Prominent Characteristics | Frequently Asked Questions | Classroom Strategies

What is ABI?

ABI, or acquired brain injury, is any type of sudden injury that causes tempory or permanent damage to the brain. This damage is most often associated with some kind of trauma to the head, but can also occur as a result of other factors.

How does it occur?

The majority of the time the causes of ABI are associated with motor vehicle collisions, however, there are serveral less common ways that children and adolescents can acquire a brain injury such as:

• Falling (off bike, tree, ice skating)
• Near drowning
• Suffocation
• Illness/disease
• Stroke
• Assault
• Shaken Baby Syndrome

Who does it affect?

The prevalence of school age individuals in Ontario who have sustained a brain injury and survived is approximately 27,000.

What can teachers do?

Teachers can become more informed about ABI so that they can provide a safe and structured learning environment. They can also put some simple procedures into place that will dramat"imagesove both the classroom and child's future.

Prominent Characteristics of ABI

The deficits associated with ABI can be generalized into 3 main categories that could include, but are not limited to any combination of the following.

1. Cognitive Deficits

• Judgement: making poor decisions, impulsive judgements
  
  
• Initiation: appears to be lazy, requires consistent cues to begin new tasks
  
  
• Problem Solving: poor planing, sequencing, lack of understanding cause & effect, inability to consider alternate perspectives or multiple variables
  
  
• Transfer of Learning: problems with learning, generalizing, retaining new information, recalling previously learned information, following through with things in the future
  
  
• Fatigue: cognitive fatigue or "brain drain"
  
  
• Perception: problems with hearing, seeing, sensing and interpreting one's environment in a familiar way
  
  
• Memory: problems with retaining or learning new information
  
  
• Attention: problems with sustained concentration, staying on task, distractibility, multi-tasking

2. Physical Deficits

• Speech, hearing, vision, taste, olfaction and perception
  
  
• Muscle spasticity, contracture
  
  
• Loss of fine motor control
  
  
• Paresis or paralysis
  
  
• Balance/gait
  
  
• Fatigue (exhaustion)

3. Behavioural and Emotional Deficits

• Agitation/Anxiety: sudden anger (short fuse), impulsivity, low frustration tolerance
  
  
• Self-awareness: difficulty experiencing empathy, only aware of their own needs, difficulty relating to their peers, unaware of their behaviour and its impact on others
  
  
• Social Inappropriateness: disinhibition, socially inappropriate, inability "imagesial cues, socially withdrawn, isolated

Frequently Asked Questions

Q. Are all brain injuries the same?

A. No, brain injuries and the kinds of deficits that a person will show are as different as the individuals they affect. Deficits will vary depending on factors such as:

• The extent of the injury.
• The location of the injury.
• The person’s pre-injury personality.
• The amount and type of rehabilitative services provided to the person.

Q. Does the brain heal?

A. The brain is made up of a unique set of cells called neurons. Unlike other cells in the body, neurons do not reproduce themselves. This means that when a neuron dies it does not heal nor does a new one take its place. Therefore, this type of injury is permanent. On the other hand, if the brain is “bruised” (i.e. the neuron’s nucleus survives) as in concussions, then . there can be complete recovery. In both cases, remaining neurons continue to have the .. ability to learn new funtions and can therefore compensate for other damaged neurons.

Q. How does the presentation of brain injury relate to development?

A. Some types of brain injuries can actually be disguised because of developmental effects. For example, certain frontal lobe functions are not developed nor required until a child is in grade 6 or 7. Therefore, if a child suffers a frontal lobe brain injury in grade 1 or 2, the deficits that are a result of the injury may not surface simply because the demand for that function has not yet been made. Unfortunately by the time the deficits surface several years later, they are no longer correlated to a brain injury and therefore not dealt with . appropriately.

Q. Are children with brain injuries the same as children with other types of learning disabilities?

A. No. The deficits associated with acquired brain injuries are diverse and can vary as a function of site of injury and other individualized charcteristics. Distinguishing between these different conditions is important for successful teaching.

Q. Is it possible to address the needs of students with ABI in the regular classroom?

A. Yes. With education, understanding and appropriate modifications "imagesite possible and realistic to meet the needs of these students.

Classroom Strategies

• Find out as much information on the student's injury and needs as possible.
  
  
• Identify the imperception/misperception.
  
  
• Emphasize funtional skills.
  
  
• Provide a low stimulus environment.
  
  
• Role play socially appropriate behaviour.
  
  
• Alter rules and techniques to allow age appropriate interactions with peers.
  
  
• Assist the student with organizational skills and staying on task (break directions down into easy to follow steps).
  
  
• Allow for frequent breaks and rests if needed.
  
  
• Allow for extra time when completing assignments and while writing tests.
  
  
• Repeat new information frequently.
  
  
• Offer a wide range of opportunities to practice new skills.
  
  
• Prepare ahead of time for transitions (library to gym, math to reading).
  
  
• Manage frustration levels (change tasks or redirect where appropriate).
  
  
• Maintain consistent and predictable rountines and provide clear expections before starting any task.
  
  
• Educate staff members to both maintain consistency and to avoid problems outside the classroom.
  
  
• Develop an individual education plan focused on the student's sucess.
  
  
• Communicate regulary with stakeholders (parents, medical personnel, community partners).
  
  
• Become more informed, as a teacher, about ABI.