SCEMA: A team-based approach to serving secondary students with executive dysfunction following brain injury

Abstract

IntroductionWhile the incidence of acquired brain injury (ABI) has remained constant over the past 40 years, advances in medical intervention have dramatically increased the survival rate. The highest incidence occurs in youths between the ages of 15 and 24 (Finlayson and Garner 1994). Epidemiological trends coupled with increasingly restricted medical rehabilitation services and the federal education mandate to include traumatic brain injury as a disability category (IDEA) are forcing schools to confront the problems of adolescents with brain injury.The challenge in serving middle-and high-school students with ABI is related to three factors: (1) brain injury has unique and deleterious effects on students' abilities to learn and perform in cognitive, behavioural and social domains ; (2) educational and social demands increase with entry into secondary settings and escalate throughout the secondary years, thereby increasing pressure on the students and school; and (3) current educational models do not meet the needs of students with brain injury. Current fiscal constraints and increasing demands on teacher time and expertise make it difficult for school personnel to begin to address these challenges. Consultation L y rehabilitation professionalsOften the burden of addressing these challenges can be alleviated by the involvement of rehabilitation professionals in designing effective school programmes (Lash and Scarpino 1993). Rehabilitation professionals have specific expertise in cognitive, physical, emotional, communication and behavioural needs of students with ABI, and can serve as resources for educators who may not be knowledgeable about this new population of students. However, in the current climate of restricted health-care expenditure, medical consultants need to have effective and efficient means of transmitting their knowledge to educators. They also need to tailor their recommendations to the public middle-or high-school context in which the student will receive the services, a context with which many rehabilitation personnel are not familiar.

Effects of Moderate to Severe Traumatic Brain Injury on Anticipating Consequences of Actions in Adolescents: A Preliminary Study

“…Due to the fact that an adolescent brain is still in active development, any injury to the brain incurred either during adolescence or before this time (i.e., childhood) can be particularly detrimental to newly-developed or later-emerging skills. Research in pediatric traumatic brain injury (TBI) has demonstrated that long-term recovery is often characterized by a persistent gap or ''neurocognitive stall'' between children with TBI and their typically developing peers in terms of both cognitive and everyday life functioning (e.g., Anderson, 1999;Chapman, 2006;Cook, DePompei, & Chapman, 2011;Sohlberg, Todis, & Glang, 1998).…”

The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury.

“…The nature of intervention following pediatric TBI has largely been determined by the target problem. Thus, interventions to improve behavioral problems typically include either antecedent or consequent behavior management programs (e.g., Feeney & Ylvisaker, 1995), whereas academic interventions emphasize classroom supports such as memory aids and reminders, advanced organizers, and graphic materials to guide learning (e.g., Sohlberg, Todis, & Glang, 1998).…”

Exploring the adaptability of TeachABI as an online professional development module for high school educators

“…Acquired brain injury (ABI) is a complex condition that affects brain functioning and includes traumatic (e.g., concussion) and non-traumatic injury (e.g., stroke) to the brain [ 1 , 2 ]. ABI symptoms can have a negative impact on a child's participation in daily activities, including learning in the classroom [ 3 , 4 ]. Following an ABI, school-age children experience issues involving academic underachievement, disruptive behaviours, low self-esteem, and social isolation [ 5 , 6 ].…”

“…Building off the efforts invested in developing this elementary-focused intervention, the current study seeks to consider opportunities for adaptation towards the unique needs and context of high school educators, who also face challenges in the classroom supporting students with ABI. High school students experience greater student responsibility and higher cognitive, behavioural, and social demands [ 4 ]. With respect to concussion, high school students often face more severe symptoms, longer recovery times, and challenges returning to school compared to younger students [ 23 , 24 ].…”