PowerPoint Presentation - Traumatic Brain Injury Collaboration Space by liwenting

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									   Partners in Communication

                Supporting
                          Student
                                    Transitions
From Hospital




                    To Home


                                      To School
 Program Funding                            




    Project B.R.A.I.N. is a project of the Tennessee Disability Coalition
        in collaboration with the Tennessee Traumatic Brain Injury
          Program and the Tennessee Department of Education.


Project B.R.A.I.N. is supported in part by project #1 H82MCO3810-01-00
from the Department of Health & Human Services, Health Resources &
Services Administration, Maternal & Child Health Bureau. The contents
are the sole responsibility of the authors and do not necessarily represent
the views of DHHS. This is in the public domain. Please duplicate and
distribute widely.
Project B.R.A.I.N.
Brain Resource & Information Network

   A Resource and Training
    Network for Educators,
   Families and Healthcare
  Professionals who Support
   Tennessee Students with
  Traumatic Brain Injury (TBI)
Project B.R.A.I.N.
Brain Resource & Information Network


                   Identifying students who may
                   experience a variety of
                   changes after sustaining a
                   head injury.

 OBJECTIVES
                   Providing appropriate &
                   timely education, follow-up &
                   intervention throughout the
                   transition from hospital to
  Section I        school...into the future.
Objectives   


      Recognize the discrepancy between
   incidence rates of TBI for ages 3-21 years


                   VERSUS



    Number of students in Tennessee school
     systems who are identified with a TBI
Objectives   




   Develop an awareness of the potential physical,
 cognitive, behavioral, & psychosocial effects of a TBI.
Objectives      




 Develop effective communication links, successful
    strategies & resources to establish ongoing
  supports for students with TBI in the classroom.
A Closer Look at the Numbers   



          National Data
        Tennessee Data



                           Section II
                      National Average
                  of Annual Number of TBI’s

                                                                        Ages 0-24 years
700,000


600,000


500,000
                         644,000                                               1995-2001
400,000


300,000
                                                                               Tre a te d a nd re le a se d
                                                                             from the Em e rge nc y
200,000
                                                                             De pa rtm e nt
100,000
                                                                               Hospita lize d
                                            81,000
     0



               Centers for Disease Control and Prevention www.cdc.gov/injury
       Langlois JA, Rutland-Brown W, Thomas K. Traumatic Brain Injuries in the United States: Emergency
      Department Visits, Hospitalizations and Deaths. Atlanta: US Dept Health & Human Services, Centers for
               Disease Control & Prevention, National Center for Injury Prevention & Control; 2004.
Counting Heads 
Where Do The Numbers Come From ?

                          TENNESSEE TBI REGISTRY

                              Hospital medical records
                              databases retrieve all TBI data
                              sorted by injury codes.

                              The code classifications are
                              determined by the Centers for
                              Disease Control and Prevention.



 In Tennessee, an individual must remain in the hospital 24 hours
      or longer after an injury to be included in the registry.
TBI Registry in Tennessee 

Documented TBI data is
mandated by the state to
be sent from the hospital
to the TBI Registry

TBI Registry Letters are
distributed to those
individuals who had
been counted as having
sustained a TBI


TBI Registry establishes initial communication for individuals and
  their families, making TBI services and resources available.
IN TENNESSEE               




1600                        The number of people,
1400                        ages 3 to 21, who were
                            recorded in the TBI
1200            TBI         Registry for the 2003 -
1000            Registry    2004 school year: 1547
 800
 600            DOE         Number of students
                            classified as having a TBI
 400            Report      according to the
 200                        Department of Education
                            report for the 2003 - 2004
   0                        school year : 306


  What is happening with the 1,241 students?
   What To Look For ?



