Traumatic Brain Injury

Table of Contents

Fact Sheet 18 (FS18)
January 2004
Approx. 8 pages when printed.
PDF version



Susan's Story

Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She also hit her head very hard. The doctors say she sustained a traumatic brain injury. When she came home from the hospital, she needed lots of help, but now she looks fine.

In fact, that’s part of the problem, especially at school. Her friends and teachers think her brain has healed because her broken bones have. But there are changes in Susan that are hard to understand. It takes Susan longer to do things. She has trouble remembering things. She can’t always find the words she wants to use. Reading is hard for her now. It’s going to take time before people really understand the changes they see in her.




What is Traumatic Brain Injury?

A traumatic brain injury (TBI) is an injury to the brain caused by the head being hit by something or shaken violently. (The exact definition of TBI, according to special education law, is given below.) This injury can change how the person acts, moves, and thinks. A traumatic brain injury can also change how a student learns and acts in school. The term TBI is used for head injuries that can cause changes in one or more areas, such as:

The term TBI is not used for a person who is born with a brain injury. It also is not used for brain injuries that happen during birth.

The definition of TBI below comes from the Individuals with Disabilities Education Act (IDEA). The IDEA is the federal law that guides how schools provide special education and related services to children and youth with disabilities.


IDEA's Definition of "Traumatic Brain Injury"

Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines traumatic brain injury as...

“...an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to 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; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.” [34 Code of Federal Regulations §300.7(c)(12)]






How Common is Traumatic Brain Injury?

More than one million children receive brain injuries each year. More than 30,000 of these children have lifelong disabilities as a result of the brain injury.




What Are the Signs of Traumatic Brain Injury?

The signs of brain injury can be very different depending on where the brain is injured and how severely. Children with TBI may have one or more difficulties, including:


A child with TBI may not have all of the above difficulties. Brain injuries can range from mild to severe, and so can the changes that result from the injury. This means that it’s hard to predict how an individual will recover from the injury. Early and ongoing help can make a big difference in how the child recovers. This help can include physical or occupational therapy, counseling, and special education.

It’s also important to know that, as the child grows and develops, parents and teachers may notice new problems. This is because, as students grow, they are expected to use their brain in new and different ways. The damage to the brain from the earlier injury can make it hard for the student to learn new skills that come with getting older. Sometimes parents and educators may not even realize that the student’s difficulty comes from the earlier injury.




What About School?

Although TBI is very common, many medical and education professionals may not realize that some difficulties can be caused by a childhood brain injury. Often, students with TBI are thought to have a learning disability, emotional disturbance, or mental retardation. As a result, they don’t receive the type of educational help and support they really need.

When children with TBI return to school, their educational and emotional needs are often very different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes. The child’s family, friends, and teachers also recall what the child was like before the injury. These other people in the child’s life may have trouble changing or adjusting their expectations of the child.

Therefore, it is extremely important to plan carefully for the child’s return to school. Parents will want to find out ahead of time about special education services at the school. This information is usually available from the school’s principal or special education teacher. The school will need to evaluate the child thoroughly. This evaluation will let the school and parents know what the student’s educational needs are. The school and parents will then develop an Individualized Education Program (IEP) that addresses those educational needs.

It’s important to remember that the IEP is a flexible plan. It can be changed as the parents, the school, and the student learn more about what the student needs at school.




Tips for Parents





Tips for Teachers





Resources

DeBoskey, D.S. (Ed.). (1996). Coming home: A discharge manual for families of persons with a brain injury. Houston, TX: HDI. (Telephone: 800.321.7037. Web: www.braininjurybooks.com)

DePompei, R., Blosser, J., Savage, R., & Lash, M. (1998). Special education: IEP checklist for a student with a brain injury. Wolfeboro, NH: L&A; Publishing/Training. (Telephone: 919.562.0015. Web: www.lapublishing.com)

DePompei, R., & Cluett, B. (1998). All about me! Wolfeboro, NH: L&A; Publishing/Training. (For use by elementary school children with TBI. Available from L&A;, at contact information above.)

Hibbard, M., Gordon, W., Martin, T., Rashkin, B., & Brown, M. (2001). Students with traumatic brain injury: Identification, assessment, and classroom accommodations. New York: Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury. (Telephone: 888.241.5152. Web: www.mssm.edu/tbinet/alt/pubs/tbikids.pdf

Lash, M., Wolcott, G., & Pearson, S. (2000). Signs and strategies for educating students with brain injuries: A practical guide for teachers and schools. (2nd ed.). Houston, TX: HDI. (See contact information above.)

Schoenbrodt, L. (Ed.). (2001). Children with traumatic brain injury: A parents' guide. Bethesda, MD: Woodbine House. (Telephone: 800.843.7323. Web: www.woodbinehouse.com)

Senelick, R.C., & Dougherty, K. (2001). Living with brain injury: A guide for families (2nd ed.). San Diego, CA: Singular. (Telephone: 800.347.7707. Web: www.delmarhealthcare.com)

Snyder, H. (1998). Elvin the elephant who forgets. Wolfeboro, NH: L&A; Publishing/Training. (A 16-page picture book for children. Available from L&A; at contact information above.)

Ylvisaker, M. (1998). Collaborative brain injury intervention: Positive everyday routines. San Diego, CA: Singular. (See contact information above.)




Organizations

Brain Injury Association (formerly the National Head Injury Foundation)
8201 Greensboro Drive, Suite 611
McLean, VA 22102
Telephone: 800.444.6443 (Family Helpline); 703.761.0750
Email: FamilyHelpline@biausa.org
Web site: www.biausa.org

Emergency Medical Services for Children—National Resource Center
111 Michigan Avenue N.W.
Washington, DC 20010
Telephone: 202.884.4927
Email: information@emscnrc.com
Web: www.ems-c.org/

Epilepsy Foundation-National Office
4351 Garden City Drive
Suite 500
Landover, MD 20785-7223
Telephone: 301.459.3700; 800.332.1000
Web site: www.epilepsyfoundation.org

Family Caregiver Alliance
690 Market Street, Suite 600
San Francisco, CA 94104
Telephone: 415.434.3388; 800.445.8106
Email: info@caregiver.org
Web site: www.caregiver.org

Family Voices
3411 Candelaria NE, Suite M
Albuquerque, NM 87107
Telephone: 505.872.4774; 888.835.5669
Email: kidshealth@familyvoices.org
Web site: www.familyvoices.org

Head Injury Hotline
212 Pioneer Building
Seattle, WA 98104-2221
Telephone: 206.621.8558
Email: brain@headinjury.com
Web site: www.headinjury.com





Publication of this document is made possible through a Cooperative Agreement between the Academy for Educational Development and the Office of Special Education Programs of the U.S. Department of Education. The contents of this document do not necessarily reflect the views or policies of the Department of Education, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.