Traumatic Brain Injury: What About School? | BrainLine (2023)

Children with TBI

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Traumatic Brain Injury: What About School? | BrainLine (2)

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In this article:

  • In the Classroom: What Are the Signs of TBI?
  • What About School?
  • Is There Help Available?
  • Tips for Parents
  • Tips for Teachers

IDEA's Definition of "Traumatic Brain Injury"

Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines traumatic brain injury as...

“ 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.” [34 Code of Federal Regulations §300.7(c)(12)]

In the Classroom: What Are the Signs of Traumatic Brain Injury

The signs of brain injury can be very different depending on where the brain is injured and how severely. Children with TBI may have one or more difficulties, including:

  • Physical disabilities: Individuals with TBI may have problems speaking, seeing, hearing, and using their other senses. They may have headaches and feel tired a lot. They may also have trouble with skills such as writing or drawing. Their muscles may suddenly contract or tighten (this is called spasticity). They may also have seizures. Their balance and walking may also be affected. They may be partly or completely paralyzed on one side of the body, or both sides.
  • Difficulties with thinking: Because the brain has been injured, it is common that the person’s ability to use the brain changes. For example, children with TBI may have trouble with short-term memory (being able to remember something from one minute to the next, like what the teacher just said). They may also have trouble with their long-term memory (being able to remember information from a while ago, like facts learned last month). People with TBI may have trouble concentrating and only be able to focus their attention for a short time. They may think slowly. They may have trouble talking and listening to others. They may also have difficulty with reading and writing, planning, understanding the order in which events happen (called sequencing), and judgment.
  • Social, behavioral, or emotional problems: These difficulties may include sudden changes in mood, anxiety, and depression. Children with TBI may have trouble relating to others. They may be restless and may laugh or cry a lot. They may not have much motivation or much control over their emotions.

A child with TBI may not have all of the above difficulties. Brain injuries can range from mild to severe, and so can the changes that result from the injury. This means that it’s hard to predict how an individual will recover from the injury. Early and ongoing help can make a big difference in how the child recovers. This help can include physical or occupational therapy, counseling, and special education.

It’s also important to know that, as the child grows and develops, parents and teachers may notice new problems. This is because, as students grow, they are expected to use their brain in new and different ways. The damage to the brain from the earlier injury can make it hard for the student to learn new skills that come with getting older. Sometimes parents and educators may not even realize that the student’s difficulty comes from the earlier injury.

What About School?

Although TBI is very common, many medical and education professionals may not realize that some difficulties can be caused by a childhood brain injury. Often, students with TBI are thought to have a learning disability, emotional disturbance, or mental retardation. As a result, they don’t receive the type of educational help and support they really need.

When children with TBI return to school, their educational and emotional needs are often very different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes. The child’s family, friends, and teachers also recall what the child was like before the injury. These other people in the child’s life may have trouble changing or adjusting their expectations of the child.

Therefore, it is extremely important to plan carefully for the child’s return to school. Parents will want to find out ahead of time about special education services at the school. This information is usually available from the school’s principal or special education teacher. The school will need to evaluate the child thoroughly. This evaluation will let the school and parents know what the student’s educational needs are. The school and parents will then develop an Individualized Education Program (IEP) that addresses those educational needs.

It’s important to remember that the IEP is a flexible plan. It can be changed as the parents, the school, and the student learn more about what the student needs at school.

Is There Help Available?

Yes, there’s a lot of help available, beginning with the free evaluation of the child. The nation’s special education law, IDEA, requires that all children suspected of having a disability be evaluated without cost to their parents to determine if they do have a disability and, because of the disability, need special services under IDEA. Those special services are:

  • Early intervention: A system of services to support infants and toddlers with disabilities (before their 3rd birthday) and their families.
  • Special education and related services: Services available through the public school system for school-aged children, including preschoolers (ages 3-21).

To access early intervention:To identify the EI program in your neighborhood, ask your child’s pediatrician for a referral. You can also call the local hospital’s maternity ward or pediatric ward, and ask for the contact information of the local early intervention program.There, you can have your child evaluated free of charge and, if found eligible, your child can begin receiving early intervention services.

