Creative Community Involvement to Prevent TBI

Amy Skinder-Meredith, The ASHA Leader

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In the fight to prevent traumatic brain injuries — and the speech, language, hearing, and swallowing disorders that may result — the ammunition of choice may include a melon, a swim cap, and brain-shaped chocolates.

Prevention of communication disorders is one of the primary responsibilities of the communication sciences and disorders (CSD) profession (ASHA, 1988, 1991). However, this responsibility probably is not stressed enough—clinicians spend the majority of the day assessing and treating patients who have already acquired a communication or swallowing disorder, and faculty train future professionals to do the same. ASHA offers a tutorial on preventing communication disorders (1991) that provides many suggestions on how CSD professionals can be involved in prevention and educational outreach throughout the lifespan: increasing awareness of the relationship of alcohol and tobacco use to oral and laryngeal cancer, improving diet to reduce the risk of strokes, and providing a language-rich environment to prevent language delay are just a few.

Prevention of traumatic brain injury (TBI), which can cause speech, language, hearing, and swallowing disorders, is another area prime for targeting, especially because TBI risk factors are numerous and vary according to age.

It was my 7-year-old son who led me to take a stronger role in prevention of communication disorders. He volunteered me to speak about the brain to his first-grade class a little more than a year ago. What started as a one-time effort has grown into something much larger.

I may be "Dr. Meredith" to my college students, but to younger students I am "The Brain Lady." Earlier this year, from mid-May through July, I spoke to hundreds of school-aged children in their classrooms, at a skate park, and in summer youth programs; participated in a community safety fair; did an interview at a local radio station; and consulted with the local bicycle shop on spreading the word on bike safety.

Teaching the basics about the brain and brain safety can be fun, especially when you have engaging teaching tools. Depending on the audience, my props may include a variety of brains (models, real specimens, and made of chocolate), gloves, a model skeleton, white swim caps, permanent magic markers, melons, a helmet, a large colorful brain atlas, and pictures with stories about real people who wore helmets and those who did not.

Primary Grades 

In the elementary-school classroom, I begin by discussing the brain, spinal cord, and nerves with a basic picture book about the nervous system. Next, I have an eager volunteer don a swim cap, and I tell the children I can see the volunteer's brain through his or her head with my "special glasses." I illustrate the different lobes of the brain and discuss the various functions of each location as I draw them on the volunteer's swim cap. For example, on the occipital lobe, I draw eyes representing vision; on the temporal lobe, I draw an ear to depict listening.

When we get to the frontal lobe we discuss its role in good decision-making as well as in other cognitive functions. This explanation leads into a discussion about good choices for a healthy brain and poor choices that would hurt the brain. The lesson also includes the role of the cerebellum (taught to them as "Sarah Bellum"), as they practice standing on one leg, touching their fingers to their nose, and walking a straight line from heel to toe. Depending on the age of my audience, I discuss other details, such as the role of the neurons.

After this brief neuroanatomy lesson, I introduce the children to Mr. Bones, my plastic skeleton who is dressed with his own brain swim cap, a helmet worn incorrectly, pink feather boa, bike jacket, bike shorts, and flip flops. We engage in an energetic dialogue about what Mr. Bones has done correctly and incorrectly. Children love to point out what is wrong. The fact that the helmet is not covering his frontal lobe and that he is wearing a pink boa are often noted first.

The conversation provides many teaching opportunities. The lesson ends with true stories available through Trauma Nurses Talk Tough. The first story is about a boy on a bike who did not have a helmet and collided with a car. The boy was in a coma for three months and in rehabilitation for six months; pictures depict the boy trying to learn to walk and eat again. The second story is of a boy in a similar accident, but because he was wearing a helmet, he escapes with minor scratches on his face. The students are asked to think about which child they would rather be. I then share a parallel story about two adults, emphasizing the point that even adults need to wear helmets.

After the large group lesson, children are invited to put on gloves and get a closer look at the real brains in small groups. This activity provides an excellent opportunity to fuel their interest in neuroscience, as well as in brain protection.

Safety Fair 

My involvement in the schools led to my membership on the planning committee for an annual safety fair. The committee comprised a wide variety of citizens concerned with health and safety, including law enforcement officers, an insurance business owner, parents, bike shop employees, parks and recreation employees, advocates for safe routes to school, and psychology and early education professors. It is encouraging that there are so many others in our communities with whom we can work to address the prevention of injuries that can lead to communication disorders. About 600 people visited the safety fair and its more than 20 organizational booths. Some booths represented safety advocates for guns, water, bikes, ATVs, automobiles, and pedestrians; others offered free bike helmets, car seats, car seat checks, gun locks, DNA kits, and brochures on myriad topics.

My booth was popular — I had real brains and the booth was adjacent to the free helmet giveaway. I distributed safety literature, fun pages, reflectors provided by the Idaho transportation department, and chocolate brains that I had made and individually packaged with a label that included a list of bike safety facts (with parents, I refer to this list as "nag facts"). I also told the children that they could use these facts to get their parents to wear helmets as well.