Beth Wicks Consultancy Ltd

Acquired Brain Injury (ABI)

The Special Educational Needs of Children with Acquired Brain Injuries

Acquired brain injury is not an area which is usually covered in the initial training of teachers or educational psychologists and so they cannot be expected to have awareness or understanding without the provision of additional information .

After an injury to the brain, specific skills or functions may be affected, whereas others are left intact. Previous learning may be preserved, whereas the ability to acquire new learning is often significantly affected, for instance as a result of poor memory or information processing skills. Although in some cases there is global intellectual impairment, in others basic levels of ability are preserved, but skills necessary to fully utilize this potential are affected. As a result of these factors, the special educational needs of these children can be very complex and easily misunderstood. Understandably, experienced professionals will assess these children and make assumptions about their strengths and weaknesses based on experience of developmental or other difficulties. However, a child who has suffered an acquired brain injury cannot be judged in the same way as a child experiencing difficulties for other reasons.

Many of the problems experienced by these children and young people may seem to be the same or similar to those seen in other children with learning difficulties. In fact, teachers are often heard to say that they have other children in their care with more significant needs or worse behavioural difficulties. This is not relevant to the individual child with the brain injury. It cannot be emphasised enough that these children are unique and cannot just be taught in the same way as others who have learning difficulties for other reasons, without careful assessment of their needs.

The main differences are:

• Although the manifestation of a difficulty may appear similar, as the cause is not, this often requires different remediation. These children have suddenly acquired problems, while others with learning difficulties may never have been functioning at age appropriate levels.
  

• Their problems are complicated by the emotional difficulties with which they have to cope, caused by the sudden onset of difficulties and the trauma of the injury or illness. Clearly, trauma experienced by the whole family will also affect the child.

• Their level of ability will change as some difficulties may resolve in time, whereas others may only emerge as the child matures. A child is within a process of cognitive development and it may be many years after an illness or injury that it becomes clear that the injury is preventing normal development of certain skills. Without appropriate awareness and support, these emerging problems can be exacerbated.
  

It is very important to efficiently assess the problems, but this may be difficult as they can be so closely linked and interrelated.
Teachers experienced in the field of special educational needs are more than capable of instigating appropriate levels of support, devising sound individual educational plans and providing an appropriately differentiated curriculum for these children, but in order to do so they must:

• Be aware of the potential consequences of brain injury

• Recognise that it can be easy to misinterpret difficulties, as the web of possible problem areas may be hard to disentangle, as initial signs can be misleading and as they may have unusual patterns of strengths and weaknesses

• Be aware of the specific difficulties already identified by other professionals

• Be aware that the usual ongoing process of review and reassessment will be particularly important in these cases and to expect changes of need or levels of difficulty

• Be particularly vigilant in spotting the emergence of new difficulties at times when additional demands are made, such as transfer to secondary education or at the beginning of examination course work.

• Forget preconceived ideas, not make assumptions and take a global view of the problems.
  

The importance of efficient assessment applies not only when practical information is provided for school staff, but also for the process of statutory assessment by a Local Education Authority. When an LEA conducts such an assessment and then may produce a Statement of Special Educational Needs, this must be comprehensive. Many Statements identify, for instance, a physical disability, such as a degree of hemiparesis, or an obvious communication problem, without ever mentioning significant and complex cognitive issues.

Children who have severe behavioural difficulties after an acquired brain injury can be most challenging and difficult to deal with in the classroom. The difficulties can be as a result of the actual brain damage, or as a result of subsequent problems, such as frustration, lack of self-esteem or both. Particularly if this is related to the organic damage, it can be very difficult for education professionals to understand and is unlikely to respond to traditional methods of behaviour management. In these instances, school staff will need a particularly high level of support and guidance.

Unfortunately, it is very unusual, if not impossible, for a child to recover from a serious brain injury with no subsequent problems affecting future educational progress or potential. There is a much larger group of children who suffer moderate and mild brain injuries, which research and experience now show can also provoke ongoing subtle but significant cognitive and psychosocial problems.