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Traumatic Brain Injury (TBI) is where someone has received brain damage which impacts their ability to learn. More specifically, the National Institute of Neurological Disorders and Stroke defines Traumatic Brain Injury as follows:

"Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. "

Meanwhile, TBI is defined under the Individuals with Disabilities Education Act (IDEA) as:

"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 child’s educational performance.”

Discussion of eligibility for special education under IDEA with regards to TBI can be found here:

https://youtu.be/rIblZqKOJVk

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The IDEA's Special Education Categories: Traumatic Brain Injury

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The effects of TBI on an individual's function can vary significantly depending on the degree of trauma, and the location of the damage in the brain. This means the symptoms can manifest in many different ways. Under the IDEA act, the symptoms of TBI are summarised thusly:

“Traumatic brain injury 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; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.”

The signficant breadth and variance of symptoms resulting from TBI mean that no two cases are likely to be alike, and accordingly, there will be no cookie-cutter one-size-fits-all set of accommodations or strategies. This can be true of many learning disability diagnoses, but the degree of variance between cases of TBI is likely to be particularly high.

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The Individuals with Disabilities Education Act (IDEA) defines “visual impairment including blindness” as an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.

How Low Vision diagnoses is a surprisingly complex issue and not all eye care professionals agree on how it should be defined. (Low Vision and Legal Blindness Terms and Descriptions | American Foundation for the Blind, 2015)

In the United States, the Snellen Eye Chart (see above)  is used to test visual acuity. The results of this test can be used to determine if a person has low vision.

However, not everyone agrees on using numerical values to determine low vision. Some prefer a functional definition. That is, Low vision is "uncorrectable vision loss that interferes with daily activities." (Low Vision and Legal Blindness Terms and Descriptions | American Foundation for the Blind, 2015)

The Individuals with Disabilities Education Act (IDEA) defines “visual impairment including blindness” as an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.

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According to Brainline, only 1 in 10 Special Education books contain a chapter on TBI, 85% of teachers working with students with TBI possess no relevant training ,scant knowledge of TBI and little idea of how to accommodate accordingly.

https://youtu.be/3be-_zIHKNg

To facilitate the process of reintegration of a student with a TBI to the classroom, every school should have a Brain Injury Management Team, to organise the coordination of the may parties involved, including:

-Caregivers
-Medical providers
-Therapists
-Teachers
-School counsellors

The specific accommodations and services a student with a TBI receives will depend on neuropsychological and cognitive evaluations. Some of the general accommodations may include:

-Returning to school gradually
-Additional breaks
-Reduced distractions

This video outlines the process of returning to school:

https://youtu.be/ogGj6zCYJq0

Beyond this, accommodations for a student with a TBI will need to be more specific to their particular disabilities and limitations. Returning to the symptoms listed under IDEA, these may include impairments to:

"cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech"

This wide range of symptoms may merit a wide variety of accommodations and modifications. These essentially run the gamut across the extraordinary range of accommodations made for all manner of different learning disabilities, and a full accounting for every single one would require taking on almost the entire scope of all special education accommodations and modifications. To cover some of the bigger ones however:

-Impediments to cognition, memory, reasoning, abstract thinking, judgment, and problem solving might warrant differentiated tasks, worksheets and materials, partially completed notes, clearer and more explicit, step-by-step instructions, additional time to complete tasks or assessments.

-Impediments to sensory and perceptual abilities might require modifications to the way material is presented. Larger text copies or audio versions of text if sight is impaired, text versions of hearing is impaired, modifications to seating arrangements according to sensory needs, etc.

-Motor-ability impairments might warrant differences in classroom layout, seating arrangements, and equipment and facilities

-Language and speech impairments might warrant differences in assessment and alternative classroom participation, and the assistance of speech therapists

These are once again merely broad strokes summaries, and the IEP developed for students with TBIs will need of course to be more specifically tailored to the precise impediments the student faces due to the high variability in the ways TBIs present.

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Helping Teachers Working with Children with TBI

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ADHD-attention deficit hyperactivity disorder is a neurodevelopmental disorder that affects the brain and how it communicates with the rest of your body. ADHD is categorized as 3 different types: Inattentive, Hyperactive, and Combined Type. Inattentive typically looks like difficulty paying attention especially to details, difficulty following long conversations without getting distracted or interrupting, easily distracted and forgetful. Hyperactive type is often seen as fidgety and has difficulty sitting still, in children they often display impulsive or potentially dangerous activities (jumping, climbing trees, doing things without thinking of consequences). They often have difficulty waiting in lines, taking turns, or holding conversations. Combined type presents as symptoms of both types depending on different stages of life.

