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Acquired Brain Injury (ABI) Program
What is an Acquired Brain Injury/ABI? Comparison with Specific Learning Disabilities
Santa Monica College has developed various educational approaches to serve students with acquired brain injuries. Our students’ success rates are such that we encourage anyone with an interest in educational growth to take part in our program. The SMC Acquired Brain Injury (ABI) Program is designed for the adult who wants to pursue educational goals. SMC offers two types of educational opportunities for those with acquired brain injuries:
What is an Acquired Brain Injury/ABI?
More than one million people who incur head injuries each year are between the ages of 15 and 28 years of age. Many sustain injuries that leave them with hidden disabilities, decreased abilities not easily understood by others.
Brain injury can occur in two ways: 1.) from external events, such as a head trauma resulting from a severe blow, or 2.) from internal events, such as cerebral vascular accident, strokes or tumors. The consequences of brain injury are many and complex. The structures of the brain and their role in thinking and doing may be the most complex puzzle in science. For our educational purposes understanding how the brain functions differently after injury has much greater importance than knowing the cause or type of the injury.
Areas of Impairment
There is great variation in the possible effects of a head injury on an individual. Injuries may result in some degree of impairment in the following functions:
Memory – Memory difficulties are probably the most common characteristic of students with brain injury, and present the greatest challenge for learning. The primary problem is a decreased ability to store information and recall it at a later time. The storage and retrieval of pre-injury memories or previously acquired knowledge may be surprisingly intact.
Distractability – Poor attention and concentration, often caused by poor filtering or processing of sensory information, may reduce the ability to focus long enough for learning to take place.
Speed of Thinking –New information may take longer to process effectively. Communication-Language functions such as writing, reading, speaking, listening, and “pragmatics” may be impaired. Communication pragmatics problems are interrupting, talking out of turn, dominating discussions, speaking too loudly or rudely, or standing too closely to the listener. Spatial Reasoning refers to the ability to recognize shapes of objects, judge distances accurately, navigate, read a map, visualize images, comprehend mechanical functions, or recognize position in space. Mathematic abilities are linked to spatial reasoning.
Conceptualization – Deficits of this type may reduce the ability to categorize, sequence, abstract, prioritize, and/or generalize information.
Executive Functions – The ability to set goals, plan, and work methodically toward a goal, especially with any mental flexibility, may be impaired. The difficulty may show as disorganization and poor problem solving and judgement especially with time and money.
Psychosocial – Some common types of psychosocial disabilities may appear as depression or withdrawal, poor insight, poor reality orientation, low frustration tolerance, heightened irritability, restlessness, anxiety, emotional lability, impulsiveness, poor social judgment, disinhibited sexual behavior, euphoria, apathy, fatigue, and/or poor personal hygiene.
Movement, Vision, Hearing, and Physical Disabilities – Specific somatic impairments may be present after an injury.
Educational Implications
Those with learning differences due to acquired brain injuries can use a variety of compensatory strategies to improve their performance. Often the greatest hurdle is coming to terms with the changes as on-going rather than “curable.” Beneficial strategies may involve the consistent use of memory devices (calendar notebooks, notetaking systems, etc.) and learning enhancement procedures (such as multiple encoding or mneumonics). Many of the approaches used by those with lifelong learning disabilities can also be useful with some of these types of acquired problems. Santa Monica College has developed the Acquired Brain Injury Program to address the unique challenges of this type of disability. Common needs for students with head injuries Structure – Survivors of recent injuries often do not organize well. Returning to, or entering, school may provide a badly needed routine. Flexibility – A great deal of flexibility is needed in scheduling the re-entry. Routines may need to be slowed down, and placement decisions may need to change after periods of rapid recovery. Reduced Demands – Reducing demands on the student with a head injury may involve substituting a less demanding class, altering response modes (such as oral vs. written responses), providing books and lectures on tape, or providing other support services. The students may need a reduced course load, or classes that meet for shorter periods of time, and should be encouraged to enroll in a study skill refresher course. Supervision – The poor judgment and memory problems of a student with a head injury may make supervision a necessary ingredient of the educational program. For the student, this supervision could take the form of a planning and monitoring system which requires the faculty member and the student to plan together, set goals and report and evaluate progress. Intervention – With head injuries, students are often not conspicuous before they begin to have serious trouble and they often misjudge their own problems. The head injury may make the student unable to assess the need for help without direct intervention.
Comparison with Specific Learning Disabilities
On the surface, problems encountered by the person who has survived a head injury may seem like those common to students with learning disabilities. Many of the academic modifications listed for students with learning disabilities will also be appropriate for students with head injuries. Whereas similarities exist, there are important differences which have significance on effective programming.Compared to students with learning disabilities, the student with an acquired brain injury may:
*Be more impulsive, hyperactive, distractible, verbally intrusive, and/or socially inappropriate *Have discrepancies in ability levels that are more extreme and harder to understand, such as reading comprehension at a level four years lower than spelling ability *Learn some material rapidly, since they may need only to be reacquainted with a process or concept which they knew pre-injury *Have more severe problems generalizing and integrating skills or information *Resist new learning strategies which seem too elementary (not accepting the changes caused by the injury)*Be unable to process information presented through usual remedial strategies because comprehension may deteriorate as the amount and complexity of material increases*Require a wider variety of strategies to compensate for impaired memory and problems with word retrieval, information processing and communication *Have more pronounced difficulty with organization of thoughts, cause effect relationships, and problem solving;
*Require on-going monitoring of tasks using independent thinking and judgment
*Retain the pre-trauma self-concept of a student without a disability and have difficulty accepting that abilities and behaviors have changed and need to be adjusted
*Be unable to process information presented through usual remedial strategies because comprehension may deteriorate as the amount and complexity of material increases*Require a wider variety of strategies to compensate for impaired memory and problems with word retrieval, information processing and communication*Have more pronounced difficulty with organization of thoughts, cause effect relationships, and problem solving; *Require on-going monitoring of tasks using independent thinking and judgment
*Retain the pre-trauma self-concept of a student without a disability and have difficulty accepting that abilities and behaviors have changed and need to be adjusted
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