Brain Injury Support (BIRSST)  


Brain injury is a leading cause of death and disability for children in the U.S. (Dise-Lewis, Calvery, & Lewis, 2002) Brain injuries can be traumatic or acquired, and may involve loss of oxygen to the brain, bleeding in the brain, tearing of brain cells, or neurochemical disruptions. "Acquired" brain injuries occur as a result of acute health difficulties, such as stroke, substance inhalation, near drowning, or illnesses such as meningitis or encephalitis.  Common causes of "traumatic" injuries include motor vehicle accidents, auto/pedestrian accidents, child abuse, falls, or sports related injuries.

About 85% of traumatic injuries are classified as MILD, and up to 80% of these are not initially identified (Terryberry-Spohr, 2007). Mild traumatic brain injuries include concussion, brief loss of consciousness, or amnesia without loss of consciousness, but only 15% of mild injuries involve obvious symptoms and often result in negative routine neurological evaluations. On the other hand, 85% of mild injuries involve microscopic injuries that do not appear on CT scans or MRIs (Terryberry-Spohr, 2007). MODERATE traumatic injuries include loss of consciousness for less than 24 hours, while SEVERE injuries involve loss of consciousness for longer than 24 hours.

Unfortunately, the strongest predictor of a head injury is a previous head injury, and 90% of repeat injuries occur within ten days of a previous injury due to subtle changes in balance and reaction time (Terryberry-Spohr, 2007). Recovery time for a mild injury with no loss of consciousness may last four to eight weeks; while for a more severe injury, the recovery time may extend a full year or longer.

Observable changes in students who have experienced brain injury include changes in attention, memory, and personality. Sometimes students become more restless, more easily confused, or more easily upset. Sometimes they experience physical symptoms, such as headache or fatigue. They may have more difficulty learning, completing school work, and maintaining interest in school. Students who have suffered a brain injury may benefit from a variety of instructional strategies and accommodations, dependent on their particular symptoms. Students who have suffered a brain injury may be eligible for accommodations and instruction through an IEP or through a 504 Plan.

* Dise-Lewis, J. E., Calvery, M. L., & Lewis, H. (2002). BrainSTARS Brain Injury: Strategies for Teams And Re-education for Students. Denver, CO.
* Terryberry-Spohr, L. (2007). Mild Traumatic Brain Injury and Sports Related Concussions. Nebraska Brain Injury Conference. Grand Island, NE

Brain injury symptoms

Children and students may have had a brain injury known by the school; others may be "hidden" as often the parents and the child are unaware that a brain injury has occurred.

Has the child experienced any of the following?

  •       Concussion
  •       Bicycle or motor vehicle accident
  •       Playground fall or sports-related injury
  •       Serious illness
  •       Oxygen deprivation
  •       Shaken as an infant

Have you noticed any changes following a possible brain injury?

  •       Physical (fatigue, lack of interest, headaches, slowed reactions,
          heightened sensitivity to light or noise, nausea or vomiting, balance, blurry vision)
  •       Cognitive (forgetfulness, word-finding difficulties, inattention, distractibility, confusion)
  •       Emotional (moodiness, depression, anxiety)
  •       Behavioral (irritability, aggressiveness, frustration over minor incidents)

Has the child struggled with any of these challenges? 

  •       Information and processing speed (processing visual and/or auditory
          information more slowly than others)
  •       Memory (difficulties with short-term memory, or with learning, storing, and
          retrieving new information)
  •       Executive function (reduced ability to prioritize, organize themselves, plan ahead, follow through)
  •       Attention/concentration (problems sustaining attention over time;
          inability to do two tasks at the same time)