Hospital to Home to School   



                         Section III
What To Look For ?
    Hospital to Home to School   


  HOSPITAL

  Recognize that
  any injury to the
   head has the
 potential to affect
    a student’s
    educational
   performance.
What To Look For ?
     Hospital to Home to School               




                                                 H
                                                 O
                                                 M
                                                 E


Be aware that less visible changes in an individual may
    or may not be immediately linked to the injury.
What To Look For ?
       Hospital to Home to School   


   S
   C
   H
   O
   O
   L

 Anticipate the possibility that the whole student and family may
              experience temporary or lasting effects
 (physical, cognitive, social & emotional) as a result of the injury.
What Can Be Done To Help ?
       Hospital to Home to School   

Hospital
Healthcare Providers communicate the importance of careful
  attention to identify possible changes the student may
  experience & to share information with the school.

Home
Family Members communicate to the school that an injury
  occurred. Facilitating a successful transition is possible only
  when maintaining open dialogue between the family & school,
  documenting any observed changes within the student.

School
Educators communicate with the family & student by establishing
  effective educational supports when appropriate.
Why Are We Doing This ?
                      Video Clip
Questions to Consider ?



Hospital to Home to School   



                          Section IV
What To Ask : Hospital                       


 Is it possible that this individual has sustained a TBI ?

                           Sports                Bicycles




Possible causes of injury to consider:
Falls, violence, motor vehicle, or ATV?
What To Ask : Hospital                




     Is this individual enrolled in school ?


Preschool ?
K – 12 ?
Higher Education ?




Things to think about …
What TBI May Look Like      




                            Headaches
                                Sleep
                              Balance

                              Physical
                               Fatigue

                               Mental
                              Fatigue
                              Sensory
 Looks can be deceiving …     Function
Be aware that less visible changes in
an individual may or may not be
immediately linked to the injury :


                                Social Skills

                                   Thinking

                                    Memory

                                 Personality



   Communicating       Mood / Behavior
Hidden effects may be revealed by any
or all of the following cognitive changes:

    Varied ability to
   maintain attention
  and/or concentration




                         Ability to initiate, organize,
                          and/or complete tasks
                               may be changed
What To Look For :
  Home & School                   




                                   Hidden effects
                                     continued:

                                Flexibility of thinking,
                                reasoning, and/or
                                problem-solving may
                                be distorted

                          Difference in abstract thinking

  Possible tendency towards confabulation (story telling)
What To Look For :
  Home & School                       



 Varied
 ability to
 sequence,
 generalize,
 or plan

Judgment
and or
perception
may be
distorted
               Long-term or short-term memory may be affected
What To Look For :
  Home & School    




                Possible changes in
                the ability to acquire or
                retain new information


                Information
                processing speed
                may be altered
Continued Effects :
   Behavioral / Social                     



       IMPAIRED
 ABILITY TO PERCEIVE,       VERBAL / PHYSICAL
       EVALUATE,              AGGRESSION
        OR USE
     SOCIAL CUES/
       CONTEXT                            MOOD SWINGS
                                              OR
                                         EMOTIONAL LABILITY
                        IMPULSIVITY


     IMPAIRED
 ABILITY TO COPE                               LOW
       WITH                 LACK OF        FRUSTRATION
OVER-STIMULATING           AWARENESS        TOLERANCE
  ENVIRONMENTS             OF DEFICITS
New Learning
  After A Brain Injury                 




may be delayed, disordered, or may not occur at all.
       Transitions



Hospital to Home to School   



                         Section V
Planning For Successful
   Transitions                


           Hospital to Home     Grade to Grade




  School
    To
  School
Specific Tools
   in the Hospital         




Present information
to student and family,
making everyone
aware of possible
changes that may
occur due to the injury.


