TBI Kansas -

Information for Parents of Students with TBI
Developed by:
Janet Tyler, Ph.D. Brain Injury Education Consultant, jtyler@kstbi.org

Overview of Educational Impact of TBI
Educational Definition of TBI
Section 504 of the Rehabilitation Act
School Re-Entry Following TBI
Educational Programming
Advocating for Your Child
TBI Articles/Facts Sheets for Parents
Resources for Parents

Overview of Educational Impact of TBI
A traumatic brain injury (TBI) may alter how your child thinks, acts, or moves. Following a TBI many children experience the following difficulties:

Physical: reduced stamina, seizures, balance problems, lack of motor coordination, headaches, hearing losses, vision problems
Cognitive: memory deficits, reduced intellectual functioning, organizational impairments, attention and concentration difficulties, language impairments, planning and problem solving difficulties, impairment of judgment, reduced academic functioning
Behavioral: impulsivity, irritability, poor frustration tolerance, socially inappropriate behaviors, withdrawal, and depression.

These problems can impact your child's daily functioning and effect how he/she learns. Depending on the severity of the injury, these difficulties may last for a short period of time or may be permanent in nature.

While children who have moderate-to-severe injuries tend to have the most pronounced challenges, studies have shown that even a mild brain injury can create significant learning and behavioral problems for some children.

As a result of the difficulties your child experiences following a TBI he/she may require specialized assistance in school. Depending on your child's needs the school can provide a number of services that will help him/her learn, including special education instruction, occupational therapy, speech/language therapy, physical therapy, adaptive physical education, and social work services, as well as curriculum modifications and classroom accommodations.

Students with TBI may qualify for these special school services through the Individual with Disabilities Education Act (IDEA) or Section 504 of the Rehabilitation Act of 1973.

Educational Definition of TBI
The Individuals with Disabilities Education Act (IDEA), our nation's special education law, includes TBI as one of the thirteen eligibility categories within the federal law. IDEA defines TBI as follows:

"Traumatic brain injury means 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; psychosocial behavior; physical functions; information processing, and speech. The term does not apply to brain injuries that are congenital or degenerative or brain injuries induced by birth trauma."

The state of Kansas adheres to the federal educational definition of TBI. Thus, children who have medical documentation of an open or closed head injury, or a near- drowning episode, and have resulting impairments can qualify for special education services under the TBI category in Kansas. Children who have incurred other types of acquired brain injuries (such as brain tumors, strokes, brain infections, etc.) and have resulting impairments may qualify under the special education category "Other Health Impaired".

Once a child has qualified for special education services an Individualized Education Plan (IEP) will be develop. The IEP is a contract between the school, parents, and the student. The IEP describes what is needed to support the student and how the school will provide those services The IEP will serve as a guide for teachers and other school personnel to best teach and interact with your child.

Section 504 of the Rehabilitation Act
Not all students with TBI need, or are eligible for, special education services even though a brain injury may effect learning. Those students who do not require direct special education services, yet still need academic classroom adjustments and curriculum modifications in order to successfully participate in the general education program may receive those accommodations under Section 504 of the Rehabilitation Act.

Under Section 504, a 504 plan is developed (similar to an IEP under IDEA) that documents the proposed adjustments and modification to the regular curriculum and learning environment. The plan lists specific adjustments to the learning environment and modifications to the curriculum. It also indicates who is responsible for carrying out and evaluating each adjustment or modification. Examples of accommodations provided through a 504 plan include: extended time to complete assignments/tests, provision of notes for class lectures, preferential seating in the classroom, a reduced schedule, planned rest breaks, TBI inservice training for staff/classmates, and special materials (e.g., large print books).

Unlike special education services that end when the child graduates high school, 504 services can be accessed in post-secondary settings (e.g., college, vocational schools, etc.). Students who are transitioning to post-secondary settings should contact the institution's office of disabilities services to receive assistance.

School Re-Entry Following TBI
As soon as possible following an injury, parents should notify the school that their child has sustained a TBI so school personnel can coordinate with hospital personnel and the family to begin the process of planning for the student's return to school. Parents will need to provide the school with written medical documentation of their child's injury. Copies of any cognitive or academic testing that was conducted while the child was hospitalized, as well as all reports from therapists, should also be provided to the school. This information combined with a functional evaluation of the student's skills will help the school obtain a comprehensive picture of the student's abilities and difficulties.

Whenever possible, the IEP or 504 Plan should be established before your child returns to school. Parents will need to meet with school personnel in order to plan for the child's school re-entry well in advance of his/her return to school. Provisions to ensure the child's safety, such as direct supervision during passing times, before and after school, restroom breaks, and lunch, if needed, must be established prior to school re-entry.

The need for assistance may be greatest as your child transitions back into school and may decline over the next months. However, for others, the need for support may become more evident over time â€” perhaps not until years after the injury when increased demands for thinking and independence are required. Thus, it is recommended that the school monitor any student who has sustained even a mild brain injury for several months to detect any future problems that may occur as a result of the injury and any occurrence of a TBI should be documented in the student's school records.

Many school districts in the state of Kansas have TBI Miniteam Members who have been specially trained to provide TBI consultation and training to local school staff. Parents should ask that a TBI Miniteam Member assist in the school re-entry planning and provide inservice training for their child's teachers. If your school district does not have a TBI Miniteam Member available to assist, you may ask the district to bring in a TBI educational consultant.

Educational Programming
Because of the diverse needs of students with TBI, there is no one educational setting, teaching program, set of accommodations, or teaching strategies that will be effective for all students. Your child's educational program should be developed with remediation, accommodations, and teaching strategies based on an assessment of your child's current needs.

The individual needs of a student with TBI can be expected to change rapidly as the student continues to recover and as development comes into play. Thus, ongoing assessment of the student's functioning is required to give an accurate picture of needs at any given point in time. Because rapid changes take place after a brain injury, the IEP or 504 plan must be frequently reviewed and updated to meet changing needs.

Advocating for Your Child
Despite the high incidence of children who sustain TBIs, many medical and education professionals are unaware of the educational consequences of childhood brain injury. Students with TBI are too often unidentified or inappropriately classified as having learning disabilities, emotional disturbance, or mental retardation. As a result, the needed educational and related services may not be provided.

As a parent of a child with TBI you have a responsibility for learning about brain injury and taking an active role in advocating for your child. The more you know and understand about TBI, the better equipped you will be in helping your child navigate the school and community environment. The following sections provide information and resources to help parents learn more about brain injury.

TBI Articles/Facts Sheets for Parents

Resources for Parents

Brain Injury Association of America
The country's oldest and largest nationwide brain injury advocacy organization provides a special section of information on pediatric brain injury.

Brain Injury Partners Navigating the School System
An extensive site designed to give parents the skills they need to obtain appropriate education for a school-aged child who has sustained a TBI. The "Guide Me" section (on the home page) is a great starting point.

Center for Disease Control and Prevention (CDC)
Funded by the Department of Health and Human Services, the CDC's mission is to promote health and quality of life by preventing and controlling disease, injury, and disability. The CDC provides numerous articles and fact sheets on traumatic brain injury.

Lash & Associates Publishing
Lash & Associates offers books, tip cards, tool kits, and other resources to help treat children, adults, and veterans living with brain injury. Free downloadable articles are available.

Learnet
A problem-solving system and resource website designed to help identify useful procedures for helping students with TBI in school and at home. The website offers a special section for parents of children with TBI.

Parent Pals
The site provides special education information, support, tips, games and book and product resources for parents and professionals. Specific information on TBI is provided.

Wright's Law
Provides accurate, reliable information about special education law, education law, and advocacy for children with disabilities.