To access special education and related services: We recommend that you get in touch with your local public school system. Calling the elementary school in your neighborhood is an excellent place to start. The school should be able to tell you the next steps to having your child evaluated free of charge.If found eligible, he or she can begin receiving services specially designed to address your child’s needs.

In the fall of 2011, nearly 26,000 school-aged children (ages 3-21) received special education and related services in our public schools under the category of “traumatic brain injury.”

Tips for Parents

  • Learn about TBI. The more you know, the more you can help yourself and your child. See the list of resources and organizations at the end of this publication.
  • Work with the medical team to understand your child’s injury and treatment plan. Don’t be shy about asking questions. Tell them what you know or think. Make suggestions.
  • Keep track of your child’s treatment. A 3-ring binder or a box can help you store this history. As your child recovers, you may meet with many doctors, nurses, and others. Write down what they say. Put any paperwork they give you in the notebook or throw it in the box. You can’t remember all this! Also, if you need to share any of this paperwork with someone else, make a copy. Don’t give away your original!
  • Talk to other parents whose children have TBI. There are parent groups all over the U.S. Parents can share practical advice and emotional support. Call NICHCY (1-800-695-0285) or find resources in your state, online at ( to locate parent groups near you.
  • If your child was in school before the injury, plan for his or her return to school. Get in touch with the school. Ask the principal about special education services. Have the medical team share information with the school.
  • When your child returns to school, ask the school to test your child as soon as possible to identify his or her special education needs. Meet with the school and help develop a plan for your child called an Individualized Education Program (IEP).
  • Keep in touch with your child’s teacher. Tell the teacher about how your child is doing at home. Ask how your child is doing in school.

Tips for Teachers

  • Find out as much as you can about the child’s injury and his or her present needs. Find out more about TBI. See the list of resources and organizations at the end of this publication.
  • Give the student more time to finish schoolwork and tests.
  • Give directions one step at a time. For tasks with many steps, it helps to give the student written directions.
  • Show the student how to perform new tasks. Give examples to go with new ideas and concepts.
  • Have consistent routines. This helps the student know what to expect. If the routine is going to change, let the student know ahead of time.
  • Check to make sure that the student has actually learned the new skill. Give the student lots of opportunities to practice the new skill.
  • Show the student how to use an assignment book and a daily schedule. This helps the student get organized.
  • Realize that the student may get tired quickly. Let the student rest as needed.
  • Reduce distractions.
  • Keep in touch with the student’s parents. Share information about how the student is doing at home and at school.
  • Be flexible about expectations. Be patient. Maximize the student’s chances for success.

Posted on BrainLine November 21, 2017.

“Traumatic Brain Injury.” Center for Parent Information & Resources, NICHCY, 16 June 2010, Accessed 21 Nov. 2017.

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Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Anonymous replied on Permalink

Very bad.....this story made me think about all the cases I worked on as an attorney that had serious brain damage as an element. Every time I see something new and it dissapoints me...

  • reply


Traumatic Brain Injury: What About School? | BrainLine? ›

When children with TBI return to school, their educational and emotional needs are often very different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes.

How does traumatic brain injury affect education? ›

Students with TBI can become over-stimulated easily (from noisy hallways, crowded classes, too much information too quickly), which may lead to difficulty thinking and emotional distress. The student with TBI may respond negatively to an unexpected event or a lack of clear structure.

What are the educational considerations for students with TBI? ›

Students with traumatic brain injuries often need extra time to process information and complete tasks as well as to respond to verbal cues and instructor questions. Encourage the use of schedules, checklists, and notebooks to assist in organizing daily information. Break assignments into smaller parts.

Is traumatic brain injury a learning disability? ›

Although TBI is very common, many medical and education professionals may not realize that some difficulties can be caused by a childhood brain injury. Often, students with TBI are thought to have a learning disability, emotional disturbance, or an intellectual disability.

How a brain injury affects learning and behavior? ›

The cognitive effects of brain injury include attention and concentration problems, memory problems and difficulty with motivation and making decisions. This may mean that people with a brain injury become easily distracted, or experience information overload and be slower at taking in and making sense of information.

What are the effects of trauma on schools and learning? ›

School-related trauma (like bullying or unfair punishment) often leads to school avoidance, leaving the most vulnerable students behind academically. Trauma also negatively impacts young people's sense of self, making it difficult for those students to feel motivated, proud, and engaged in their learning.

