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.