Strategies for Educating
Children with ABI Related
Complex Needs
Kevin Garner
Specialist Teacher – St. Andrews Healthcare,
Elgar Unit, Northampton.
How to teach Children with ABI
Kevin Garner
Specialist Teacher – St. Andrews Healthcare,
Elgar Unit, Northampton.
Acquired Brain Injury – what
we all need to know
Kevin Garner
Specialist Teacher – St. Andrews Healthcare,
Elgar Unit, Northampton.
A bit about me........
Acquired Brain Injury?
• An acquired brain
injury or ABI is brain
damage caused by
some event after
birth.
• Traumatic
• Non - Traumatic
Acquired Brain Injury – some stats
• First of all its not
really about the
frequency of
incidence, but
prevalence – numbers
currently affected.
• 3% of all adolescents
Acquired Brain Injury – some stats
• Advances in
diagnostic techniques,
medical technology
and critical care
medicine have led to
an increase in ABI
survival rate.
Acquired Brain Injury – some stats
• As a result the
number of pupils with
an acquired brain
injury in schools and
rehab units has
dramatically
increased.
clips
Brief overview of the brain
• Complex structure, but in simple terms it has
three major parts.
»Brain Stem
»Cerebellum
»Cerebral Cortex
Brief overview of the brain
• Brain Stem
Essential for basic body functions such as
breathing, heart rate, blood pressure.
• Cerebellum
Coordinates body movements and muscle
tone. Enables us to walk, jump, climb, hold a
pen, write.
Brief overview of the brain
• Cerebral Cortex
This is dedicated to the highest levels of
thinking, moving and acting and makes up
7/10 of the central nervous system.
Split into two hemispheres, LEFT and RIGHT.
Each hemisphere contains 4 lobes. Each lobe
is associated with different aspects of
functioning.
Brief overview of the brain
• When any of these areas are
damaged their are associated
problems with their function.
Acquired Brain Injury – Problems
• It’s important to recognise that a child with an
ABI might be different from a child that has a
learning difficulty since birth.
• And the point where a child is physically well
enough to go back to school isn’t necessarily
an indication that they have made a full
recovery.
Acquired Brain Injury – Problems
• Memory:
Working memory
Short term memory
Long term memory
Acquired Brain Injury – Problems
• Memory:
one of the most common effects on memory
is the learning of new information.
• How information is processed (working
memory) and how that information is stored
(short and long term memory)
Acquired Brain Injury – Problems
• Fatigue:
It’s very common for a child with an ABI to feel
very tired and fatigued in the classroom and
this can affect their ability to learn in a
classroom.
• Short lessons
• Lots of breaks to rest in a quiet space
Acquired Brain Injury – Problems
• Attention and Concentration
It’s very common for a child with an ABI to be
susceptible to distraction “switch off”,
impulsivity, can’t follow instructions
• Short lessons – small lesson chunks
• Environmental changes
Acquired Brain Injury – Problems
• Executive problems
Very common and affects the ability to plan or
to follow complex tasks that involve multiple
steps
Results in ABI often being phrased “a hidden
disability.”
Strategies?
Acquired Brain Injury – Strategies
• A large number of
initiatives have been
developed for
educating adolescents
with a large spectrum
of disorders.
ADHD
AUTISM
LEarNing
DisabiLi
Ty
DSYEL
XIA
Acquired Brain Injury – Strategies
• There has been a
notable lack of
strategies and
guidance on dealing
with the challenge of
educating adolescents
with ABI.
Cognitive and Communication Needs
Psychosocial and Behavioural Needs
Sensorimotor and Physical Needs
How do we do it?
• The neuro-behavioural approach
Creating a relentlessly positive environment
Success through achievable goals
Steps behaviour system
Implemented consistently
How do we do it?
• Classroom modifications and strategies
Environmental Modifications
Learning strategies
Environmental Strategies!
• Minimizing distraction
• Environment allows for scheduling
Environmental
Low stimulus environment
Velcro task board for scheduling
Environmental
Visual cues regarding behaviour
and impulsivity
Environmental
Velcro task boards allow for easy
scheduling
Learning Strategies!
Dealing with cognitive problems including:
• Reduced speed of processing of visual and verbal
information
• Poor attention and concentration
• Memory and learning problems
• Problems with executive skills
Memory Game
William Shakespeare was born in 1564
First seven digits of PI = 3.141582
Memory Game
William Shakespeare was born in 1564
First seven digits of PI = 3.141582
Memory Game
Obstacles to success…
Assessments
• Need to be meaningful
• Need to be formative
• Psychology assessments need to give
teachers workable strategies
Curriculum
Adaptable Strategies!
How good is your memory? Did you use a
compensatory strategy?
• When was William Shakespeare Born?
• I wrote Hamlet well
• 1 5
6
4
• First six digits of PI?
• How I wish I could remember PI
• 3. 1 4 1
5
8
2
Case Study
Names have been changed to protect the young person’s confidentiality
Case Study
• Pupil K was a 12 year old boy on admission.
• Previous placements (19 in the previous year)
had broken down due to risk issues
(absconding/aggressive behaviour)
• Developed a brain tumour in early childhood
Names have been changed to protect the young person’s confidentiality
Case Study
• The story of Patient K
• Refused to attend any education at the start
• Subsequently didn’t earn many of the
reinforcers.
• After a couple of weeks he reluctantly started
to attend.
Names have been changed to protect the young person’s confidentiality
Case Study
• Initially he was a vey passive learner and
didn’t engage vey well. But he was attending!!
• Patient K had a love of playing video games
• He was given the chance of playing a game of
bowling on the WII console after finishing his
lesson.
Names have been changed to protect the young person’s confidentiality
Case Study
• A consistent lesson structure was set up for
him....always with the reward at the end.
• Gradually tasks were made more difficult.
• Unknown to him he had started to complete a
number of unit awards!!
Names have been changed to protect the young person’s confidentiality
Case Study
• Tasks where part skills such as memory
strategies (games; COGMED) and part
curriculum based.
• After 8 weeks patient K had passed his first
unit awards. Certificates were in the post!!
Names have been changed to protect the young person’s confidentiality
Case Study
• Anxiety levels had significantly dropped,
attention span started to improve. K agreed to
start Entry Level Certificates.
• K’s willingness to engage improved. He started
to ask for extra lessons!!
Names have been changed to protect the young person’s confidentiality
Case Study
• The frequency of opting out of lessons
dramatically fell. Attending 93% of lessons
each week
• K’s started to think about his answers before
shouting them out impulsively
• He had learned his routine in class and started
to self monitor.
Names have been changed to protect the young person’s confidentiality
Case Study
Names have been changed to protect the young person’s confidentiality
The Climate of Success
Parents
If you want any further information
“Educating Children with Acquired Brain Injury” – Beth Wicks,
Sue Walker
CBIT
child brain injury trust.org.uk
headway.org.uk
Kevin Garner
Email – [email protected]
Tel – 01604616457
Thank you for listening!
Kevin Garner
Email – [email protected]
Tel – 01604616457
What do we want?
Achievable goals:
• Better outcomes for our
young people with ABI
• Setting a benchmark
• Fostering a climate of
success