What activities to avoid after TBI? ›

Avoid activities that are physically demanding (e.g., heavy houscleaning, weightlifting/working-out) or require a lot of concentration (e.g., balancing your checkbook). They can make your symptoms worse and slow your recovery.

What behavioral issues do children with TBI have? ›

The child with a TBI may experience poor emotional control. Tasks that the teacher considers to be easy may be difficult for the child, and this may result in an overreaction, such as crying. Whenever possible, redirect the child and refocus on another aspect of the assignment.

What are three memory tips useful for people with TBI? ›

Cognitive Tricks to Improve Short-Term Memory After Brain Injury
  • Use Association. One of the best ways to improve your short-term memory after brain injury is to use association. ...
  • Use Vivid Images. Not all association has to be mnemonic. ...
  • Space Your Repetition. ...
  • Listen to Music. ...
  • Write it Down.
Sep 29, 2020

How much disability will I get for a TBI? ›

If the Veteran's TBI residuals qualify as “total” severity in any of the facets, then the veteran is entitled to a 100 percent disability rating. If the highest level of severity is a 3, then the disability rating will be 70 percent. If the highest level of severity is a 2, then 40 percent will be assigned.

Is TBI a lifelong disability? ›

Moderate and severe traumatic brain injury (TBI) can lead to a lifetime of physical, cognitive, emotional, and behavioral changes. These changes may affect a person's ability to function in their everyday life.

Can TBI cause permanent disability? ›

Moderate to severe TBI can cause permanent physical or mental disability. Because polytrauma is common with moderate to severe TBI, many patients face additional disabilities as a result of other injuries.

What are reasonable accommodations for TBI? ›

Modifications of duties such as not having to answer phones if speaking clearly is a problem, as long as those duties are not basic to the job. A place to be alone for quiet time away from the job. Rest breaks to prevent stimulus overload and fatigue. Job restructuring or part-time or modified work schedules.

What are four areas of impairments a student with TBI may experience? ›

Persons with TBI are often experiencing other medical conditions as well as multiple behavioral health disorders. Common health problems among persons with TBI include headache, fatigue, sleep disturbance, balance problems, pituitary dysfunction, seizure disorders, and vision abnormalities.

What are the activities for TBI? ›

Complex activities such as baseball, bowling, and cycling are usually done as a group which can also help improve any feelings of social isolation that may occur after brain injury. Social isolation may interfere with recovery and therefore it's important to find a community in which you feel comfortable and welcomed.

What is inappropriate behavior of a TBI? ›

People with a TBI may avoid others, interrupt others, or say things that do not fit the situation or are hurtful. They also may make sexually inappropriate comments. Refusing to do things. People with a TBI may say “no” to doing something, such as going to therapy or doing other activities.

How does your personality change after a brain injury? ›

After a brain injury, you might suffer from social anxiety, irritability, anger, depression, feelings of overwhelm, general anxiety, mood swings, or emotional lability (teariness).

What are the consequences for students with trauma? ›

Students who have experienced trauma may be particularly likely to experience dysregulated emotions and behavior in school settings, including poor concentration and difficulty staying on task, disruptive behavior, and even verbal and physical aggression towards peers or staff.

What trauma looks like in the classroom? ›

As we have learned reactions to trauma looks like many different things. In some children it may appear like an attention issue, in others it may appear that a student is lazy, or resistant. Some students may exhibit lethargy or other psycho-somatic symptoms (e.g. complain of stomach ache, headache, etc.)

How does trauma affect child development in school? ›

They may struggle with sustaining attention or curiosity or be distracted by reactions to trauma reminders. They may show deficits in language development and abstract reasoning skills. Many children who have experienced complex trauma have learning difficulties that may require support in the academic environment.

Do people with TBI go back to normal? ›

The prognosis for mild TBI is usually better than for a moderate TBI, and the prognosis for moderate TBI is usually better than for a severe TBI. With a concussion (mild TBI), most people recover most or all of their brain function within 3 months following injury, with most recovering sooner.

Can you go back to normal after TBI? ›

Therefore, a full and functional TBI recovery is almost always possible, even though it might take several years of dedication. But in order to make this type of progress, you must take initiative. In fact, without consistent work, brain injury recovery can stall and even regress.

