A Developmental and Functional Approach Towards Students with Brain Injuries

Abstract

ABSTRACTChildren who suffer traumatic brain injury frequently experience difficulties in those behaviours represented as “executive” or prefrontal lobe functioning. In an educational setting these may involve disorganisation, difficulty moving from one activity to another, following rules, and staying on task to complete activities. Return to school involves a three-phase process: (1) an assessment period where school is viewed as a vehicle for stability; (2) modification of the school environment; and (3) student strategies. For the assessment phase, checklists are based on neurobehavioural sequelae of brain injuries in children and classified according to functional categories of Personal/Social, Work Habits, and Cognitive/Communicative behaviours. These are used to generate teaching and learning strategies for the second and third phases. One approach presently under trial is the development of executive skill training involving student plans. Student plans provide a framework for training students to generalise from one activity to another. Recent research provides some promise for the efficacy of this approach. The challenge to those working in rehabilitation of students with brain injuries, particularly where the frontal lobes are implicated, is to develop a process where students can recognise there is a problem, apply strategies across settings, unprompted, and monitor their performance. These are the very dysexecutive behaviours typical of students with brain injuries.