Returning to School after a Brain Injury

Returning to school after a brain injury can be both an exciting and stressful experience for students and their families.  In this article, we’d like to share some ideas to help the back-to-school transition go smoothly.

Contact the school and request a school meeting.

Often, meetings will include the Principal and/or Vice Principal, Learning Support Teacher, and Classroom Teacher.  Meetings provide a platform to discuss the child’s strengths and challenges, share relevant medical and rehabilitation information, and to map out a plan for successful school re-integration.  If your child is receiving services from a rehabilitation team (e.g., case management, occupational therapy, physiotherapy, social work, psychology, speech-language pathology, etc.), it is often beneficial for those members to attend the school meeting, since they will have information to share about the child’s strengths and needs from their respective scopes of practice.

Discussion might focus on topics such as:

  • Whether special transportation is required (e.g., if the child has problems with mobility)
  • What time of day the child should attend (depending on factors such as fatigue, it may be best for the child to attend in the morning, midday, or afternoon)
  • The specific class or classes the child should participate in (based on their strengths, needs, and interests. Attending at lunchtime may be an important consideration for social reintegration)
  • Whether specific academic accommodations and additional classroom supports are required to facilitate academic and social success (see below)
  • Ongoing communication between family, team and school staff is very important, and therefore it’s beneficial to identify an individual or individuals who will be the main points of contact

 

What are some of the challenges students face after a brain injury, and what types of accommodations may be required? Academic accommodations are adjustments or supports that maximize the student’s opportunity for success.  Although not exhaustive, the table below identifies some common difficulties after a brain injury, and accommodations that might be considered:

 

COMMON CHALLENGES POSSIBLE ACCOMMODATIONS & STRATEGIES
PHYSICAL:
Fatigue / reduced tolerance for activity –          Gradual return to school
Pain (including headache) –          Opportunity to go rest in a quiet place
Visual disturbances / sensitivity to light –          Consult with a Neuro-Optometrist
Hearing impairment / sensitivity to noise –          Use of ear plugs or specialized noise filters (prescribed by an Audiologist when appropriate)

–          Use of an FM system

Mobility (e.g., problems with walking, balance, and coordination) –          Leave class 5 minutes early to avoid the risk of being jostled in the hallway

–          Identify a buddy who can carry books

COGNITIVE AND COMMUNICATION:
Attention and concentration –          Preferential seating (e.g., close to verbal instruction)

–          Use of an FM system

–          Verbal or non-verbal cues from the teacher to ensure that the student is paying attention

Memory and new learning –          Present information in smaller chunks

–          Allow for repetition and rehearsal of information (see below)

Organization –          Provide assistance with organizing notebooks

–          Use of graphic organizers to assist with organization of information

Information processing –          Opportunity to write tests or do schoolwork in a quiet, distraction-free environment

–          More time to write tests and complete assignments

Reading and writing –          Access to the teacher’s notes/handouts

–          Use of assistive software (e.g., text-to-speech software that reads text aloud while the student follows along, and/or dictation software that allows the student to dictate their ideas rather than having to write or type them)

–          Use of a laptop or tablet

Social interaction and behaviour –          Identifying a peer who may be able to help the child reintegrate into social activities

–          Model and positively reinforce appropriate behaviour and social interaction

–          Identify ‘triggers’ that lead to inappropriate behaviour

 

The Importance of a Growth Mindset

Researchers and educators have seen that students fall into roughly two mindsets about their skills and potential. The first is what is called fixed mindset. Students with a fixed mindset see their capabilities as unchangeable. The second belief is called a growth mindset. Students with a growth mindset view their skills and potential as something that can be developed. Which belief students have turns out to have important consequences. The table below summarizes the main differences between a fixed mindset and a growth mindset.

 

Fixed Mindset Growth Mindset
Belief Nothing will change, I can’t get better at this I can and will improve; I can develop skills and I can use strategies
Tendency I try to appear as capable as much as possible I will try to learn and improve as much as possible
Challenges I avoid challenges, I give up quickly I will take on challenges because I can learn from them and grow
Effort I won’t put in any effort because nothing will change I will give this all the effort I can because it’s needed for growth
Criticism I ignore feedback – it’s not useful and I get defensive I will be open to feedback – I am eager to learn and grow
Interactions I will not ask for help I will cooperate and work with others; asking for help helps me grow

(Adapted from Carol Dweck, 2006)

Fostering a Growth Mindset for a Successful Return to School

A growth mindset can indeed be taught. You can find some tips below:

  • Use ‘Growth Mindset’ language and scripts: use the table above to develop and consistently frame conversations and give feedback to foster a growth mindset
  • Encourage students to identify and analyze their own ‘growth’ experience: You can ask a student to describe how they have managed to become better in something which they used to not be so good at
  • Learning from someone else’s ‘growth’: students can be asked to think of and find examples of situations in which someone else had learned something that they did not think they could

Originally published in the Brain Injury Association of London and Region‘s Monarch Magazine

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