Mild Traumatic Brain Injury

General Information

Traumatic brain injury (TBI) is damage to the brain that occurs after birth as a result of an external force (e.g., falls, sports injuries, accidents, medical treatment).The severity can vary greatly depending on the part of the brain that is affected. The recovery from a brain injury takes time. The length of time depends on the nature and severity of the injury. Children who sustain TBI may experience a complex array of problems that can affect alertness and concentration, self-awareness, perception, memory and learning, reasoning, planning and problem solving, speech and language, motor control, and emotions.

General Characteristics To Look For

Anyone who suffers a blow to the head should be checked by a doctor.

Prevention is key. Preventive strategies include

  • always wearing a seat belt
  • always wearing a helmet while riding a bicycle or a horse, skiing, skating, skateboarding, riding a motorcycle, snowmobile, or all-terrain vehicle
  • always wearing head protection when at bat or running bases or playing a contact sport.

Changes in behaviour may be related to a mild traumatic brain injury. If a child presents with one or more of the following behaviours that are different from his/her normal state, consider this a concern.

Concentration and Learning
  • difficulty remembering—short- and long-term memory is affected
  • makes up stories to fill memory gaps
  • impaired concentration, limited attention span
  • difficulty in attending to more than one thing at a time
  • confused about time and place, confuses past and present events
  • does not start or is slow to start conversations, ask questions, or make comments
  • increased time required to learn new information or skills
  • difficulty planning a sequence of tasks
  • difficulty with decision making and reasoning
  • appears disorganized
  • impairment of perception, communication, word finding, reading and writing skills, planning, sequencing, processing speed, and judgment.

  • nausea, repeated vomiting, loss of consciousness
  • dizziness, confusion, headaches (intermittent or persistent ), lightheaded
  • sensory problems: blurred vision or double vision, ringing in the ears, bad taste in the mouth
  • listless and irritable
  • change in appetite or sleep patterns, refusal to eat
  • seizures
  • pupils of unequal size
  • bruises
  • sensory processing difficulties
  • poor balance, reduced motor speed, lack of fine motor coordination, spasticity of muscles, paralysis of one or both sides

  • changes in behaviour
  • mood swings
  • mind gets stuck on one idea or activity
  • socially inappropriate behaviour or comments
  • personality change
  • withdrawal, depression, frustration, anxiety
  • difficulty with turn taking
  • acting out of place in unfamiliar or public settings
  • lower tolerance for frustrating situations
  • loses interest in favourite activities, possessions or pastimes

Impact On Student Success

The impact of a Mild Traumatic Brain Injury on student success varies widely dependent on the nature and severity of the injury. Students may have difficulties with areas such as alertness and concentration, self-awareness, perception, memory and learning, reasoning, planning and problem solving, speech and language, motor control, and emotions.

  • A team approach and planning are important. Work together with families, schools, and community services. The team could include a rehabilitation team (including doctors and nurses, occupational therapists, speech pathologists, educators, social workers, etc.).
  • Encourage the use of a calendar, memory aids, post-it notes, and a notebook to log activities at home and at school.
  • Schedule brief rest periods between short periods of activity.
  • Be aware that because the child’s short-term memory may be impaired, what appears to have been learned may be forgotten later in the day.
  • Build opportunities for success and maximize the student’s strengths.
  • Develop strategies to support students who have difficulty with attention and concentration, memory, organization, and following directions. These might include:
    • reducing distractions in the work area (e.g., remove extra pencils, books)
    • dividing work into smaller sections
    • establish a non-verbal cueing system (e.g., eye contact, touch) to remind the student to pay attention.
  • Link new information to the student’s relevant prior knowledge.
  • Colour code materials for each class/subject.
  • Provide oral and written instructions.
  • Avoid figurative language.
  • Slow down the pace of instruction.
  • Demonstrate new tasks, state instructions, and provide examples to illustrate ideas and concepts.
  • Teach compensatory strategies for increasing memory
  • Maintain current knowledge of available community resources.
  • Ensure solid transition planning between grades and provide opportunities for teachers, families, and community partners to share knowledge/information about what works for the child.
  • Support training opportunities for teachers and other staff.
  • Use the family, rehab centre, and other community partners as information resources.
  • Provide information about the child, including what motivates him/her, what interests him/her, what makes him/her special, what his/her strengths are, etc.
  • Help with transition planning and building consistency for the child in home and school expectations.
  • Be a supportive advocate for the child.
  • Consider use of community supports and participating in parent support groups
  • Provide supportive consultation, resources, and referrals to other services if needed.
  • Work collaboratively with other community services to provide a “big picture” support system.