How long does it take to fully recover from a TBI? ›

Recovery time varies but according to a study published by the National Library of Medicine, it can take up to two years to fully recover from a TBI. In some cases, it can take from five to 10 years to recover following the injury.

What is the most common TBI in children? ›

Falls and assault (e.g., shaken baby syndrome or other physical abuse) are the most common mechanisms of TBI in infants, toddlers, and preschoolers.

What are social problems after TBI? ›

After a traumatic brain injury (TBI), people may have problems with social skills. These problems can differ from person to person and can be harder to manage when feeling strong emotions, such as anger or excitement. Common examples are: Feeling out of place and uncomfortable around other people.

Do children recover better from TBI? ›

Generally, children who have less severe traumatic brain injuries are able to recover more quickly. Children often recover from mild traumatic brain injuries within weeks to months. When effects last longer than this, as is the case for 10 to 30% of children, it is referred to as persistent post-concussion syndrome.

What is the best therapy for TBI? ›

Cognitive-behavioral therapy is the most widely used treatment method for mental and emotional health. It is effective for treating TBI patients. CBT focuses on getting patients to understand why they behave in the way they do. At the root, CBT helps patients uncover distorted or unhealthy thinking patterns.

What is the fastest recovery from TBI? ›

The most rapid recovery occurs in the first week after mild TBI. Most patients will be back to normal in a week to a month. Everyone recovers differently. People under the age of 40 get better faster.

What medication is used for TBI memory loss? ›

Methylphenidate is a mixed dopaminergic and noradrenergic medication that has been used to treat both patients with TBI as well as those with other diagnoses with related clinical presentations such as attention deficit disorder.

Does TBI qualify for SSI? ›

Yes, you can receive long term disability benefits for a traumatic brain injury (“TBI”). A TBI is a serious and life-changing injury caused by a sudden blow to the head that damages the brain. Suffering a TBI can lead to physical and/or cognitive difficulties requiring intense rehabilitative care.

How many people go back to work after a TBI? ›

According to a study published in Brain Injury, nearly 40 percent of people with TBI or a non-traumatic acquired brain injury are able to return to work after one to two years.

Can a TBI get worse over time? ›

Can a TBI get worse over time? The short answer is: yes, it can. Every brain injury is different and even though many secondary effects of a brain injury improve with time, others may linger and interfere with rehabilitation. Survivors with long-term effects can often present signs of decline in their recovery process.

What is it like living with a TBI? ›

An individual with TBI may have difficulty focusing, paying attention, or attending to more than one thing at a time. Difficulty concentrating may lead to restlessness and being easily distracted or they may have difficulty finishing a project or working on more than one task at a time.

Does TBI show up on MRI? ›

Newer, specialized MRIs can measure brain function for detecting changes in brain function and structure because of TBI or evaluate the structure of the brain at an even finer level. MRI might show brain atrophy long after the injury, which results when injured or dead brain tissue is reabsorbed after TBI.

Can you work with traumatic brain injury? ›

Many individuals never fully regain the skills and functioning they had prior to the injury. However, with appropriate support and adequate accommodation, many people with TBI are able to return to work and be successful.

Can I work after traumatic brain injury? ›

Mistakes made because of the brain injury could damage your confidence and hinder recovery. Be honest with yourself, prepare as much as possible and don't try to rush your recovery. Remember, try not to take on overtime, shift work or new responsibilities until you feel ready.

What two conditions need to be present to be classified as a TBI? ›

Two main mechanisms that cause primary injury are: Contact i.e. an object striking the head or the brain striking the inside of the skull.

How do you accommodate students with TBI in the classroom? ›

Examples of accommodations include:

Providing the student with the instructor's (or detailed) notes. Allowing the student to record classroom instruction for later playback. Providing clear oral and written instructions. Implementing assistive technology when applicable.

What are the most common behavioral deficits seen after mild TBI? ›

Attention and memory deficits are the most common cognitive difficulties reported by patients and their families after the TBI.

Where do TBI patients go? ›

Patients with severe injuries may be referred to a long-term acute care hospital or to inpatient rehabilitation followed by support services that allow them to return to the home environment, and/or may be transferred to a nursing home or residential care facility.

