Acquired Brain Injury in the Classroom
Bennett, Dawn Good and Dawn Zinga
Eric was an enthusiastic student who worked to his full potential. During the December
holidays, he and his mother were in a motor vehicle collision on Highway 401 while
returning from a day of skiing. Once back in school, Eric was irritable, distracted,
refused to participate in group activities and his academic performance changed noticeably
for the worse.
His Grade 4 teacher felt that Eric was affected by his mother's remaining in hospital
throughout the remainder of the term.
In Grade 5, Eric's teacher told the family that Eric was unmotivated and refused to
apply himself. They agreed that the stress of the accident and the trauma of his mother's
near death had emotionally scarred Eric and affected his behaviour. They agreed to get him
some counselling and to address his behavioural dysfunction.
In fact, Eric is one of an estimated 27,000 students in Ontario with an acquired brain
injury (ABI). Some are diagnosed by the medical community; others are never diagnosed. In
the classroom, such students are mistakenly seen as behavioural and motivational problems.
Teachers were never told that Eric had sustained a brain injury in a car accident.
Because he suffered a "closed head" injury and he did not present any overt
physical disfigurement or disability - he could walk and talk - Eric's teachers had no way
of recognizing the signs on their own.
It is important for teachers to be aware that an ABI is a
medical diagnosis made by a trained medical professional. Often the diagnosis of ABI is
made available to teachers, but other times it is not. Many children may be undiagnosed as
ABI. Bearing this in mind, teachers' observations and involvement with the student can
provide vital information and support systems to promote the child's adjustment and
academic success in an educational setting.
How can educators be alerted to the possibility of acquired brain injury
in the classroom? Children with ABI may experience cognitive problems such as deficiencies
in memory, attention, concentration or problems with language or overall intellectual
functioning, behavioural and social problems such as acting out, impulsiveness,
inattention or irritability, and/or physical neurological problems such as dysthymia,
slowed motor skills and impaired gait or balance, depending on the location and the extent
of the injury.
All of these symptoms can have a severe impact in the classroom. The emotional scars
cannot be ignored either. Isolation, rejection, failure, inability to accomplish and
inability to do what they used to do all can take their toll on the student as well.
The effects of ABI can change as a child develops. An injury that occurred when the
child was in Grade 1 may seem to have little impact on the child's behaviour and academic
performance. However, that same child may display difficulties in Grade 6 when she
develops higher level cognitive processing abilities such as abstract thought and problem
Children with ABI are often more distracted and become frustrated in the classroom
which frequently results in acting out. If a child demonstrates a change in behaviour and
starts having trouble with tasks they showed evidence of handling well previously, the
root of the problem may be an acquired brain injury.
How to Help
What can educators do to assist students with ABI in the
classroom? Students with ABI benefit from consistent routines and clear expectations. They
may need assistance with organization and staying on task. These students often tire
cognitively as well as physically and become frustrated. Minimizing distractions and
allowing students opportunities to rest as needed helps them cope more effectively and may
minimize acting out.
Students often need more time to complete assignments and tests. Information processing
difficulties and memory impairment make it difficult for students with ABI to follow
complex directions and to consolidate new skills.
Educators can address these difficulties by giving directions one step at a time or by
providing written directions. Offering a wide range of opportunities to practice new
skills helps with consolidation. It is also important to ensure that students have learned
a new skill by working through examples with them before providing opportunities to
practice the new skill individually. With the introduction of some of these simple
procedures, both classroom performance and the child's future can dramatically improve.
If you have a student with ABI in your classroom or would like further information, you
can contact the Ontario Brain Injury Association at 1-800-263-5404 or the Educating
Educators about Acquired Brain Injury project at 905-688-5550, ext. 3556. Over the next
two years, this project will be providing resource binders for educators, in-service
training sessions and a resource web site.
Dawn Good is an associate professor of psychology at Brock
University and the director of Brock's neuroscience program. Sheila Bennett is an
assistant professor at the Faculty of Education at Brock University and a veteran
classroom teacher specializing in research and teaching on special needs. Dawn Zinga is a
PhD candidate at the Ontario Institute for Studies in Education of the University of