Teachers Information on Acquired Brain Injury - Fact Sheet
With the increasing number of brain injuries
being reported each year, identification of students with a
traumatic brain injury and other brain disorders is becoming an
Traumatic Brain Injury (TBI) is often called the invisible
disability as there may be no observable evidence of the injury. As
a result, students with TBI or similar brain disorders may simply
be seen as moody and sulky kids, the problem student syndrome, or
beliefs such as 'that's just the way they are'. But with a little
understanding and modified teaching strategies, problems resulting
from a brain disorder can be reduced dramatically.
Students with a mild traumatic brain injury are often more
challenging than those with more severe disabilities. Students who
experience these problems are often not identified as needing
additional teaching time and instruction. Accurate diagnosis of
a Traumatic Brain Injury will improve the
outlook for a student's educational progress. Appropriate
assessment can also facilitate greater understanding in teachers,
which in turn provides the opportunity for more flexible and
effective teaching methods to be applied.
The difficulty recognising problems associated with
Traumatic Brain Injury is that they are not
always visible. The task of diagnosis is made more difficult when
we consider that the person with a TBI may not attribute his/her
difficulties to the injury.
An injured brain may never be restored to pre-injury capabilities
but performance can generally be improved. Difficulties are often
experienced in the areas of attention and concentration. It will be
necessary to encourage students with a brain disorder to gradually
build up their tolerance for concentration daily but this is not as
simple as it sounds. Keep periods of concentration short by
allowing regular breaks. Start with ten minutes and build up
gradually with a few extra minutes daily.
LACK OF INSIGHT
Many students with an a brain injury have a lack of insight
regarding their level of ability. They may be unable to recognise
that their performance and capabilities are functioning at a
reduced level. If this is the case, point out in simple terms the
areas that require improvement, continually reinforcing this
information so that it is not lost. Focusing on improvement rather
than impairment will encourage the student to be more active in
trying to correct the deficit.
LACK OF PLANNING AND ORGANISATIONAL SKILLS
Planning and organisational skills can be impaired to the extent
that the student knows what he or she wants to do, but has
difficulty getting started. This means that the person will need a
very clear plan of how to go about carrying out a task. The first
step will be to stop and think - he or she will need time and
support to work out a plan by identifying the task, keeping it
simple and addressing one task at a time:
- Write down all the steps required to complete the task
- Sort out the list of steps in the order they are to be
- Treat steps as a self-contained goals and tackle them one at a
- As each step is completed, reinforce it as an achievement of
- Create a distinct break between each step
- Review each preceding step before moving onto the next.
SHORT-TERM MEMORY PROBLEMS
Most brain disorders will result in impairment of short-term
memory and the ability to retain or process new information.
Students will lose books and equipment, forget appointments and
arrangements, ask the same questions again and again, or forget
which classroom they are supposed to be in. Fortunately, there are
ways to assist memory and it can be an exciting challenge to work
out new avenues to compensate for problems. However, it is
important that the students are aided but not rescued from their
own failing memory.
Common memory aids include:
- A diary to note all class times, appointments and
- A notebook to list common times and protocols
- A map of the school showing classrooms, toilets, offices, bus
- Clearly marked exercise books and equipment
- Thong necklace for keys
- Wristwatch with an alarm.
Students with poor memory will need to become familiar with
using memory aids and will need constant reinforcement. Other
helpful aids are clocks, calendars, blackboards, whiteboards,
signs, notices, photos, post-it notes, or anything that provides a
compensation to memory deficits.
Normally, people use their planning and organising skills to work
their way through confusion. However, because a Traumatic
Brain Injury often results in some loss of these
skills, it may be difficult for a student with an acquired brain
injury to deal with confusion. Confusion usually comes about
- Unrealistic self-expectations e.g. the student may have a
memory of achievement that is inconsistent with their impaired
- The student's inability to recognise that a disability
- Others having too high an expectation of the student
- The student attempting to achieve too much at once
- Interruptions, noise, clutter or visual distractions around the
- Too many instructions being given to the student at the one
Teachers may find that a student may get stuck with a problem and
then appear to be not listening. Alternatively, the student may
argue or demonstrate difficult behaviour. To avoid this, teachers
need to be aware of their student's history, make sure that things
are kept simple and take it slowly. If a student is becoming
confused or frustrated it may be necessary to take time out.
DIFFICULTY ACCEPTING CHANGE
Human beings don't always find it easy to cope with change.
Adjusting to change becomes more difficult when the student has
problems with planning, organising, problem solving or learning new
material. In order to protect themselves, students with a brain
injury are prone to resist change or attempt to avoid it.
Strategies to assist acceptance to change include:
- Discussing anticipated changes with students before the event
to prepare the students for what lies ahead and encourage them to
'own' the decision to change
- Not forcing the change upon the students too quickly
- Writing things down and going over them until the person is
familiar with them
- Offering advice, help and reassurance prior to and during the
process of change
- If students appear unable to cope, offering them understanding
about their situation.
STRESS, FRUSTRATION AND ANGER
A common trigger to personal stress is the feeling of helplessness
or being trapped in a situation over which we have no control.
Disciplined or authoritarian environments can add to students'
beliefs that they are deprived of alternatives. Being able to offer
students a number of options to choose from will support a feeling
When stress is unable to be avoided, relaxation and meditation
can act as good insurance policies. Time out may also provide the
opportunity to restore balance and perspective as long as it is not
seen as punishment. In extreme cases, a student may become openly
aggressive. The most appropriate response is to have an agreed
response by all members of staff. It should be negotiated with all
possible stakeholders to enhance the chances of success.
Students with a brain disorder often do things on impulse.
Behaviours displayed are often a genuine case of innocently doing
what seemed to be a good idea at the time. In most cases the
undesirable behaviour can be replaced with an agreed alternative,
negotiated directly with the student. It is also helpful to agree
on a signal that the teacher can give as a sign for the student to
stop and think about what they are doing. It could be a word (e.g.
herring), a song (e.g. Waltzing Matilda), or a sign (e.g. arm up in
the air). In time it will become an automatic process. Wherever
possible, strategies for the intervention should be developed with
all stakeholders (including student and parents).
All educational institutions now have policies that make
allowances for people with disabilities in terms of time given for
tests and assignments. These institutions are frequently unaware of
the multiple impacts on a student's abilities such as short term
memory difficulties, mental fatigue, lack of concentration,
susceptibility to stress and lowered organisational ability.
Teachers should refer students to the Disabilities Officer to make
suitable arrangements for tests and assignments.
References and further information