What to Look For if You Suspect a Student has a TBI

Communication

• How does the student follow directions?
• What types of directions are most easily followed?
  • Spoken directions
  • Written or visual directions
• How much structure does the student need to follow directions?
• Does the student often forget verbal directions - even with reminders?
• How is the student’s vocabulary, rate of speech, grammar and ability to respond to questions?
• What is the student’s ability to carry on a conversation (e.g., fluency, ability to track conversation and respond appropriately)?
• How are the student’s listening skills (e.g., interrupting the class, asks for information or directions multiple times)?

Organization

• Does the student become confused, irritated or lost when changing tasks within the classroom?
• Does the student become physically lost when changing classes – even if it is a familiar route?
• How are the student’s organizational abilities?

Physical

• Does the student show signs of fatigue or irritability?
• How is the student’s dress and hygiene?
• What is the student’s rate of body movements (e.g., slow, halting, rapid or impulsive)?
• How are the student’s spatial skills (e.g.,getting lost, misreaching)?
• What are the student’s motor mannerisms (e.g., balance, muscle tone, restlessness)?

Academic

• Does the student begin and end assignments independently?
  • Are cues needed?
  • What cues are needed?
• Does the student stay on task? How long? Under what circumstances?
  • Does the student need cues or structure to stay on task?
• Are assignments incomplete or do they have errors that appear to be careless?

Social

• How is the student’s judgment about safety and social situations?
• How is the student’s affect (e.g., flattened, aroused, depressed, under responsive)?

Cognitive

• Does the student have difficulty knowing what to pay attention to when there are several distractions?
• How is the student’s attention span (e.g., attentive, distractible, variable throughout the day)?
• Does the student have difficulty understanding new concepts in a specific academic area?
• Is the student’s rate of learning and performance slow or reduced?
• How is the student’s behavior (e.g., social appropriateness and ability to modify behavior to fit the situation)?
• How is the student’s memory for new learning?

Adapted from:

Missouri Department of Education (1987), as cited in http://www.adhdservices.org/Parent/Manual_TBI_Charts.pdf

Sattler, J. M.  (1997).  Clinical and Forensic Interviewing of Children and Families: Guidelines for the Mental Health, Education, Pediatric, and Child Maltreatment Fields.  Jerome M. Sattler Publisher. p. 634.