School-based Services
for Students with Traumatic Brain Injury
Karen Hux, Ph.D., Jennifer Marquardt,
M.S., Suzanne Skinner, M.S.,
Valerie Bond, M.S., & Dixie
Sanger, Ph.D.
Barkley Memorial Center for Special Education
and Communication Disorders
University of Nebraska - Lincoln
Complete
reports documenting the results of this research appear in the journal,
Brain
Injury:
Hux,
K., Marquardt, J., Skinner, S., & Bond, V. (1999). Special education
services provided to students with and without parental reports of traumatic
brain injury. Brain Injury, 13, 447-455.
Hux,
K., Bond, V., Skinner, S., Belau, D., & Sanger, D. (1998). Parental
report of occurrences and consequences of traumatic brain injuries among
delinquent and nondelinquent youth. Brain Injury, 12, 667-681.
Abstract
This study is purpose was to determine:
-
the frequency with which documented and undocumented
traumatic brain injury (TBI) incidents occur among middle school and high
school students;
-
the causes of TBIs among adolescents;
-
the impact of TBI incidents on the academic,
behavioral, and social skills of youth; and
-
the frequency and type of special education
services provided to youth with histories of TBIs.
A questionnaire mailed to the parents of all
middle school and high school students within a midwestern community served
as the basis for data collection. Results indicated that about 45% of respondents'
children had sustained one or more TBIs during their youth, with the most
common cause being sporting accidents. Approximately 25% of children with
reported TBIs received special education services-a percent not differing
significantly from students without TBIs. However, students with
TBI whose parents reported long-term consequences were significantly more
likely to receive special education services than students with TBI whose
parents did not report long-term consequences or students without TBI.
Method
A 57-item questionnaire:
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15 items about the demographic and educational
background of each respondent's child;
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21 yes/no questions related to respondents'
awareness of blows to the head sustained by their children;
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Likert-scale items about social, emotional,
or academic consequences of each identified instance of head injury; and
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Open-ended items to allow respondents to provide
descriptive information about TBI instances and consequences.
Questionnaires were sent to all parents of
students (N = 686) enrolled in a public middle school or high school in
a midwestern community.
Results
Demographic and Educational
Background Information
Response rate: 61.22% (n = 420/686)
Characteristics of respondents' children:
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Age range from 11-3 to 20-1 years;
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48.57% male and 51.43% female;
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24.76% (n = 104/420) had been evaluated for
or had received special education services at some time during their school
attendance;
-
None received services through verification
in the TBI disability category;
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12.50% (n = 13/420) had received special education
evaluations without subsequent services; and
-
Among the students who received special education
services (n = 91), speech-language pathology and learning disability services
were the most common (56.04% and 50.55%, respectively).
TBI Occurrences and Consequences
-
44.52% (n = 187/420) of respondents' children
had sustained one or more TBIs during their childhood or youth.
Figure 1. Percent of youth with TBI who sustained
injuries from various causes.
Figure 2. Percent of students with TBI
who experienced immediate consequences from blows to the head.
Figure 3. Percent of students with TBI
who experienced long-term consequences from blows to the head.
Frequency of Special Education
Services
No significant difference (c2 = 3.06;
p * .05) in receipt of special education services
by students with reported
TBIs: 28.88% (n = 54/187)
by students without
TBIs: 21.46% (n = 50/233)
A significant difference (c2 = 7.01; p
< .05) in receipt of special education services among:
-
youth with reported long-term consequences
from TBIs,
-
youth without reported long-term consequences
from TBI, and
-
youth without histories of TBIs.
The presence of long-term consequences significantly
increased a student's likelihood of receiving special education services.
Figure 4. Percent of students who received
special education services.
Types of Special Education
Services
Figure 5. Types of impairments for which
students with TBI were verified to receive special education services.
Discussion
TBI Occurrences
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More than 40% of youth sustain one or more
blows to the head before reaching adulthood.
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The majority of TBIs are mild. However, even
mild blows to the head can cause structural and physiological changes in
the brain and are worthy of note.
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As many as 8 of every 100 middle and high
school students may experience TBIs of sufficient magnitude to affect academic
and social performance.
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Sporting accidents are the most frequent cause
of TBIs among youth.
Special Education Services
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No difference in the likelihood of students
receiving special education services based on parental reports and non-reports
of TBIs.
-
Those students with reported persistent changes
in academic, behavioral, or social functioning following TBI were significantly
more likely to receive special education services than students without
such reported changes. Still, less than half of the students whose parents
reported long-term consequences received special education services.
Conclusions
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Educators continue to need information about
TBI and its potential consequences, as well as training in the most effective
ways for schools to address the educational needs of TBI survivors.
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Mild TBIs are common among youth and can result
in academic, behavioral, and social challenges. Too often, educators are
unaware of or overlook the potential impact of these injuries. The tendency
for school officials not to recognize the effects of TBI in adolescents
can have substantial societal ramifications because of the subsequent failure
of these students in higher education and vocational endeavors.
-
Although schools in general are well-suited
to addressing the needs of students with TBI, they can not be expected
to do so when teachers do not know injuries have occurred or have not received
training about TBI.
