Acquired Brain Injury, Defined

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http://www.dissvcs.uga.edu/whatabi.html

Acquired Brain Injury, Defined

Acquired brain injury (ABI) is the leading killer and cause of disability in children and young adults. More than two million head injuries occur each year. Statistics show that the highest rate of injury occurs in young men between the ages of 15 and 24. As a result, there is an emerging population of students with ABI on the college campus today. Due to the symptoms associated with their brain injuries, the Disability Services (DS) provides academic and support services to these students.

ABI is an impairment of brain functioning that is physically or psychologically verifiable. Common causes of ABI are brain lesions caused by traumas such as motor vehicle accidents, falls, assaults and violence or sports injuries. Other brain lesions can be due to internal events such as focal brain lesions, tumors, cerebral vascular accidents, aneurysm or infections of the brain. Another cause of ABI is ingestion of toxic substances due to either alcohol or drug abuse or exposure to toxic chemicals.

Students who have experienced a brain injury often enter or return to college with cognitive, psychological and/or sensorimotor disorders. Problems in the cognitive area usually pose the greatest challenge in the classroom. Although students may experience cognitive problems in such areas as memory, attention, and organization, they may still possess the abilities to succeed in an academic environment.

Differences between Acquired Brain Injuries and Learning Disabilities:

Students with Acquired Brain Injuries (ABI) and Learning Disabilities (LD) may, on the surface, exhibit similar cognitive deficits. However, the National Head Injury Foundation (BIA) cautions us to be aware of each population's unique needs. The BIA states, ". the cognitive profiles of students with traumatic brain injuries differ in important ways from profiles of [students] with congenital learning disabilities or developmental delays.

It is also suggested that a neuropsychological assessment be performed by a professional trained in such assessments. According to the BIA, "it is most important that assessment and evaluation procedures be comprehensive and that those specialists administering such tests be acquainted with the unique needs of this population." (1988)

Service providers should be aware of the differences between students who have ABI and LD. Students with LD have usually lived with the disability all their lives. However, students with ABI have experienced a trauma and must reorient their lives accordingly.

Differences between ABI and LD:

1. ABI can have an academic profile which changes frequently as recovery occurs over time necessitating ongoing program changes. This invalidates a rigidly sequential curricula for most ABI.

2. There is unpredictable progress for months and years after the injury, based on the neurologic recovery. Therefore, the pattern of academic functioning over time may be quite different than most LD.

3. Assuming there was pre-traumatic mastery of a process or concept, ABI often reacquire some material rapidly despite significant processing and learning problems acquired after the injury. The curricular emphasis for LD is thus inappropriate for ABI.

4. In the early months following ABI, there is more confusion, disorientation and lack of control than LD. Further, ABI might be more impulsive, hyperactive, distractible, verbally intrusive and socially inappropriate than LD.

5. Students with ABI may have to change a thoroughly habituated learning style that is no longer useful after the injury.

6. There are different emotional stresses in that ABI have to deal with a loss of capacity along with ongoing experiences of failure and frustration.

7. There are more extreme discrepancies in ability levels for ABI.

8. ABI may have more problems generalizing and integrating information. ABI may need more individualized teaching, reteaching and monitoring.

9. ABI may need ongoing monitoring of tasks requiring independent thinking and judgment.

10. ABI may have difficulty processing information because their comprehension is decreased with more complex material.

11. ABI may need more compensatory strategies because of impaired memory, problems with word retrieval, information processing and communication.

12. ABI may have more difficulty with organization of thoughts, cause- effect relationships and problem-solving.

13. ABI may be resistant to new, easier techniques and learning strategies because they want to use their pre-trauma techniques and strategies.

Students who have ABI may have problems in the following areas:

Cognitive:

communication and language

memory

comprehension (especially learning new information) perception

short attention span

concentration

distractibility

expressive language skills

organization, planning, and decision making

judgment and reasoning

flexibility (adjusting to change)

studying and academic skills

Physical:

vision, hearing, and speech

coordination

balance, strength, and equilibrium

limited movement/motor function - walking, writing

eye-hand coordination

spatial orientation

seizures

fatigue (sleep disturbances)

weight

Emotional:

denial

depression

anger

fear

self-esteem self-control awareness of self and others

interest in activities and social involvement

family relationships

age-appropriate behavior

post-traumatic stress disorder

social isolation

Environmental:

noise

temperature

visual distraction

unexpected change (class location moved, class canceled, etc.)

inadequate support/information/transportation

misunderstanding by others/rejection