Traumatic Brain Injury

1. Traumatic Brain Injury EEX 6107 – Dr. Lee Cross Teaching Written & Spoken Language 10/2/2009 Created by... Sue Fontaine Tina Gonzalez Sandra Rivera Jayne Stewart

2. Characteristics of TBI - Traumatic Brain Injury... Each to a varying degree dependent on the scope of the injury...what part of the brain & how badly • Physical difficulties: • headaches • seeing • hearing • other senses... (smell, sensing hot/cold, etc.) • fine motor skills (writing, drawing) • spasticity (sudden muscle contraction) • fatigue • seizures • balance • paralysis • Social, behavioral, or emotional: • sudden change in mood • anxiety • depression • trouble relating to others • restlessness • laughing or crying a lot • lack of motivation • lack of emotional self-control • Thinking/Cognition: • short-term memory loss (what was just said) • long-term memory loss (formerly known facts) • short attention span • slow processing skills • slow talking and listening • slow reading and writing • poor planning/judgment • poor sequencing CT scan showing cerebral contusions According to the IDEA (2004)...a traumatic brain injury is an acquired injury to the brain...resulting in total or partial functional disability or psycho-social impairment, or both, that adversely affects a child's educational performance.” (Sec. 300.8(c)(12)) NICHCY (2006) Wikipedia

3. Impact of TBI on Language and Speech Development Aphasia... difficulty with understanding & producing spoken & written language... Dysarthia... speech is slurred, slow, and garbled due to damage to the part of the brain that controls the muscles used in speech production • fluent aphasia... • Patients speak in fluent sentences and use complete grammar... however they display little meaning. • They speak in gibberish • They are usually unaware and become angry that others do not understand • non-fluent aphasia... • Patients have trouble recalling words and speaking in complete sentences. • They speak with frequent pauses and broken phrases. • Patients may be aware and become frustrated. Prosodic Dysfunction of intonation and inflection • may also have difficulty with: • reading, spelling, and writing • taking turns • maintaining a topic of conversation • interpreting subtleties of conversation: • body language and nonverbal signals • keeping up with others in fast paced • conversations Symptoms will vary depending on the extent of damage to the brain as well as the location. Language deficits can lead to miscommunication, confusion, and frustration. www.nursingceu.com/course/213/index-nceu.html www.asha.org/public/speech/disorders/TBI.htm

4. Impact of TBI on Second Language Acquisition Dissociation between ability to perceive and to produce the second language. Disturbance in auditory comprehension of second language may improve with treatment. Language impairment is more severe in the second language... Impairment in naming ability – in all types of naming tasks. Therapy may provide mild improvement. Speech is characterized by...word-finding pauses ...paraphasic (speech production) errors ...non-fluent speech Written Language... Problems in reading and writing Poor performance in reading Abilities remain comparable to first language Single-word reading Writing in dictation

5. Intervention, Strategies, and Resources for Teachers • To progress to the most independent level of language functioning possible... • utilize augmentative assistive devices...letter/word/picture boards, portable computers • improve their ability to define words or describe actions or events • help them express their needs in simple terms TBI Resource Guideswww.neuroskills.com/index.shtml www.braininjuryresources.org/speech.html National Resource Center for Traumatic Brain Injury http://www.neuro.pmr.vcu.edu/LINKS/support.htm The Brain Injury Ringw/chatroom http://www.alliance.net/~jame/bir/bir.htm • If unsure, ask what was meant • List directions and number the steps • Avoid completing the student’s sentences • Provide structured activities & predictable routine • Let them know in advance of deviations in routine • Integrate/relate new information with old information • Avoid conversations in noisy distracting environments • Use a visual cue to indicate that important information is coming • Allow time to complete his/her thought processes before speaking • Train students to prepare mentally when waiting for their turn to speak • Simple cues may calm the struggling student trying to retrieve the correct word/s • To increase comprehension, present information in the student’s preferred mode • of learning...written, auditory, kinesthetic, or a combination A Kid’s Guide to Brain Injury - ages 6-14 This book can be purchased through the National Resource Center. Perspectives Network database of support groups http://www.tbi.org/ www.fldoe.org/ese/pdf/trauma.pdf www.neuro.pmr.vcu.edu/

6. References: Understanding and teaching students with traumatic brain injury: What families and teachers need to know. (2005). Florida Department of Education: Bureau of Exceptional Education and Student Services. Retrieved from http://www.fldoe.org/ese/pdf/trauma.pdf Ibrahim, R. (2009). Selective deficit of second language: A case study of a brain damaged Arabic-Hebrew bilingual patient. Behavioral and Brain Functions. Retrieved September 28, 2009 from http://www.behavioralandbrainfunctions.com/content/5/1/17 IDEA. (2004). US Department of Education. Sec. 300.8(c)(12). Retrieved September 19, 2009 from http://idea.ed.gov/explore/view/ p/%2Croot%2Cregs%2C300%2CA%2C300%252E8%2Cc%2C12%2C NICHCY. (2006). Disability Fact Sheet #18. The National Dissemination Center for Children with Disabilities. Retrieved September 19, 2009 from http://www.nichcy.org/InformationResources/Documents/NICHCY%20PUBS/fs18.pdf Robertson, Laura. (2007). Traumatic Brain Injury Hope Through Research. Retrieved September 25, 2009, from www.nursingceu.com/courses/213/index_nceu.html Traumatic Brain Injury: National Resource Center. (2008). Virginia Commonwealth University. Retrieved from www.neuro.pmr.vcu.edu/ Traumatic Brain Injury. (nd). Retrieved September 25, 2009, from http://www.asha.org/public/speech/disorders/TBI.htm Wikipedia. (1989). Photo of CT scan of brain showing cerebral contusions. Retrieved September 19,2009 from http://upload.wikimedia.org/wikipedia/ commons/thumb/8/89/Brain_trauma_CT.jpg/190px-Brain_trauma_CT.jpg

7. Gray Matters