icing to the cake: EF & TBI


Traumatic brain injuries (TBI) are really common.  The Centers for Disease Control (CDC), noted among their collection of statistics that 1.7 million people in the United States are seen for TBIs annually, but that they are unfortunately confident that the number of people affected by a brain injury is much higher.  Children under four, adolecents between 15 and 19 and seniors are the most commonly attributed groups which means that if you’re a caretaker or a teacher, you probably should have a solid understanding of what a TBI is and how it can affect the behavior and academic success of the children we love.

A TBI has a very high likelihood of affecting the ability of the injured to fulfil some ‘basic’ processes and can therefore be very detrimental to learning.  Check out this chart and YOU tell ME: why could having a brain injury be difficult for a student?


I’d love to hear from you about this but even if you just keep the thoughts in your mind: please respect the silent, invisibile injury and the individual who has to navigate through it.

If an injury is severe enough, it’s almost inevitable that there will be acknowledgement of the injury and perhaps even a process set up to reintegrate the student back into the learning environment.  But many times it is imperative to educators to make sure that some of the challenges they see in a classroom  aren’t attributed to “mild” or “minor” brain injuries that were never given medical oversite.

But having had major medically noted head injuries, I can go ahead and tell you this from my personal experience:  absolutely nothing was done in terms of accomidations.  In fact, the day after one of them I was attempting to take the PSAT even though I couldn’t move my eyes.  That’s like jumping on a broken ankle and wondering why it won’t heal quickly!  Yeesh!  Even when I was given some time to rest my brain, I was assumed to reenter high school fully ready to perform regularly.  I didn’t know just how much it was affecting me but this I can tell you: after the last big one, I have sometimes had issues translating English to something my head can understand.  In other words, sometimes words just don’t mean anything to me.  Other times I can’t get simple words to come out.  But I was just considered lazy and apathetic: not literally unable to understand the world of Emily Bronte or Jefferey Chauser.   Frankly, twenty years later, anybody who has observed me in action could probably tick off a few of those traits even today.

TBIs cause major issues with the executive functions.  When Phineas Gage had that thirteen pound tamping iron shoot through his head, the lucky fellow survived pretty well.  But people that knew him before and after could tell that he wasn’t the same anymore: he could talk and walk and remember things–but he had issues controlling his impulses, verbally and physically.  He was unable to work without strict daily schedules and oversite, whereas before he had BEEN the overseer.  He became irrationally emotional and prone to violence in a way he never exhibited before.  Phineas Gage is a really important person for helping doctors understand brains.

Gage had the very front of his prefrontal cortex shot through when he was 26.  That meant that his other lobes were fine and functioning–but the prefrontal cortex was severely damaged.   Gage’s behaviors, when compared to a list of what is challenged in an executive function deficit (EFD), one could see that clearly that prefrontal cortex is really important.

Many teachers and parents will enounter individuals who have hurt their head.  The individual might not even realize what kind of damage has incurred and that is why it is important that we, as the ones who love and take care of these people, know about them.  Here’s a fantastic resource FOR CLASSROOM TEACHERS and parents alike:

fantastic PDF resource


If you have students that play contact sports, keep a lookout.  Football players commonly have silent head injuries that they’d never tell anybody about.  But if you, as a teacher, sees a student behaving differently for no appararant reason, do your own assessing and asking.  Now that we understand more fully that a brain injury, any brain injury, has LIFELONG, cummulative affects, it’s more important than ever that we emphasize just how important it is to keep our beloved childrens’ noggins safe.

Be mindful and make sure that the child who is failing and/or acting out: make sure there’s not something going on in the brain before you assume the child is being LAZY or whatever other negative term teachers come up with.  They already feel rotten enough, they don’t need to be told that they’re choosing to stink as well.


This was a quick one tonight, I’ll talk more later, but it was just “on my mind.”


also, here’s a link to a collection of videos by the U. of Oregon for working with students with TBIs.



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