Traumatic Brain Injury: Perspectives from Educational Professionals

J. Darrell Mohr and Lyndal M. Bullock, Preventing School Failure (Heldref Publications)

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Given the fact that over 1 million children and youths sustain brain injury each year (Clark, Russman, & Orme, 1999), one might assume that adequate numbers of educators are being prepared to support this population of students in schools. However, there is evidence indicating that this may not be the case (Chapman, 2000; Clark, 1996; Semrud-Clikeman, 2001). Although traumatic brain injury (TBI) was added as a separate disability category within the Individuals With Disabilities Education Act (IDEA) in 1990, many educators still are not aware of the unique challenges involved in providing educational and social support to this student population (Chapman). This article examines some of the critical aspects of brain injury that educators should be familiar with in order to meet the needs of students with TBI. The information herein is derived from the brain-injury literature and from two focus groups involving educators. The purpose of the focus groups were to identify (a) educators’ perceptions of their ability to meet the needs of students with TBI, (b) when and how they obtained their knowledge of TBI, (c) what more they would like to know about TBI, and (d) their concerns regarding meeting the challenges presented in working with this population of students. The discussion presents highlights from the focus groups, and comments on them with regard to what the TBI literature deems important for educators to know regarding TBI.

Focus Groups

The idea behind conducting the focus groups was to discover more about educators’ perceptions regarding their ability to support students with TBI. We wanted to discover how educators felt about their own training with regard to TBI, and how they felt about the adequacy of existing training resources for educators in general. Finally, we were interested in the kinds of questions and concerns they currently have about serving students with TBI.

Our focus groups consisted of a total of 15 professional educators, composed of special education teachers, diagnosticians, and behavior specialists. Prior to the focus groups, we asked the participants to complete a short questionnaire that consisted of five questions in a Likert scale format (see Appendix). The questionnaire was designed to (a) focus the participants’ attention on the topic, (b) prepare them mentally for the focus group, and (c) collect data regarding major points of interest.

TBI Awareness

For over 2 decades, education researchers in the field of brain injury have been attempting to assemble a convergent database of information that will help professional educators effectively support students with TBI. Although the literature now contains many promising practices and tools for educators, this valuable information is yet to be effectively disseminated.

Although most of the participants were at least somewhat familiar with TBI, only half had received any type of formal training with regard to the subject. Formal training, according to the participants, took the form of either an in-service session offered by their school district or education service center, or as part of a college course. Interestingly, all of those who received information through a college course did so as graduate students— none were offered information about TBI as part of their undergraduate teacher preparation. One educator expressed concern that not only had her undergraduate program been devoid of preparation for working with students with TBI, but that she had never heard of the term until she met her first student with TBI. Others, upon being notified that they would soon be working with a student with TBI, took the initiative to learn as much about it as they could. The Internet was the most popular informal source of information for those who engaged in self-study. When asked about the importance of having college coursework devoted to brain injury within teacher preparation programs, 71% said they felt it was very important, and 14% viewed it as extremely important.

With the exception of one participant, who was aware of TBI staff development opportunities at her education service center, most comments from the participants seemed to indicate that information regarding TBI was disseminated on a "need-to-know" basis within their districts. This may be because of the perception that TBI is rare, and does not justify wide-scale training. One participant relayed the story of how she was quickly briefed by a diagnostician the day prior to a brain-injured student’s return to school. The briefing consisted of basic background information, but no strategies were offered on how to work with the student. Another educator told us that she found out about a student’s history of brain injury as she searched his file for clues regarding his unusual behavior. No one had mentioned his TBI to her, and she found out about it from his records. These types of stories are probably not uncommon, and should cause concern among educators, administrators, and parents.

Regarding their preferred source of TBI information, the respondents identified a variety of sources, including college course work, seminars, conferences, district clearinghouses, and online resources. Most of those who had already received formal training indicated the desire to have someone who specializes in rehabilitation, such as a neuropsychologist or TBI specialist, supplement the information that they received. They felt that such personnel would be best qualified to provide information regarding cognitive retraining. All but two of those who had no previous training in TBI expressed the belief that staff development opportunities and periodic consultation with a psychologist would suffice. Such in-service training has been identified as an essential component for providing an adequate level of educational services to students with TBI (Bullock, Gable, & Mohr, 2005; Mira & Tyler, 1991).

Many participants expressed the importance of providing quality training for all teachers who work with a child with TBI. According to one teacher, the lack of information regarding TBI impedes collaboration because of the varying expectations held for the student—"It is setting the student up for failure." This view is supported in the literature (e.g., Semrud- Clikeman, 2001; Tyler & Mira, 1999).