oerdr the ltteres in a wrod are, the olny iproamtnt tihng is taht the frsit and lsat stteer be in the rghit pclae.

13. Aggression / Anger control Poor Attention Easily frustrated Perserveration Impulsivity Impulsive Depressed Mood Swings Non-compliant Lack of social skills Poor persistence Physical Acting Out Disinhibited Difficulty with transitions Lack of motivation Immature behavior Denial of deficit Egocentric Anxiety and Stress Emotional Outbursts Behavioral Problems

14. Social Problems • Poor eye-contact • Inability to stay on topic • Difficulty forming or maintaining relationships • Lack of response to social cues • Invasion of personal space of others • Withdrawal or Isolation • High risk behaviors • Socially inappropriate statements • Poor personal hygiene • Sexual acting out • Excessive self-focus

15. Gait deficits Cranial defects Seizures Balance Mobility Abnormal tone Change in vision Change in hearing Frequent headaches Fatigue or weakness Spasticity & tremors Speech deficits Decreased strength Lack of endurance Taste and Smell Motor coordination Physical Changes

16. Motor Coordination 1. Slightly lift your right foot off the floor. 2. Begin circling your foot clockwise. 3. Write your whole name in cursive.

17. LEA Special Education Guidelines for Health Services • If the health care needs of a student is consistent with those typically proved to all student within the general education environment (core instruction), no health care services are warranted. • If specific health intervention is needed, the health care provide should become a member of the intervention team. • Health care services specific to an individual student (i.e. brain injury), and Intensive Instruction Intervention/Stage 3 Plan should be written with the involvement of all team members.

18. LEA Special Education Guidelines for Health Services • An Individual Health Plan (IHP) may be developed regardless of whether a student is eligible for special education services or not. • A medical diagnosis by itself does not make a student eligible for special education services. • When in doubt speak to your team!