TRAUMATIC

BRAIN INJURY
Cindy Llanas

Traumatic Brain Injury (TBI)

IDEA Definition
An acquired injury to the brain caused by an external
physical force, resulting in total or partial functional
disability or psychosocial impairment, or both, that
adversely affects a childs educational performance. The
term applies to open or closed head injuries resulting in
impairments in one or more areas, such as cognition;
language; memory; attention; reasoning; abstract thinking;
judgment; problem solving; sensory; perceptual, and motor
abilities; psychological behavior; physical functions,
information processing; and speech.
(IDEA 20 U.S.C. 1401 [2004], 20 C.F.R. 300.8[c][12])

TBI Identification
Closed Head Injury

Open Head Injury

Mild Brain Injury

When the brain in injured

by bouncing around inside
the skull but there is no
physical damage to the
skull itself.

When the skull is fractured

and the membrane
surrounding the brain is
penetrated, resulting in
the brain being directly
injured.

Concussion is any altered

mental status that occurs
after a blow to the head.
With these types of blows,
the head is rotated in a
violent fashion causing a
shaking of the brain inside
the skull.
*accounts for the majority
of brain injuries

(National Institute of Neurological

Disorders and Stroke, 2012)

I is usually identify through a CAT scan or an MRI.

a school setting they also identify the intellectual functioning, academic achievement, language and relate
ugh formal and informal assessments.

TBI Social Implications

Early Childhood
Isolation
Attention problems
Poor social problemsolving
Aggression
Bossiness

(McKinlay et al., 2010)

Childhood

Behavioral Problems
Hyperactivity
Conduct problems
Poor self-control
Internalizing difficulties.
Safety skills
Self-direction

Adulthood
Not driving
Some friendships are
lost
Unemployed
Increased rates of
depression & obesity
Increased stress
Love relationships are
affected
Interpersonal difficulties
Social cue
misperception
Inappropriate
verbalization
(Sale, 1991)

TBI Academic Implications

Early Childhood

Childhood

When a child suffers a brain injury, damaged brain cells cannot

regenerate or repair themselves; however, new neural
connections can form between the intact areas of the brain.
These new connections allow areas of the developing brain to
take over the functions of the injured brain cells. However, this
reorganization of brain functions usually results in a cost to
the childs overall cognitive capacity. (Lowenthal, 1998).

As infants and toddlers

mature, delays are more
evident and children may
grow into their deficits,
with new impairments
emerging as expected
developmental gains are
not achieved.
problems with gross motor
coordination and balance
are common

Adulthood
They have difficulty with
planning, organizing,
initiating a task, inhibiting
responses, and selfmonitoring

Speech-impairments

Delays in expressive
vocabulary and rapid
naming of objects.
lower scores on all
measures of academic skills
have short-term memory
problems (may recall prior
knowledge before TBI)

have short-term memory

problems (may recall prior
knowledge before TBI)

TBI Medical Implications

Early Childhood

Childhood

Adulthood

Fatigue and sleep problems Headaches Seizures Bladder/bowel problems

Temperature regulation Orthopedic problems Vision problems Hearing
problems Sensory sensitivity Motor problems
(Babikian et al., 2009)

TBI Emotional Implications

Early childhood

Depression
Anger and Irritability
Anxiety
Mood changes

Childhood

Adulthood

Mood swings
Self-centeredness
Anxiety
Depression
Lowered self-esteem
Lack of motivation
Difficulty controlling
emotions
Seek out sensory stimuli

Sexual dysfunction
(inappropriate sexual
behavior)
Depression
Anxiety
Embarrassed, ashamed,
or frustrated that they
can no longer perform
as they once could

(Babikian et al., 2009)

(Prigatano, 1992)

References
Babikian, T., & Asarnow, R. (2009). Neurocognitive outcomes and recovery after pediatric TBI:
Meta-analytic review of the literature. Neuropsychology, 23, 283-296.
Lowenthal, B. (1998). Traumatic brain injury in early childhood: Developmental effects and inter
ventions. The Transdisciplinary Journal, 8(4), 377388.
McKinlayA,GraceRC,HorwoodLJ,FergussonDM,MacFarlaneMR.Long-term behavioural
outcomes of
pre-school mild traumatic brain injury.Child Care Health Dev. 2010;36(1):2230
pmid:19250251
National Institute of Neurological Disorders and Stroke. (2012). Traumatic brain injury: Hope
through research. Retrieved from
http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm#193633218
Prigatano, George P., Personality disturbances associated with traumatic brain injury. Journal of
Consulting and
Clinical Psychology, Vol. 60(3), June 1992, 360-368.
Sale P, West M, Sherron P, Wehman P. Exploratory analysis of job separations from supported
employment for
persons with traumatic brain injury. J Head Trauma Rehabil. 1991; 6(3): 1-11.