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Children and Traumatic Brain Injury (TBI)

  • Synopsis: Published: 2013-03-07 - Individuals with Disabilities Education Act is the federal law guiding how schools provide special education and related services to children with disabilities - Disabled World.
Traumatic Brain Injury (TBI)
Traumatic Brain Injury - (TBI) Caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from "mild," i.e., a brief change in mental status or consciousness to "severe," i.e., an extended period of unconsciousness or amnesia after the injury. The majority of TBIs that occur each year are concussions or other forms of mild TBI.

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Quote: "Children with TBI might have difficulties with relating to others. They might laugh or cry a lot, or be restless. They may not have much motivation, or control over the emotions they feel."

A Traumatic Brain Injury (TBI) is a form of injury to a person's brain caused by being shaken violently or by the person's head being hit by something.

The injury may change how the person moves, acts, and thinks. A traumatic brain injury may also change the way a student learns or behaves in school. The term, 'TBI,' is used for head injuries that may cause changes in one or more areas to include:

  • Learning
  • Speaking
  • Behaving
  • Problem-solving
  • Paying attention
  • Abstract thinking
  • Hearing or seeing
  • Remembering things
  • Understanding words
  • Reasoning and thinking
  • Physical activities such as walking

The term, 'TBI,' is not used in association with people who are born with a form of brain injury. The term is also not used in relation to people who experienced a brain injury that happened during birth.

IDEA's Definition of Traumatic Brain Injury (TBI)

The Individuals with Disabilities Education Act (IDEA) is the federal law guiding how schools provide special education and related services to children with disabilities. 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."

Around 1.7 million people experience TBI's every single year. Out of children between the ages of 0 and 19 years, TBI's result in 631,146 trips to emergency rooms every year, 35,994 of which result in hospitalizations and nearly 6,169 deaths.

Signs of a Traumatic Brain Injury

The signs of a TBI can vary depending upon where a person's brain is injured and the severity of the injury. Children who experience a TBI can experience one or more difficulties. The difficulties they may experience can include the following.

Physical Disabilities: People with a TBI might have issues with seeing, hearing, speaking, and using their other senses. They may experience headaches and feel tired much of the time. They might also have difficulties with skills including drawing or writing. The person's muscles might suddenly tighten or contract referred to as, 'spasticity.' They may experience seizures, and their balance or walking might be affected. The person may be partially or completely paralyzed on one side of their body or both sides.

Difficulties with Thinking: Due to a brain injury it is common for the person's ability to use their brain to change. As an example, children who have experienced a TBI might have trouble with their short-term memory. They may also experience difficulties with their long-term memory. People with a TBI might have trouble concentrating and only have the ability to focus their attention for short periods of time; they may also think slowly. The person might have trouble with listening and speaking with others. They may also experience difficulties with writing, reading, planning, and understanding the order in which events occur - referred to as, 'sequencing,' as well as judgment.

Behavioral, Social, or Emotional Issues: The difficulties might include sudden changes in the person's mood, depression, and anxiety. Children with TBI might have difficulties with relating to others. They might laugh or cry a lot, or be restless. They may not have much motivation, or control over the emotions they feel.

A child with TBI may not experience all of the difficulties mentioned. Brain injuries can range from mild to severe and the changes that result from the injury can as well. What this means is that it is difficult to predict how any one person will recover from such an injury. Early and ongoing assistance can make a huge difference in how a child recovers. The help may include occupational or physical therapy, special education, and counseling.

It is also important to be aware that as a child with a TBI grows and develops, parents and teachers might notice new issues. The reason for this is because as a child grows they are expected to use their brain in new and different ways. The damage to their brain may make it difficult for them to learn new skills that come with aging. At times, parents and teachers might not even realize that the child's difficulties arise from the earlier injury.

Assistance for Children with TBI's

Help is available, starting with the free evaluation of the child. America's special education law - IDEA, requires that every child who is suspected of experiencing a form of disability be evaluated at no cost to their parents in order to determine if they do indeed have a disability and, due to the disability, need special services under IDEA. The services include:

Early Intervention: Early intervention involves a system of services to support infants and toddlers with disabilities prior to their third birthday, as well as their family members.

Special Education and Related Services: The services are available through the public school system for children of school age, to include preschool age children.

To access early intervention, identify the program in your particular neighborhood and consult NICHY's State Organizations page at: nichy.org/state-organization-search-by-state. Early intervention is listed under, 'State Agencies.' The agency that is identified has the ability to place you in contact with the early intervention program in your specific community. Through this agency you have the ability to have your child evaluated free of charge and, if you are eligible, your child may start to receive early intervention services.

To access special education and other related services, get in contact with your local public school system. Call the school in your neighborhood to begin. The school should have the ability to tell you the steps you need to take next to have your child evaluated at no cost. If you are eligible, your child may begin receiving services specifically designed to meet their needs. The Fall of 2011 found almost 26,000 children of school age receiving special education and other related services in public schools under the category of, 'Traumatic Brain Injury.'

School and Children with TBI's

While TBI's are very common, a number of eduction and medical professionals might not realize that some difficulties may be caused by a childhood brain injury. Too often, students with TBI are believed to have a form of learning disability, intellectual disability, or emotional disturbance. Due to this they do not receive the types of support and educational assistance they truly need.

When children with TBI return to school their emotional and educational needs are many times very different than they were prior to their injury. The disability they experience happened traumatically and quickly. They may often remember how they were before the injury, something can bring on many social and emotional changes. Their family, friends, and teachers may also remember what they were like before they were injured. Other people in the child's life might have trouble adjusting or changing their expectations of the child.

It is very important to plan carefully for the child's return to their school environment. Parent should find out ahead of time about special education services at the school. The information is often available through the school's special education teacher or the principal. The school will need to evaluate the child completely, which will let the parents and the school know what their educational needs are. The parents and the school will then develop an, 'Individualized Education Program (IEP),' that addresses the child's specific needs.

Traumatic Brain Injury in the United States, Assessing Outcomes in Children
www.cdc.gov/traumaticbraininjury/assessing_outcomes_in_children.html

Each year an estimated 3,000 children and youth die from TBI; 29,000 are hospitalized; and 400,000 are treated in hospital emergency departments.

Child Head Injury - Brain Injury in Children
www.braininjury.com/children.shtml

Unfortunately, head injuries are very common with children, accounting for approximately one hundred thousand hospitalizations annually.

Brain Injury in Children
www.biausa.org/brain-injury-children.htm

While the symptoms of a brain injury in children are similar to the symptoms experienced by adults, the functional impact can be very different.

Related Information:

  1. The Realities of a Brain Injury - Informative article examines TBI including signs symptoms and importance of seeking medical aid as soon as possible - (Published 2012-10-07).
  2. CT Scans Often Unnecessary After Head Injury in Children - Large study finds CT scans are frequently unnecessary after head injury in children - (Published 2011-05-09).
  3. Concussion - Signs, Symptoms and Treatment - Symptoms and treatment of concussion and post-concussive syndrome the most common type of traumatic brain injury - (Published 2011-01-29).


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