Recognize the need
for possible referral of
specialized educational
programs.
Specific Tools
   in the Home                  




    Physician’s letter documenting injury: TBI diagnosis

    Complete medical history

    Complete educational history: academic & social

    Local educational resources


  It may be helpful for the family to keep resource materials
together in one place, such as a notebook, for easy reference.
Specific Tools
   in the Home, continued                      



    Project B.R.A.I.N. training – “Brain Injury 101”
     www.tndisability.org/brain

    Statewide TBI Service Coordination Programs

    Local TBI Support Groups

    Brain Injury Association of America
     www.biausa.org

A recommendation for the family is to keep resource materials
together in one place, such as a notebook, for easy reference.
Brain Injury 101: Supporting
   Students in the Classroom
A free 2 – hour training for schools, families, Healthcare
   professionals and related service providers

                 Training Objectives
A comparison of definitions for traumatic brain injury (TBI)
Incidence rates of TBI for ages 3 to 21 in Tennessee and
nationwide
Common causes of TBI and the impact of this type of
injury on students of varying ages
Additional local and national resources for professionals &
families who support students with TBI
Strategies for supporting students with TBI
Specific Tools
   in the School                     


                             Physician’s letter documenting
                             the traumatic brain injury.




Family interview of the injured student to obtain pre-injury academic
 and social histories, as well as changes observed since the injury.
Specific Tools
   in the School                 




If possible, a school staff
member will be designated to
visit the student before he or
she returns to school.


Establishing communication
links will strengthen the
foundation for a smooth
transition.
     Obtain & Share Information:
        Partnering Home & School
                                   Medical Documentation of the injury:
                                               Site of injury or lesion
                                               Duration of coma
                                               Services received post-injury
                                               Medications
                                               Contact information for doctors




 The Medical Release
 Specifies the student’s ability to
participate in physical activities at school.
    Obtain & Share Information:
       Partnering Home & School
Rehabilitation Records

 Initial evaluations & discharge
summaries from all therapies administered


 Specific recommendations for
adaptations to the school environment

 Instructions related to use of
adaptive equipment

   Therapy recommendations
Obtain & Share Information:
   Partnering Home & School
 Psychosocial
                 Pre-injury history of student
                from an educational and
                social perspective

                 Relevant information on siblings,
                including ideas about how to
                address their reaction to the injury


                  Educate support team about
                possible emotional changes post-
                injury (especially with adolescents)
Obtain & Share Information:
   Partnering Home & School
    Educational
   Contact person for family
   Initial and subsequent IEP’s
   Records from support
    personnel
   Attendance records
   Records from other schools
    attended, if applicable
   Specific information related
    to sensory issues
Success
   in the Hospital       




Life Beyond the Hospital: providing ongoing
      quality care for the whole person.
Healthcare Providers                  




Understanding the possible
effects of TBI

Supporting students & families
with hospital to school transitions

Accessing community resources
promoting successful educational
outcomes of students with TBI
At Home & School                    




                Each TBI is unique to an individual.




 The effects of TBI may last beyond hospital discharge.
At Home & School                 




Less visible
changes
may or may
not be
immediately
linked to the
injury.




                TBI may seriously affect new learning.
Communication Holds the Key to
 the Student’s Overall Success:




Improving the Quality of Life   
Student Success :
   Looking Ahead    
                          Video Clip
Resources       




  Tennessee Traumatic Brain Injury Program
                1-800-882-0611
  http://www2.state.tn.us/health/TBI/index.htm




      Brain Injury Association of America
                1-800-882-0611
   http://www.biausa.org/Pages/splash.html
Acknowledgements                           




              Video Clips Featured Guests


Andrea, Keith & Dawn Scruggs    Patsy Allen, MS, MAT, CCC-SLP
Cheryl & Thor Spencer           Beth Urbanczyk, CCC-SLP
Tyler, Patsy & Scott Ferguson   Lorraine Jefferson
Steven Couch, MD                Erin Potts



                   PowerPoint Assistance
                       Jody Bailey
Project B.R.A.I.N.
Brain Resource & Information Network


                                 Project B.R.A.I.N.
                                 Tennessee Disability Coalition
                                 480 Craighead Street, Suite 200
                                 Nashville, Tennessee 37204
                                 615 / 383-9442
                                 615 / 212-7790 TTY

                                 Paula Denslow, Coordinator
                                 Jennifer Jones, Resource Specialist
                                 http://www.tndisability.org/brain

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