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There are several signs that can indicate a child may have low vision:

Sitting too close to the TV or holding books very close

Blinking repeatedly or squinting and closing one eye or the other

Tilting their head to one side in and effort to see better

Frequent eye rubbing during activities

Light sensitivity and/or frequent headaches

Losing their place while reading

Avoiding reading or close up work

Irritation while doing visual work

Poor hand-eye coordination

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The manner in which TBI in one student will impact fellow students and peers depends significantly on both the degree of impairment the TBI imparts, as well as the circumstances in which it occurred.

For example, if a "normal" student who is established within a school and known to his peers goes on to incur a TBI and subsequently returns to their class in an impaired state, this may prove more psychologically distressing to peers than if a student with a pre-existing TBI were to join the class. The salience of the alteration in the TBI afflicted individual's personality, behaviour, and physical, cognitive and communicative capabilities will represent a vastly different experience for peers than the inclusion of a student whom they had never known or observed prior to their traumatic injury. In cases such as these, it would be highly advisable to include a psychologist in the process of re-inclusion for this student, both in terms of assisting the student themselves adapt and adjust, and in helping their peers understand and accept the changes undergone by their classmate, and to help them employ empathy towards them and facilitate a smooth transition back into the class.

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-Difficulty paying attention
-Cannot sit still for prolonged periods
-Often impulsive
-Demand attention-talking out of turn, always wandering
-Difficulty following directions- cannot manage tasks organized as long list or ordered steps
-Often forgetting to write down homework assignments, forget to complete the homework, or forget to bring completed work to school
-Often lack fine motor skills (poor handwriting)
-Difficulty with long projects, especially without check-ins or monitoring
-Difficulty with group projects, often not completing their share of work or causing the group to not complete their work

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Developmental Cognitive Disability (DCD) is defined as a condition that results in intellectual functioning significantly below average and is associated with concurrent deficits in adaptive behavior that require special education and related services.

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There is something particularly tragic about traumatic brain injuries. Where many people with some form of learning disability were born with the challenges they face, it is somehow more heartbreaking to consider the case of someone who is not merely attempting to overcome in-born limitations, but trying to regain potential they once possessed but which may now forever elude them.

Looking back on my years of teaching, I struggled at first to find examples of students who were suffering a TBI - at least, to my knowledge. But, wracking my supposedly un-traumatised brain, I did come up with two examples.

The first was not in a teaching context. It was when I was a student, and an awful accident occurred at my school, as a student a couple of grades below me was climbing a tree - which I had frequently climbed myself in the past - had a branch snap and send him approximately 4 meters down onto hard concrete. I did not know this student well, but I recall his return, months later, now required to wear a protective helmet. He had a motor impairment which was obvious from his uneven and awkward movement. I did not really interact with him, but it is my understanding that he was left seriously cognitively impaired. Taking on this task, it occurred to me how difficult that must have been, both for the student and for his peers, hence my inclusion of discussion about this in the appropriate section above.

The second case I remembered was one of my own students, but in this case an adult student, herself a teacher. For a number of years, in addition to teaching British National Curriculum to Vietnamese public school students, my previous company also had me teaching IELTS to Vietnamese English teachers, who had become required by the government to seek an IELTS score of 6 or above.

This student had received a TBI as a result of a coconut falling on her head as a young girl. She had been told that she wouldn't be capable of graduating high school, but she soldiered on, did so, and eventually went on to become a teacher herself. What I noticed about her was that she had an odd manner, staring somewhat unnervingly while talking, spoke slowly, and seemed to have slow processing in general. Nevertheless, the fact that she defied expectations and achieved success, while receiving no form of accommodation for her difficulties whatsoever is something to take inspiration from. I also now look back on my time teaching her, and wonder whether making accommodations for her would have been appropriate. She performed pretty much on par with her peers, which is great under the circumstances, but had I known about her TBI sooner, and understood what I know now about accommodations for learning disabilities, I wonder whether she might have benefitted from differentiated activities, additional time during tests etc. On the other hand, I was dealing with a class of adult professionals, and I'm not sure how i would have approached the issue of differentiated treatment in the classroom, materials, assessments etc and done so in a sensitive manner that did not put a spotlight on her, or make her feel singled out or insulted by such efforts. On the whole, I don't think special treatment was warranted in her case.

In terms of future applications, I can only petition the fates that none of my students ever suffer a TBI. What I do feel better armed with is a general knowledge of different ways of accommodating a wide variety of learning difficulties at this point, and so should the need arise, I feel confident that I can offer something beneficial to such a student and help create an IEP or IEP analogue to assist them. I also feel that this Padlet will be able to serve as a good resource to reference in the case that I come to teach students with vision impairments, hearing challenges, ADHD and developmental cognitive disabilities.

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General strategies support these students in your classroom:

Make seating changes, when needed, to help students see you, whiteboards, or learning materials. Extra lighting may be needed.

Keep walkways open. Make sure your classroom is easy to move through and free of obstacles.

