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Traumatic Brain Injury

EDUC 30000 Individual Differences and the Atypical Child

Carly McCrow

on 20 September 2012

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Transcript of Traumatic Brain Injury

Carly McCrow Traumatic Brain Injury What is it? Severity of
traumatic brain injury Traumatic brain injury (TBI) is also known as intracranial injury. It occurs when an external force traumatically injures the brain. TBI can be classified based on mechanism (closed or penetrating head injury) and severity. The Glasgow Coma Scale (GCS) - grades a person's level of consciousness on a scale of 3–15 based on verbal, motor, and eye-opening reactions to stimuli.

Post-traumatic amnesia (PTA) - Days of memory loss

Loss of consciousness (LOC) - Time spent unconscious

A current model developed by the Department of Defense and Department of Veterans Affairs (US) uses all three criteria. Historically TBI identification can be traced all the way back to Ancient times Signs and Symptoms Unconsciousness Implications in Education Strategies Resources Smartphones Questions? Implications Bleeding? Behavioral Changes Dizzy In order to classify TBI severity, it has also been suggested to use visible changes on neuroimaging, such as;
focal lesions, or
diffuse injury as method of classification. damage occurs over a more widespread area than in focal brain injury
extensive lesions in white matter tracts,
major causes of unconsciousness and persistent vegetative state after head trauma
occurs in about half of all cases of severe head trauma My cousin was in a coma for two years... Intellectual Physical Social Emotional Closed Brain Injury (blunt force trauma) Focal Brain Injury TBI is more complicated than the typical 'bruised brain' that comes to mind. Unlike broken bones or bruised organ, TBI requires a complicated process of recovery. Symptoms Neural Interruption $ Balancing needs and cost can be difficult Useful Tools: Proactive calendar
GPS function Helps to remedy: Loss of memory
Contacts, names, and faces and addresses
Becoming geographically disoriented. Awareness (both TBI victim responding, and public)
Victim acting according to how they see the world iPads (and tablets) Rehabilitation Mood swings
Personality disorders
Behavioral issues Motor skill impairment
Have to 'relearn', sometimes almost everything! Depending on the severity, TBI can represent a long road to recovery

Brainline Body Games More and more technology is available requiring the user to control the game action with their bodies
Playstation Move
Wii Memory games
'27 lifesaving apps for people with TBI' Other Aids Wheelchairs assist when mobility is an issue
Special computer software (screen enlargement, voice recognition programs) Adjustments for students who have suffered a TBI need to be made. This can include:
Automatic page turners
Specialized Computer software
Adapted pencil grips and stationery
Larger switches and controls
Curriculum modification
Length of day adjusted
Classroom seating
Mainstream or Special Needs
Cognitive issues
Physical accommodations http://www.brainline.org/content/2011/05/23-lifechanging-iphone-ipad-apps-for-people-with-brain-injury.html Since much of computer use involves memory and task analysis, individuals with TBI may have difficulty with these. Solutions tend to be idiosyncratic and may take some trial and error to discover. Below are some case studies from our experience:
Andrew is a young man whose life before and after his brain injury centers on his family. He was not able to identify keys on a standard keyboard for typing. We set up an Intellikeys keyboard overlay and asked him to specify pictures that he wanted associated with each key—e.g., “D” used a photo of his uncle Dave, and “K” used the logo from KPRA, a radio station he likes. We also used an inexpensive program called Sounding Keyboard and Mouse that permits audio files to be played when a key is pressed. Andrew was able to identify keys more easily using this setup, and the audio feedback provided reinforcement.
Miranda is a middle-aged woman whose TBI severely impaired both her memory and patience. We found that speech recognition software helped her write with satisfactory accuracy, and that the Ginger spelling/homonym checker helped her proofread her dictated text. Because many children have yet to develop cognitive and social skills, younger children often find it harder to catch up after experiencing a TBI. Adjustments Back to Basics Psychiatric issues
Loss of awareness
Problems with focus
Social cues Past Present Future Present technologies make diagnosis and identification of TBIs safer and easier than ever before. As patients can present without physical trauma, modern knowledge and technology continue to save lives. Yet, research surrounding TBI and the brain in general is constantly crossing new frontiers. Skulls found in battleground graves with holes drilled over fracture lines suggest that trepanation may have been used to treat TBI in ancient times In the Middle Ages, physicians further described head injury symptoms and the term concussion became more widespread. Concussion symptoms were first described systematically in the 16th century by Berengario da Carpi. It was first suggested in the 18th century that intracranial pressure rather than skull damage was the cause of pathology after TBI. This hypothesis was confirmed around the end of the 19th century, and opening the skull to relieve pressure was then proposed as a treatment Perhaps the first reported case of personality change after brain injury is that of Phineas Gage, who survived an accident in which a large iron rod was driven through his head, destroying one or both of his frontal lobes; numerous cases of personality change after brain injury
have been reported since. ? ? ? ? ? Don't just put a band aid on TBI! Strategies need to be be developed for each student, such as:
Current abilities
Curriculum revisions
How instructions are given
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