Centre for Accessibility Services

Traumatic and acquired brain injury

What is an acquired brain injury (ABI)?

An acquired brain injury (ABI) can be caused by traumatic injury to the brain after birth including seizures, tumors, brain deprivation of oxygen, infectious diseases, and toxic exposure. There are two types of acquired brain injury: traumatic and nontraumatic injury. A traumatic brain injury is correlated to impact outside the body, such a hit, bump or jolt whereas non-traumatic injury is related to a substance that impacts the brain tissue. The effects of an acquired brain injury can begin to show immediately or increase/decrease over time. Each individual will experience a unique combination of challenges and changes. Treatment is based on the severity of the injury through the use of medication, immediate emergency care, surgery and rehabilitation with a support worker. 

Physical symptoms

  • Fatigue, difficulties with sleeping, insomnia
  • Challenges with walking, sitting, moving from one location to another
  • Slurred speech
  • Chronic pain, headaches
  • Changes in vision
  • Seizures, fluid increase in the brain, infections, damaged blood vessels in the brain, vertigo (sensation of dizziness/spinning/loss of balance)
  • Sensory changes: ringing in the ears, trouble with hand-eye coordination, unpleasant tastes or smells, sensations on the skin like tingling, pain, or itching, difficulty with balance, dizziness 

Cognitive symptoms

  • Needing more time to understand information
  • Difficulty with making plans, organizing, or beginning tasks
  • Challenges with communicating which includes understanding conversations, finding the right word, speaking in proper sentences, understanding cues, making conversation
  • Difficulty writing
  • Difficulty with concentration; distracted easily
  • Difficulty remembering things, learning, reasoning, and judgment
  • Confusion about the current date, location, time of day

Emotional/behavioral symptoms

  • Depression, anxiety, anger
  • Prone to sudden, extreme emotions for no clear reason
  • Showing a limited emotional response to situations
  • Feeling like they have lost their identity, experiencing anxiety about further injuries to the brain
  • Lack of a ‘filter’; saying inappropriate things
  • Isolating oneself
  • Difficulty with social and work relationships
  • Changing/inconsistent sleep patterns

Centre for Accessibility support for brain injuries may include

  • Assistive technology
  • Alternate format materials (texts into PDF/E-Text)
  • Separate setting/distraction-reduced exam setting
  • Time accommodation for exams
  • Note-taking services
  • Preferential seating
  • Reader and/or scribe for exams
  • Use of a computer for exams

Statistics

  • Approximately 1.5 million Canadians live with the effects of an acquired brain injury
  • 452 people suffer a serious brain injury every day in Canada. This amounts to one person injured with a traumatic brain injury every 3 minutes
  • Brain injury is a leading cause of death and disability for Canadians under the age of 40
  • Brain injury is currently a leading cause of death and disability worldwide
  • Survivors of a brain injury are at three times greater risk of experiencing a second brain injury and face an eight times greater risk of sustaining subsequent other injuries as a result of their initial injury

Sources

Brain Injury Canada

Mayo Clinic 

How to support a student with a brain injury

  • Keep instructions as brief and uncomplicated as possible. Repeat exactly without paraphrasing.
  • Present lecture information in a visual format (e.g., overheads, PowerPoint slides, handouts, etc.). Use visual aids or examples to illustrate key points.
  • Provide hand-outs (preferably electronically) in advance of lectures and display main points to be covered in each session.
  • Use more than one way to demonstrate or explain information.
  • When teaching, state objectives, review previous lessons and summarize periodically.
  • Allow time for clarification of directions and essential information.
  • Provide study guides or review sheets for exams.
  • Provide alternative ways for the students to do tasks.
  • Introduce new concepts and vocabulary explicitly. Provide an overview of topics to emphasize the underlying structure and show how new material fits in with other parts of the subject.
  • Encourage the use of assistive technology, such as tape recorders or laptops, if students are eligible for the accommodation.
  • Give any instructions or explanations in a clear sequence, orally and in writing, and explain the purpose of whatever is to be done.
  • Allow the use of spell-check and grammar assistive devices when appropriate to the course and if a recommended accommodation.
  • Focus feedback on content and structure and encourage computer use to improve presentation. Penalizing poor spelling or handwriting can increase anxiety in students with TBI/ABI.
  • Stress organization and ideas rather than mechanics when grading in-class writing assignments.
  • Divide work into smaller sections (i.e., have the student complete one section at a time; suggest times and expectations for completion).
  • Link new information to the student's relevant prior knowledge.
  • Slowing down the pace of instruction.
  • When in doubt about how to assist the student, ask them as privately as possible without drawing attention to the student or the disability.
  • Help students to develop note-making skills and encourage them to work in pairs or small groups after lectures to pool notes and review topics.
  • Give the student time to think before answering questions in class, and enough time to read the information before being expected to use or discuss the material.
  • Contact the Centre for Accessibility Services for general ideas to help individual students.

Resources and websites

Brain Injury Canada

Mayo Clinic

Northern Brain Injury Association

HealthLinkBC

BrainLine – All about brain injury and PTSD

How to manage a brain injury as a student

Fatigue: If you are struggling with fatigue you may find it helpful to create a schedule that supports your school and personal needs. If you have more energy at a certain time of day, plan your most difficult tasks for this time. Make sure to include rest periods. Use this time to fully rest, not read or watch TV. Prioritize what needs to be done and let other things go and try not to do it all. Breaking down larger tasks into smaller tasks will give you a chance to rest while you work.

Lack of attention/focus: It may take longer to do things now. Take breaks and rest as needed. Try to focus on one thing at a time rather than multi-tasking. Reduce distractions by working in an uncluttered area and wear ear-plugs to block out sounds that may be pulling your focus.

Memory: Use a calendar, journal or notepad to help keep track of important information. Timers and alarms can help remind you of appointments, projects or class time. Ask a family member or friend to help with reminders, maybe using them as a backpack plan to your technology.

Thinking: You may need more time to process information. Avoid multitasking to give yourself more time to think things through. Break tasks into smaller steps to simplify the process and think about each step, one at a time. Ask for help to remember things or think through complicated tasks.

Communication outside of class: If you are having a hard time communicating, try to keep it simple. Use short sentences to get to the point. Patience can be key to organizing your thoughts into what you are trying to say so don’t rush. Ask questions if you are unsure what is being said or don’t understand. If speaking is difficult, try using a notepad or computer to write your message and relay it through email or other useful technology.

Emotions: If you are feeling emotional, take a breath and try to think of something positive. It may help to keep a list of positive things that you can focus on. Find strategies that help calm you down such as counting to ten, going for a walk, or deep breaths. Take a break and come back to what you were doing once you are more relaxed. Write down your feelings and consider speaking with a counsellor and/or doctor about your challenges.

Resources and websites

UFV Academic Success Centre

UFV Advising Centre

UFV Counselling

Fraser Valley Brain Injury Association

Ottawa Hospital – Coping with brain injury

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