Traumatic Brain Injury: Perspectives From Educational Professionals J. Darrell Mohr and Lyndal M. Bullock, Preventing School Failure (Heldref Publications) (page 2 of 4) Page 2 of 4

Defining Success

We asked the participants to think of critical success factors for a student returning to school following the acute phase of recovery. Although participants unfamiliar with TBI could only produce vague ideas, such as "make accommodations," "monitor the student’s progress," and "formulate a contingency plan," those who were familiar with TBI had no trouble offering more specific suggestions. The following are some of the key points mentioned:

• Establish a system of communication early between school, family, and rehabilitation centers prior to the student’s discharge from the rehabilitation facility. This concept has been mentioned as being particularly important to successful school reentry (Deidrick & Farmer, 2005; Farmer, Clippard, Luehr-Wiemann, Wright, & Owings, 1996; Farmer & Peterson, 1995; Savage, 2005). Failure to plan early and communicate decreases the probability of successful outcomes for the student.
• Obtain information about the injury along with successful interventions or strategies used in the rehabilitation setting, and use this information to help prepare staff and peers for working with the student. The chances of success upon school reentry are increased if planning and preparation are undertaken with the specific strengths and limitations of the injured child in mind (Bowen, 2005; Mayfield, 2005; Mira & Tyler, 1991; Savage & Wolcott, 1988; Semrud-Clikeman, 2001;
• Establish a schedule that allows a shortened school day to accommodate the student’s need for physical recuperation. Researchers (Clark, 1996; Deidrick & Farmer, 2005; Farmer & Peterson, 1995; Schoenbrodt, 2001; Semrud-Clikeman, 2001) have emphasized the importance of structuring the student’s school day so that he or she can be most productive. Vol. 49, No. 4 PREVENTING SCHOOL FAILURE 55 This may require accommodations, such as scheduling the most intensive classes at times when the child is most alert, and shortening his or her school day to provide for rest.
• Appoint a staff member to be the liaison between rehab and school staff. Appointing a person to be responsible for ensuring that information is shared among school, family, and rehabilitation personnel is an essential component to obtaining successful outcomes. Ideally this "case manager" is someone who is specially trained in issues related to school reentry and planning, and can facilitate a smooth transition for the injured child and family (Deidrick & Farmer, 2005; Tyler & Mira, 1999).
• Take the family’s needs into consideration and empower them by getting them involved in the planning and monitoring. Family involvement is vital to the success of the student’s reentry, and as a major part of the planning team, the family’s needs and strengths should be carefully considered (Bowen, 2005; DePompei & Blosser, 1993).
• Structure the physical environment to accommodate the student’s needs and be prepared to make changes according to the student’s results. One of the most important, yet sometimes most overlooked, aspects of preparing for the child’s return to school is the learning environment itself. In fact, assessment of the environment, as well as instructional materials, instructional methods, and task demands, should occur repeatedly throughout the student’s recovery (Bowen, 2005; Semrud-Clikeman, 2001).

It was clear that those participants who had not had the benefit of TBI training were generally unaware of some of the most unique aspects of brain injury recovery. They tended to believe that the current system of supporting students with special needs is adequate for all students, including those with TBI. In addition, the general consensus among those less familiar with TBI was that if educators (a) exhibit patience and sensitivity toward students with brain injury, (b) carefully administer academic assessments, (c) take time to become familiar with the individual’s needs, and (d) develop the educational plan accordingly, then students with TBI should have positive academic outcomes. To the contrary, however, research has led to the development of reentry models that call for a structured process for the return to school and development of education programs for students with TBI (Bowen, 2005; Deidrick & Farmer, 2005; Hibbard, Gordon, Martin, Rashkin, & Brown, 2001; Lash,Wolcott, & Pearson, 2000; Ylvisaker, 1998). In fact, some have developed checklists and guides to ensure that the education team takes a structured approach and does not inadvertently omit essential components of the process (Bowen, 2005; DePompei, Blosser, Savage, & Lash, 1998; Tyler & Mira, 1999).

Perceptions Regarding the Effects of TBI

Although some of the participants were aware of many aspects of TBI, most expressed an interest in enhancing their knowledge. Many of the comments made during the focus group clustered around two of the three functional domains that are often affected by brain injury: cognitive and psychosocial/behavioral (Mayfield, 2005). The following is background information regarding the effects of TBI as they relate to the functional domains.

Although every brain injury is different and every individual affected by TBI is unique, effects of TBI can be categorized into three broad domains: (a) physical, (b) cognitive, and (c) psychosocial. It is easy to imagine how difficulties in any, or all, of these domains could result in the injured child experiencing difficulties at school. However, because most disabilities involve one or more of these domains, it is often assumed that the needs of children with TBI can simply be addressed using existing practices of assessment and instruction. Consequently, educators who believe this may become frustrated and confused by the lack of positive outcomes. For example, a youngster who exhibits an uneven pattern of recovery, gaps in knowledge, and multiple needs across all three functional domains may exasperate the teacher who is accustomed to supporting students with learning disabilities. The ideal approach to assessment and instruction is one that appreciates the complex problems associated with brain injury, and remains flexible as the student with TBI changes during the recovery process (Bowen, 2005; Mayfield, 2005; Savage, 1991; Semrud- Clikeman, 2001; Stavinoha, 2005; Tyler & Mira, 1999).

From Preventing School Failure, Summer 2005. Heldref Publications. www.heldref.org.

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