Challenges
There is great variation in the possible effects of a head injury on an individual. However, most injuries result in some degree of impairment in the following functions:
- Memory
- Memory deficits are probably the most common characteristic of students with brain injury. The primary problem is inability to store information for immediate recall. This causes trouble in acquiring new information. However, long-term memory or previously acquired knowledge is usually intact.
- Cognitive/Perceptual Communication
- Distracted by extraneous stimuli, students may have difficulty focusing enough for learning to take place.
- Speed of Thinking
- Students with cognitive deficits from brain injury often take longer to process information which influences reaction time, speed of response and quickness of data integration.
- Communication
- Language functions (writing, reading, speaking, listening, as well as the pragmatics) may be impaired. Problems in pragmatics include interrupting, talking out of turn, dominating discussions, speaking too loudly or rudely or standing too close to the listener. The student may have trouble comprehending written or spoken material, especially under pressure such as during exams.
- Spatial Reasoning
- The ability to recognize shapes of objects, judge distances, navigate, read a map, visualize images or comprehend mechanical functions.
- Conceptualization
- Reduced ability to categorize, sequence, abstract, prioritize and generalize information.
- Executive Functions
- Inability to set goals or to plan and work toward a desired outcome in a flexible manner.
- Psychosocial Behavior
- Depression, denial, frustration, intolerance, anger, irritability, restlessness, anxiety, impulsivity, apathy and decreased awareness of personal hygiene are some of the changes in behavior, which commonly occur.
- Motor, Sensory and Physical Abilities
- Brain injury can result in seizures; impairments of vision, hearing, touch, taste, smell, bowel and bladder dysfunction; poor regulation of appetite and thirst or respiratory complications.
Often the student remembers how he/she was before the injury but does not recognize or understand how he/she has been changed by it. Recovery is often slow, taking months or years. Sometimes rapid improvement may be seen for a period of months.
Attention and concentration may be influenced by medications, nutrition patterns and fatigue resulting from disturbed sleep.
Students must learn to use compensatory devices such as schedules, checklists and other assistance in retrieving facts and organizing information. This process if often hard to accept because the adaptations required are constant reminders that the person is impaired in skills that previously may have been automatic.
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Possible Accommodations
- Reduced course load
- Note takers
- Tutors
- Extended time on tests
- Private quiet area for taking tests
- Alternative test format - some students may not be able to handle multiple-choice questions; others may need a structured memory cued test such as multiple choice or true false. The faculty member and student may agree to give a tape recorder to the student and tell him/her, "Go into the room and tell me what you know about this subject."
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Note
It is important to obtain complete neuropsychological testing results to determine how much of the behavior is due to the injury and how much can be controlled by the student in order to work with the student effectively. Any behavior that is disruptive to the class is considered unacceptable regardless of the cause.
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