Give extra time, if needed. Some students may need more time to travel between classes, complete assignments or activities, and take tests.

Know about assistive devices, technology, or other learning aids. Kids may use magnifiers for reading or read from large-printed books and handouts. Audiobooks are a good idea. For kids who can’t type, voice-activated computers help them do classwork.

Allow verbal responses for assignments or tests to measure learning.

Have a plan for missed instruction, assignments, and testing. Students with a visual impairment may miss class time to go to doctor visits. Know how the student will make up for missed time.

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Blankenship, Allison & Canto, Angela. (2016). Traumatic Brain Injuries and Special Education Services in the Schools. Exceptionality. 26. 1-12. 10.1080/09362835.2016.1238379.

Special Education Guide (Accessed 15/12/22)
https://www.specialeducationguide.com/disability-profiles/traumatic-brain-injury/

The National Institute of Neurological Disorders and Stroke (Accessed 15/12/22)
https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury

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Gissara, D. (2017, August 28). Classroom Adaptations for Students with Low Vision. Paths to Literacy. https://www.pathstoliteracy.org/classroom-adaptations-students-low-vision/

Low Vision and Legal Blindness Terms and Descriptions | American Foundation for the Blind. (2015). Afb.org. https://www.afb.org/blindness-and-low-vision/eye-conditions/low-vision-and-legal-blindness-terms-and-descriptions

Suter, P. (2016, June 24). 9 Signs Your Child Might Be Visually Impaired | Dr. Suter Vision. Dr. Penelope S. Suter, O.D., FCOVD. https://www.drsutervision.com/9-signs-child-might-visually-impaired/

UCT CILT. (2020). How visual impairment affects learning. In YouTube. https://www.youtube.com/watch?v=cwE_yZ5DWu0

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Looking way back on my first year of teaching in 2011, I can definitely see how this padlet would have been an excellent resource for me. Like many first time teachers, I often thought in terms of "good student" and "bad student". Of course, as I became more experience and educated I learned that this is not a good way to frame things, and is actually harmful to students. At the very least, this resource would have educated me on  the various impediments that may be making learning difficult for students.

This padlet offers great examples of how all students are capable of learning if teachers are understanding, patient, and imaginative.

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A learning disability has the potential to affect the student negatively in the classroom in multiple ways. Academic performance will suffer greatly in the specific areas, resulting in emotional struggles, which can affect social perceptions and success and acceptance by their peers. The problems can also begin to influence relationships with friends and family outside of the classroom if left unattended.

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Usually, the more severe the degree of intellectual disability, the earlier the signs can be noticed. However, it might still be hard to tell how young children will be affected later in life.

There are many signs of intellectual disability. For example, children with intellectual disability may:

sit up, crawl, or walk later than other children

learn to talk later, or have trouble speaking

find it hard to remember things

have trouble understanding social rules

have trouble seeing the results of their actions

have trouble solving problems

The characteristics and impact of a person’s intellectual disability will vary depending on the cause.  There are a number of common characteristics that may have a significant impact on an individual’s learning, including:

difficulty understanding new information

difficulties with communication and social skills

slow cognitive processing time

difficulty in the sequential processing of information

difficulties comprehending abstract concepts.

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Intellectual disability | Mental retardation | signs,causes,levels of ID

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Here are some teaching and assessment strategies that are useful when teaching in a group which includes students with intellectual disability.

Provide an outline of what will be taught - highlight key concepts and provide opportunities to practise new skills and concepts.

Use clear, succinct, straightforward language.

Use as many verbal descriptions as possible to supplement material presented on blackboard or overhead

Reinforce learning by using real-life examples and environments.

Present information in a range of formats – handouts, worksheets, overheads, videos – to meet a diversity of learning styles.

One-to-one tutoring in subjects may be important; this can include peer tutoring.

Students may benefit from having oral rather than written feedback on their written assignments.

Allow extensions to assignment deadlines

Encourage the student to submit an early draft of assignments to allow the opportunity for feedback to the student as a formative process.

Use technology to record students work, e.g. digital photography, tape and video.

Students may take longer to organise thoughts and sequence material. They will benefit from discussing their outlines, with particular attention being paid to appropriate relationships and connections between points.

Many students with intellectual disability are chronic misspellers and use dictionaries only with great difficulty.

