Traumatic Brain Injury (TBI)


Traumatic Brain Injury is a condition caused by a head injury that results in lasting damage to the brain. This injury disrupts normal brain functioning and may permanently impact how a person acts, moves, and/or thinks.

Traumatic brain injury is one of the categories of disability specified in IDEA. This means that a child with traumatic brain injury may be eligible for special education and related services if it adversely affects their education.

A traumatic brain injury often impacts functioning in the following areas:
Memory and cognition, social skills, emotional regulation, attention, behavior, speech and language, and physical health.

Memory and Cognition 
  • Difficulty with logic, problem solving, and reasoning
  • Slower to respond, react and complete activities and tasks
  • Difficulty remembering facts, procedures, events, etc.
  • Frequently struggles with grade level work
  • Difficulty storing new information, working memory deficits
  • Difficulty retrieving old information
  • May be disoriented with time, places, and people
  • Difficulty sequencing events
  • Physical and verbal perseverations (repeating a word, phrase, or action, over and over again)
  • Poor judgment and reasoning skills

Social Skills and Emotional Regulation 
  • Inappropriate social behaviors
  • Emotional responses may be unpredictable in nature and severity
  • Difficulty regulating emotions
  • May struggle to accurately interpret verbal and non-verbal cues
  • Emotional responses may not "fit" the situation
  • Emotional instability (happy one moment, sad the next)
  • May exhibit signs of poor self-concept, depression, isolation, withdrawal, and paranoia

Inattention and Impulsivity 
  • Difficulty focusing attention
  • May have difficulty controlling impulses, thoughts, and feelings
  • Injury and memory loss may impact successful use of behavior modification strategies
  • Distracted by internal and external events and thoughts

Speech & Language
  • May have speech and language deficits (should be checked frequently)
  • Difficulty speaking words or phrases
  • Difficulty comprehending what others say
  • May struggle to follow multi-step instructions

  • May struggle to process visual information (visual perceptual issues)
  • May experience visual deficits such as double vision and partial loss of vision
  • May have visual "blind spots"
  • Possible coma could produce some slowing and lethargy
  • Seizures are common following a head injury, and seizure medication may cause “cognitive dulling”
  • Difficulty staying awake
  • Inability to recognize post-injury deficits
  • Possible gross or fine motor deficits depending on what part of the brain was injured (may have some paralysis)
  • Short periods of disorientation or attention lapse
  • May tire frequently and quickly

The symptoms of TBI can range in severity from mild to severe.
Mild TBI:
  • Fatigue
  • Headaches
  • Visual disturbances
  • Memory loss
  • Poor attention/concentration
  • Sleep disturbances
  • Dizziness/loss of balance
  • Irritability/emotional disturbances
  • Feelings of depression
  • Seizures
  • Possible coma
  • Nausea
  • Loss of smell
  • Sensitivity to light and sounds
  • Mood changes
  • Getting lost or confused
  • Slowness in thinking
Moderate TBI:
  • Results in permanent brain damage
  • Produces lifelong deficits (to varying degrees)
  • Death may occur
  • Seizures
  • Coma (to varying degrees)
  • Confusion
  • Difficulty with "thinking skills" (memory, attention, judgment)
  • Blurred vision, loss of vision
  • Change in hearing acuity
  • Ringing in ears
  • Slurred speech
  • Difficulty understanding spoken language
  • Difficulty processing sensory input (touch, smell, hearing, etc.)
  • Personality changes
  • Loss of taste and/or smell
  • Paralysis
  • Lethargy
  • Loss of bowel/bladder control
  • Dizziness
  • Inappropriate emotional responses
Severe TBI:
  • Results in significant permanent brain damage
  • May result in total loss of speech ability
  • Produces lifelong deficits to a severe degree
  • May require lifetime care and assistance
  • Sustained loss of consciousness
  • Can result in death

Strategies for Traumatic Brain Injury