Accommodations Guide for Students with Brain Injury

Jeffrey Kreutzer, PhD and Nancy Hsu, PhD, Department of Physical Medicine and Rehabilitation Virginia Commonwealth University

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The long-term effects of brain injury can be catastrophic for students at any level. Early on, students with the most severe injuries are unable to attend school. Some require home schooling until they recover enough to travel and attend classes with other students.

Research shows that brain injury often harms basic cognitive abilities such as memory, learning, attention and concentration, word finding, and visual perception. Injury can also harm important academic abilities such as reading, arithmetic reasoning, vocabulary, writing, and spelling. Parents and students often worry about falling grades and failure. Concerns about passing the school year, graduating high school, or graduating from college with a degree are often expressed.

Frequent complaints from students with brain injury include:

• I study for twice as long as I used to, but I’m doing much worse.
• I can’t remember anything I read no matter how many times I re-read the same thing.
• I study hard and feel like I know the material. Then I go into the test and can’t come up with the answers.
• Essay exams are murder. I need 20 minutes to think of what I want to say and then the time has run out.
• I get so tired I can barely get through the school day. At night, I’m just too tired to do my homework.
• I’m so distracted. I can pay attention for five minutes and then my mind wanders.
• I go to every class, but nothing sinks in.

Most of the time, school systems are very willing to provide accommodations to students with brain injury. “What are accommodations?” you might ask. Accommodations are special services or arrangements designed to help survivors overcome and offset injury related limitations.

Students and parents often don’t know that many kinds of accommodations are available to help students succeed. Many are also unaware of what accommodations are appropriate and reasonable for them. Having a thorough evaluation of academic and cognitive abilities is a first step toward understanding a student’s special needs. Evaluations can be performed by neuropsychologists, educational psychologists, and school psychologists. Students and parents are encouraged to seek an experienced brain injury professional who can thoroughly document academic strengths, limitations, and recommended accommodations. Nearly all schools require documentation of disability and recommendations in order to provide accommodations.

To help you understand what accommodations might be appropriate for you or your student, we have prepared a partial list of commonly recommended accommodations on the next page. Talk to the psychologist or educational specialist helping you to determine what is best for your situation.

Classroom Accommodations:

• Allow additional time to complete in-class assignments
• Allow for extra or extended breaks
• Provide student with instructor’s notes or help student obtain quality notes from other students
• Allow student to audio record lectures for later playback
• Provide both oral and written instructions; clarify instructions
• For lectures, provide student with an outline or study guide when available
• Allow use of a portable computer with spelling and grammar checks for assignments and note-taking
• In grading work, reduce emphasis on spelling and grammatical errors unless it is the purpose of the assignment
• Permit referencing a dictionary or thesaurus for assignments
• Provide preferential seating at or near the front of the classroom
• Reduce quantity of work required, in favor of quality.
• Avoid placing student in high pressure situations (e.g., short time frames, extensive volume of work; highly competitive)
• Exempt student from reading aloud in front of classmates because of impaired reading skills.

Test Accommodations:

• Allow additional time to complete tests.
• Provide for completion of tests in a quiet, individual environment with the goal of minimizing distractions.
• Administer long examinations in a series of shorter segments with breaks allowed between sections.
• Allow oral examinations and assist student in having responses scribed, as needed.
• Assess knowledge using multiple-choice instead of open-ended questions.
• Allow student to clarify and explain responses on exams (and assignments).
• Permit student to keep a sheet with mathematic formulas for reference, unless memorizing the formulas is required.
• Permit student’s use of a calculator.
• Permit the student to utilize a dictionary and thesaurus in writing test responses.
• If two exams are scheduled on the same day, allow student to reschedule one for another day.