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Ch. 6: Intellectual Disability - Teaching Strategies (Sarah Loutan)

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HelpGuide. (2020, May). Teaching students with ADHD. HelpGuide.org. Retrieved December 16, 2022, from https://www.helpguide.org/articles/add-adhd/teaching-students-with-adhd-attention-deficit-disorder.htm

Imperieum. (2021, January 28). Add vs ADHD. YouTube. Retrieved December 18, 2022, from https://www.youtube.com/watch?v=EFeYH_Goa90&t=2s

Schutz, T., & Flanive, L. (2021, March 13). Understanding ADHD in children. YouTube. Retrieved December 26, 2022, from https://www.youtube.com/watch?time_continue=70&v=py_5PVn3V7w&feature=emb_logo

United States Department of Health and Human Services.       (2022, August 9). ADHD in the classroom. Centers for Disease Control and Prevention. Retrieved December 18, 2022, from https://www.cdc.gov/ncbddd/adhd/school-success.html

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Centers for Disease Control and Prevention. (2022, May 10). Facts about intellectual disability. Centers for Disease Control and Prevention. Retrieved January 2023, from https://www.cdc.gov/ncbddd/developmentaldisabilities/facts-about-intellectual-disability.html

Inclusive teaching: Intellectual disability. ADCET. (n.d.). Retrieved January 2023, from https://www.adcet.edu.au/inclusive-teaching/specific-disabilities/intellectual-disability

Learning difference – learning disabilities. Marburn Academy. (2020, November 13). Retrieved January 2023, from https://marburnacademy.org/learning-disabilities/

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This is my first year teaching and this padlet would have been very resourceful to me before coming into the school year. Coming into teaching, I have not been exposed to many disabilities and have a lack of knowledge on how I can support students who have disabilities. So coming into this school year, it was a wake up call. I had to realize that my students are not all the same and I need to see what different teaching and assessment strategies I can implement so that I am covering all levels of teaching. However, at my school they do not give this type of training to staff and this is something I had to learn on my own especially being in this class has been super helpful. If I would have had this padlet coming into the school year, I would have realized early on how there are many different types of low incidence disabilities. I would have known what these disabilities were and what strategies and accommodations I could have employed to meet the needs of the students. However, moving forward all I can do is be better and I plan to continue learning as much as I can in this class so that I can be the best version of a teacher that I hope to be.

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I am currently still in my first year of teaching, although I have worked in the classroom setting with students that have intense behavior for the past 8 years and looking at this padlet I can see how it would have been exponentially beneficial to me in the beginning if my career.  I have worked with students in every category on this list, either directly or indirectly.  Having this padlet to review could have saved me some guessing work on appropriate strategies, and possibly giving me ideas to lessen the negative effects on peers.   I am glad to have now for reference as I continue the beginnings of my new career.  I currently have students with ADHD as well as Developmental Cognitive Disabilities; Having a quick view of strategies and accommodations available to me will be beneficial in quick decision making and having references available for further research if needed.

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Deafness is usually the result of inner ear or nerve damage. It may be caused by a congenital defect, injury, disease, certain medications, exposure to loud noise, or age-related wear and tear.

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The chief symptom is an inability to hear sound.

For some, hearing may be possible with surgery or a hearing device. Lip-reading skills, written or printed text, and sign language may help with communication.

Some of the symptoms of being hard of hearing can include:

feeling like speech and other sounds are quiet or muffled

having trouble hearing other people, particularly in noisy surroundings or when more than one person is speaking

frequently needing to ask others to repeat themselves or to speak more loudly or slowly

having to turn the volume up on your TV or headphones

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Education and Employment: In developing countries, children with hearing loss and deafness often do not receive schooling. Adults with hearing loss also have a much higher unemployment rate. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce.

Social isolation, loneliness and stigma
One longitudinal study reported that, in spite of being no different from hearing adolescents with regard to social skills and behavior, DHH adolescents felt less secure than their hearing peers and faced more difficulties in making friends, (Antia et al., 2011)

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Effective strategies for reducing hearing loss at different stages of the life course include:

immunization;

good maternal and childcare practices;

genetic counselling;

identification and management of common ear conditions;

occupational hearing conservation programmes for noise and chemical exposure;

safe listening strategies for the reduction of exposure to loud sounds in recreational settings; and

rational use of medicines to prevent ototoxic hearing loss.

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Antia S. D., Jones P., Luckner J., Kreimeyer K., & Reed S. (2011). Social outcomes of students who are deaf and hard of hearing in general education classrooms. Exceptional Children, 77(4), 489–504. doi: 10.1177/001440291107700407 [CrossRef] [Google Scholar] [Ref list]

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Deaf and Hard of Hearing Students in the Classroom - YouTube

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Deaf and Hard of Hearing Students in the Classroom

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I am working on my second year as a Special- Education teacher. I have worked with several disabilities as a SpEd teacher but I have not worked with any students as of yet that were deaf and hard of hearing.  However, we do have an intern from Gallaudet college working with us. Jason is interning with the counselor.  Justin is a very nice young man, he drives himself to work.  He is very independent. He performs Group with the counselors where they discuss life issues and sometimes they show movies for the students. He has another gentleman that translates for him.  After becoming a Special Education teacher, I think that one of my future goals is to learn sign language.  This will be a great addition to my resume.