Traumatic Brain Injury And Multiple Disabilities

1. Traumatic Brain Injury And Multiple Disabilities Chapter 12 Mackenzie Miller

2. Traumatic 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.

3. Types of Brain Injury • Skull 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).

5. Severity 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 months • Categorized • Minor • Moderate • Severe 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.

6. Causes of TBI • During Childhood: • Falls from heights • Sports/rec. related injuries • Automobile/ other vehicle accidents • Child abuse or any type of assault • Most likely to occur: • When a child is under 5. • When a child reaches adolescence.

7. After 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 reflex • Tonic labyrinthine reflex • Positive support reflex

8. Effective Practices for Students with TBI • Use 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.

9. Prevalence of TBI • TBIs to children between birth and 14 yrs result in: • 2,700 deaths • 37,000 hospitalizations • 435,000 ER visits • 1 of 25 children are medically treated for head injuries • Of this group 1 of 500 suffers TBI. • Most resent date from U.S Dept. of Education • A little over 23,00 students between 6 & 21 were classified as having TBI. • Which represents only about 0.04% of the school-age population.

10. Multiple Disabilities According to IDEA “ concomitant impairments ( MR-blindness, MR-orthopedic impairment) the combination of which causes such severe educational needs that they can’t be accommodated in special education programs solely for one of the impairments.” Term doesn’t include deaf-blindness ( often classified according to the nature of their physical disabilities & other health impairments)

11. Causes of Multiple Disabilities Prenatal (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.

12. Causes of Multiple Disabilities Perinatal(around time of) Viral or bacterial maternal infections = little effect on mother can be serious to child. (Rubella, cytomegalovirus, herpes, syphilis and toxoplasmosis) Postnatal (after birth) Thalidomide- 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 brain

13. Conditions seen in individuals with multiple disabilities Cerebral Palsy (CP)- neurologically based condition. • Forms of CP • spasticity- muscle stiffness. • athetosis- unwanted or involuntary movement. • ataxia- lack of balance and uncoordinated movement Epilepsy- seizures • TYPES: • tonic-cronic seizures • partial seizures ( psychomotor or temporal lobe seizures) • absence seizures- (petit mal seizures)

14. Prevalence 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).

15. Multiple Disabilities • On a regular basis some students with multiple disabilities • will have nutrition problems such as : • Anemia • Dehydration • Skin irritation and pressure sores • Respiratory infections • Asthma • Ear infections • Contractures

16. Educational Evaluations • Focus 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?

17. Effective Practices for Students with Multiple Disabilities Preschool Programs Family-centered approach- approach to treatment or intervention that considers and addresses the strengths and needs of an individual’s family as well as those of the individual. Developmentally appropriate practices- instructional activities that are individually and age-appropriate and reflect a child’s social and cultural milieu.

18. School Programs • Inclusive 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.

19. Activity Cover 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.

20. 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!

21. Resources http://www.traumaticbraininjury.com/index.html http://injury-law.freeadvice.com/injury-law/brain-injury.htm http://projectidealonline.org/multipleDisabilities.php