What is an important goal for patients with TBI? ›

The goal of the interventions in traumatic brain injury is to achieve the highest possible level of independent function for participation in daily activities. It may address the individual's: structures and functions; activities and participation; environment and barriers modifications.

How do you calm someone with TBI? ›

Your contact with a patient with TBI should involve a social greeting, such as “Hi (name), how are you?” A handshake may accompany the greeting. The handshake and greeting are cues to relax. It is important to introduce yourself each time since, due to memory problems, the person may not remember you.

How does traumatic brain injury affect cognition? ›

People with TBI may have trouble learning and remembering new information and events. People with TBI may also have problems remembering entire events or conversations. When this happens, the mind will sometimes try to fill in the gaps of missing information with things that did not really happen.

How does traumatic brain injury affect development? ›

Common physical deficits that a child may experience are problems with motor control, visual impairment, and problems with balance and coordination. Emotional deficits – Because of their underdeveloped brains, children often struggle with managing their emotions and understanding social cues.

What are some of the cognitive impacts that a traumatic brain injury can cause? ›

Problems may include forgetting names, losing train of thought, forgetting past conversations, misplacing objects, getting lost, difficulty learning new skills. People with a brain injury may experience anomia (a form of aphasia in which the patient is unable to recall the names of everyday objects).

How a traumatic brain injury affects memory or language? ›

People with TBI may not remember the injury itself. In this case, the brain has not stored the injury as a memory or series of memories. People may remain confused and unable to store memories for some time after the injury. The loss of memory from the moment of TBI onward is called post-traumatic amnesia.

Does TBI get worse with age? ›

The short answer is: yes, it can. Every brain injury is different and even though many secondary effects of a brain injury improve with time, others may linger and interfere with rehabilitation.

What is inappropriate behavior after brain injury? ›

Disinhibition. A common change early in recovery is disinhibition, that is, loss of control over behaviour, resulting in socially inappropriate behaviour. This ranges from a tendency to divulge personal information too freely, to disturbing and unpredictable outbursts of uncontrolled rage.

How can I improve my brain after TBI? ›

You can help your brain improve by exercising it and keeping it active. Practice memorizing things or work on crossword puzzles. A memory specialist can teach you different ways to improve your memory. To prevent the loss of your keys, wallet, or important papers, have one place at home where you keep them.

How traumatic brain injury affects daily life? ›

The brain affects how you think; how you feel; how you act. So a TBI can affect your physical functions, thinking abilities, behaviors, and more. The injury can range from mild to severe, and it may increase your risk for mental health conditions such as anxiety and depression, as well as sleeping problems.

Is a traumatic brain injury an intellectual disability? ›

Several types of brain damage can lead to an intellectual disability (ID, formerly mental retardation). These are: 1) Traumatic Brain Injury (TBI), 2) congenital brain damage, and 3) progressive brain damage.

What are the long-term effects of head trauma? ›

Traumatic Injury Long-term Effects

“Trauma to the left side of your brain can cause problems with logic, speech difficulties, trouble understanding others or talking, versus right side injury, which can cause problems processing visual information, neglect, or apraxia - the ability to perform regular or familiar tasks.

Can brain damage affect thinking? ›

Different mental abilities are located in different parts of the brain, so a brain injury can affect some, but not necessarily all, skills such as speed of thought, memory, understanding, concentration, solving problems and using language.

Can a head injury cause personality changes? ›

Any type of brain injury, regardless of severity, can cause personality changes — and some patients may not experience any personality changes at all,” said Dr. Thomas. For patients who do experience personality changes, common symptoms include: Becoming quick to anger or frustration.

What are some of the consequences of a traumatic brain injury? ›

Mild traumatic brain injury may affect your brain cells temporarily. More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. These injuries can result in long-term complications or death.

How does brain trauma affect behavior personality and memory? ›

After a brain injury, you might suffer from social anxiety, irritability, anger, depression, feelings of overwhelm, general anxiety, mood swings, or emotional lability (teariness). But make no mistake: While these symptoms can make it seem like you're a different person now, your personality is intact.

What are the long term effects of childhood head injuries? ›

Childhood head injuries linked to increased risk of adult mental illness and poorer life chances. Childhood brain injuries, including concussions, are associated with an increased risk of subsequent mental illness, poor school attainment and premature death, according to a study published today in PLOS Medicine.


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