The Student with a Brain Injury: Achieving Goals for Higher Education Janis Ruoff, PhD, HEATH Resource Center. GWU Page 9 of 12

Problems: Catherine thought that doing so well the first semester meant she did not need help after all. Due to a neurological-based lack of insight into the cause-and-effect relationship, she was unable to understand that the assistance she received helped her to succeed. Furthermore, she has been isolated and lonely for much of the time since the injury, and frontal lobe damage from her brain injury has impacted her self-monitoring skills, making her unable to realize when her social activities are negatively impacting her other responsibilities. Students with brain injuries often experience difficulty fitting in socially, and the demands of college life may be too hard to handle independently. Catherine is having trouble managing the multiple demands on her time and setting priorities.

Recommendations: While Catherine’s desire for increased independence and determination to succeed alone indicate positive and healthy behavior, Catherine still needs assistance with self-monitoring, managing her schedules, and assessing her priorities. In addition, her college may need to improve its communication and coordination among DSS staff, faculty, and administrators to assist students with brain injury. While not a mandated responsibility, attuned DSS professionals might recognize and address Catherine’s difficulties handling social pressures. It might be helpful for Catherine to join a support group of other college students or adults with brain injuries. Many people with brain injuries say that they trust the advice of their peers over that of professionals.

Eric

Scenario: Eric is a 19-year-old sophomore at a small university where he has an athletic scholarship and plays on the football team. During the homecoming game, just before Thanksgiving, he was tackled and suffered a severe concussion. He was admitted to the nearby hospital for observation, but remained out of school for the rest of the semester due to headaches and fatigue. Eric received "incompletes" in all of his fall-semester classes, and his doctor instructed him not to play football the following season. Eric returned to school in January and remains popular in his fraternity and at parties. Now Eric rarely turns in any of his classwork, and the work he does complete is inadequate. His instructors complain that his handwriting is practically illegible. Because Eric attends a small university where everyone knows him, his friends notice his behavior and report him to the coach, who then talks to Eric. Based on Eric’s behavior, the coach suggests that Eric’s problems are the result of drinking or drugs. Eric responds that he drinks very little and does not use drugs, and he promises to turn in all of his work very soon. The coach notices when they talk that Eric’s speech seems slurred, he walks with a limp, and his eyes appear unfocused. He writes in his report that Eric frequently appears to be intoxicated.

Problems: Sports accidents are a common cause of brain injuries and should be taken seriously. Doctors labeled Eric’s injury as moderate and he remained unconscious for just one hour, but even brain injuries that are labeled mild or postconcussive can cause long-term effects. Someone with a brain injury should not be rushed into activities for which they may not be ready. This does not mean that Eric cannot expect to resume many of his normal activities later. Eric is experiencing academic difficulties that have not been assessed properly, and he is reacting by focusing entirely on his social life, an area in which he feels most competent and comfortable.

Recommendations: Eric may have returned to school too soon and does not yet understand or accept the effects of his brain injury. He may need rehabilitation services and perhaps a drastically reduced courseload. As he progresses in his recovery, he will be more likely to achieve success and will be better able to handle the peer pressure and demands of his classes, although he still may require supportive services. Eric needs immediate referral to the DSS office and coordinated advising from both rehabilitation professionals and academic advisors. He also needs speech-language and neuropsychological assessments to help with his communication skills and to determine the areas of learning that are causing difficulty. Based on assessment results, and further observation and interviews, Eric will need help identifying and arranging for appropriate accommodations. A pocket organizer, or some other memory aid, might be useful for Eric to keep up with his class schedules, assignments, and test dates. Eric, his coach, and possibly Eric’s family may need to seek more comprehensive information about brain injury, its effects, and the resulting recovery process. They should be referred to their state BIA office for assistance.

References

Beers, R., Goldstein, G., and Katz, L. "Neuropsychological Differences Between College Students with Learning Disabilities and Those with Mild Head Injury." Journal of Learning Disabilities, 27, no. 5 (1994).

Bunch, Jennifer. Information and Resources column. TBI Challenge 4, no. 2 (2000). BIA: Alexandria, Virginia.

Krankowski, Theresa. "Transitioning the Student with TBI from School to Employment, Postsecondary Education, and Independent Living." TBI Challenge (Spring 1995). BIA: Washington, DC. Savage, Ron and Wolcott, Gary. (1994). Educational dimensions of acquired brain injury. Pro-ed: Austin, Texas.

Starr, Jana. (1999). Public Spending on Traumatic Brain Injury (TBI): A Snapshot of FY 1998 in the USA. BIA: Alexandria, Virginia.

RESOURCES

Monographs, Pamphlets, Periodicals, and Reports

Brain Injury: Causes and Consequences for Students. 1999. McKay Moore Sohlberg, Bonnie Todis, Ann Glang, and Marilyn Lash. 28 pages. $10. Order from Lash and Associates Publishing/ Training, (919) 562-0015 (V/FAX), lapublishing@earthlink.net, or http://www.lapublishing.com.

Brain Injury: A Guide for Families and Friends. 1995. The University of Iowa Hospitals and Clinics. View the guide online at http://www.vh.org.

Brain Injury Source (quarterly journal of the Brain Injury Association). Annual subscription $38. Contact BIA at (800) 444-6443, (703) 236-6000, familyhelpline@biausa.org, or http://www.biausa.org.

Creating Options: A Resource on Financial Aid for Students with Disabilities—2001 Edition. HEATH Resource Center. Free. Contact HEATH at (202) 939-9320 (V/TTY), (800) 544- 3284 (V/TTY), (202) 833-5696 (FAX), heath@ace.nche.edu, or http://www.heath-resourcecenter. org.

From the HEATH Resource Center, The George Washington University. Reprinted with permission. www.HEATH.gwu.edu.

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