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A Gap in Teacher Training: Working With Students Who Have Concussions

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A growing number of children have experienced a brain injury—yet most teachers have never learned in preparation or professional development how to work with them. 

A traumatic brain injury can be caused by youth sports, car accidents, or any other bumps or blows to the head. In 2014, there were more than 812,000 emergency room visits related to traumatic brain injuries that took place among children, and more than 23,000 TBI-related hospitalizations occurring among children. Those numbers have risen steadily over the past decade, according to the Centers for Disease Control and Prevention. 

The most common form of traumatic brain injuries are concussions, which most people fully recover from. Many go unreported, but it's estimated that more than 3 million people in the U.S. suffer concussions every year—and many of those are children.  

"I think people are realizing that there are a lot more of these kids out there in schools than we realized," said Ann Glang, the director and research professor at the Center on Brain Injury Research and Training at the University of Oregon.

She has worked to create an online course for teachers to learn evidence-based strategies for working with students with traumatic brain injuries, including concussions. The course relaunched last month to offer teachers credit for a continuing education unit. 

Most children who have experienced a concussion or mild traumatic brain injury get better within about three weeks, Glang said. Of the children who have experienced a milder injury, 12 percent continue to experience side effects one year later.

According to the CDC, children with moderate-to-severe brain injuries earn worse grades, show higher rates of grade retention, and receive more special education services than their uninjured peers. 

"Even kids with mild injuries are affected in terms of learning and behavior and self-management," Glang said. 

Tailoring Instruction

But most teacher preparation programs do not offer any training on working with students who have traumatic brain injuries. Glang surveyed about 150 faculty members at 100 teacher preparation programs in 2013, and found that nearly 67 percent reported that they did not provide any training specifically on brain injuries to preservice teachers. And of the faculty members who did provide this training, most were in the special education department.

In fact, only 7 percent of general education faculty members provided specific training on working with students who have had brain injuries. This isn't a huge surprise: Already, research has shown that general education teachers are ill-prepared to teach students with learning disabilities.

But Glang said most students who have had mild traumatic brain injuries like concussions are more likely to be in general education classrooms. Their teachers need to be aware of the symptoms that those students might show, and how to work with them, she said.

"You start asking different questions, and you start tailoring" your instruction to meet the needs of those students, she said. "Good teaching is good teaching. It's using similar strategies, just having a slightly different lens." 

For example, students who have experienced a brain injury are often fatigued and have trouble concentrating. A teacher who understands brain injuries would know to build in some breaks throughout the day and work with the student and his or her family to come up with strategies for homework completion, she said.

Memory problems are another hallmark of brain injuries. A student might understand a concept one day, but be confused the next day, Glang said.

"If [teachers] don't have that background on brain injury, that would never be on their radar," she said, adding that the teacher might then just assume the student wasn't trying. 

Other questions teachers should consider, Glang said, include, "How can you set up your classroom to avoid some of the oversimulation and confusion that a crazy classroom environment can present?" And how can you administer assessments to these students so you have an accurate picture of their learning? 

Not on the Radar

So far, over the past year, 300 teachers have taken the University of Oregon's course on working with students who have traumatic brain injuries. Many of these teachers are in states where the education departments have prioritized this issue, including Pennsylvania, Colorado, and Oregon. 

Glang said the Center on Brain Injury Research and Training is exploring offering the course for preservice teachers at several universities in the fall.

While experts consistently recommend that educators are trained in traumatic brain injuries, few school districts provide that training, Glang said. And for many teachers, it's not even on their radar: "You don't know what you don't know," she said. 

But it's important, she said, for teachers to go through this training so they know what to do when a student comes to school after suffering a concussion. 

"I feel like having some knowledge as a teacher is the most important thing in serving these kids," she said. "Until we get everyone some basic information about these kids, they're going to continue to struggle. ... This is very stressful for families. It really defuses things when a teacher has some understanding."

Image via Getty

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