Special Education for Brain Injury

Bored school boy in the classroom

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Children with traumatic brain injury (TBI) present unique challenges for parents and special educators. Traumatic brain injury is included as a diagnostic category in the IDEA, and students with a disabling brain injury are eligible for special education and related services. Depending on the degree of injury, the needs of students will vary. Further, if a student has a learning disability before brain injury occurs, the student's learning disability will likely become more problematic.

Coordinating Special Education Services for Traumatic Brain Injury

It is very important for parents and schools to work together with medical professionals as students transition back into school after having a brain injury. This will enable planning to have the necessary supports in place in a school in time to help the student make a successful transition.

Parents can assist the school with preparations by sharing evaluation and treatment information from the student's doctors and therapists with the school district special education administrators and the school principal. This is especially important in cases where school staff needs the training to meet the child's needs before they return to school with a brain injury.

What Are Traumatic Brain Injury Symptoms and Behaviors?

Depending on the severity of the disability and which part of the brain is injured, students with these injuries will show a range of symptoms from mild to debilitating. Common problems include:

  • Hyperactivity and impulsivity
  • Mood swings and defiant behavior
  • Memory and communication problems
  • Lack of inhibition
  • Socially inappropriate language
  • Inability to recognize their behavior is offensive or inappropriate
  • Depression
  • Inability to focus or pay attention
  • Physical problems

Although students with brain injuries may appear as if there is nothing wrong with them, their internal brain injuries are very real and may or may not improve over time. Consequently, behaviors such as those listed above should not be seen by teachers and parents as simple conduct problems.

Research indicates that the first year following the brain injury is the most important in terms of providing instructional services and therapies. It is in the first six months, those researchers believe, that the most important healing takes place, and this period is critical to the student's future rehabilitation.

Brain Injured Students With Learning Disability — Special Education Program Planning

To develop an effective Individual Education Program (IEP) for students with brain injuries and related learning disabilities, it is important to gather as much information on the child as possible through reviewing all available medical data and conducting a thorough individual evaluation.

The evaluation should include intelligence testing, academic assessment in reading, writing, and math, assessment of adaptive behavior skills, problem behavior rating scales, developmental and social history, speech and language assessment, and occupational therapy evaluation. In cases where students have gross motor problems such as in walking or large body movements, a physical therapy evaluation will also be needed.

Individual Education Program Development for Brain Injured Students With Learning Disabilities

An individual education program development team comprised of the child's parents, regular teachers, a special education teacher, and the evaluators should meet to discuss their findings and develop a plan. If possible, it can be helpful to include medical professionals who treated the child during their hospitalization. If doctors are not available, bring copies of their reports for the team.

Armed with this information, the team can determine the child's present abilities and develop long-term goals and short-term objectives. The team can also determine the best way for these services to be delivered and the least restrictive environment for the student. It is critical for the team to remain flexible and to be ready to address any needs the student may have that were not anticipated. In some cases, it is not possible for the team to anticipate certain types of problems until the child re-enters the education environment.

It is sometimes necessary to provide more intensive assistance in the beginning and to remove those supports as the child demonstrates the ability to achieve and function without them.

Possibly the most significant challenge in serving the student will be in behavior management. Students are likely to be fidgety, unable to focus and be hyperactive. Among adolescents, it is common to see more intense forms of typical teen behavior. Risky behavior, disregard for personal safety and the safety of others, inappropriate and public sexual behavior and language, and classroom disruption may occur. With training for the staff and the provision of additional supports, the student will have the greatest opportunity for success.​

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5 Sources
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  2. Biederman J, Feinberg L, Chan J, et al. Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes. J Nerv Ment Dis. 2015;203(11):813-819. doi:10.1097/NMD.0000000000000375

  3. U.S. National Library of Medicine. Traumatic Brain Injury.

  4. Rabinowitz AR, Levin HS. Cognitive Sequelae of Traumatic Brain Injury. Psychiatr Clin North Am. 2014;37(1):1-11. doi:10.1016/j.psc.2013.11.004

  5. Brain Injury Alliance New Jersey. Behavior After Brain Injury: Challenges for Children and Adolescents.