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Traumatic Brain Injury

Though not always visible and sometimes seemingly minor, brain injury is complex. It can cause physical, cognitive, social, and vocational changes that affect an individual for a short period of time or permanently. Depending on the extent and location of the injury, symptoms caused by a brain injury vary widely. Some common results are seizures, loss of balance or coordination, difficulty with speech, limited concentration, memory loss, and loss of organizational and reasoning skills.

Some considerations:

  • A traditional intelligence test is not an accurate assessment of cognitive recovery after a brain injury and bears little relationship to the mental processes required for everyday functioning. For example, students with brain injuries might perform well on brief, structured, artificial tasks but have such significant deficits in learning, memory, and executive functions that they may have difficulty coping.
  • Recovery from a brain injury can be inconsistent. A student might take one step forward, two back, do nothing for a while, and then unexpectedly make a series of gains. A "plateau" is not evidence that functional improvement (or decline) has ended.
  • Students with acquired brain injuries may not be able to predict that they will have difficulty with a task post-injury until they have attempted it. Essentially, they have to "re-learn" how they learn.
  • Common accommodations for students with brain injuries are exam modifications, time extensions, taped lectures, instructions presented in more than one way, alternative ways of completing assignments, early syllabus, notetakers, course substitutions, priority registration, study skills and strategies training, and alternative print formats.

Instructional Strategies

Because of the varied and complex manifestations of traumatic brain injury, students with brain injuries often benefit from instructional strategies similar to those listed for other disabilities. The following strategies are suggested to enhance accessibility of course instruction, materials, and activities. They are general strategies designed to support individualized reasonable accommodations.

  • Include a Disability Access Statement on the syllabus, inviting students with disabilities to request accommodations.
  • Keep instructions brief and as uncomplicated as possible.
  • Assist the student with finding an effective notetaker or lab assistant from the class, if the student is eligible for these services.
  • Allow the student to tape-record lectures.
  • Clearly define course requirements, the dates of exams, and when assignments are due; provide advance notice of any changes.
  • Provide handouts and visual aids.
  • Use more than one way to demonstrate or explain information.
  • Have copies of the syllabus ready three to five weeks prior to the beginning of classes so textbooks are available for taping.
  • Break information into small steps when teaching many new tasks in one lesson (state objectives, review previous lesson, summarize periodically).
  • Allow time for clarification of directions and essential information.
  • Provide study guides or review sheets for exams.
  • Provide alternative ways for the students to do tasks, such as dictations or oral presentations.
  • As the semester progresses, verbal reminders in class of impending deadlines (e.g. "Remember, the problem sets are due Friday") are very helpful to students with traumatic brain injuries.
  • Whenever possible, start each lecture with a summary of material to be covered or provide a written outline. Broad margins and triple spacing on handouts enables students to take notes directly onto the outline, an aid to organization. Provide a review of the major points at the conclusion of each lecture.
  • Avoid making assignments only in oral form, since students with traumatic brain injuries may miss them. In addition to oral announcements, always write assignments on the board or pass them out in written form.
  • For large projects or long papers, students with traumatic brain injuries benefit from assistance with breaking the task down into its component parts and setting deadlines for each part.
  • When in doubt about how to assist the student, ask him or her.
  • Allow the student the same anonymity as other students (i.e. avoid pointing out the student or the alternative arrangements to the rest of the class).


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