Traumatic Brain Injury (TBI) Definition

Traumatic Brain Injury means acquired injury to the brain caused by an external event resulting in total or partial functional disability or psychosocial maladjustment that adversely affects educational performance. The term does not include brain injuries that are congenital or degenerative. The term includes open or closed head injuries resulting in impairments in one or more of the seven areas of functioning. Common characteristics associated with TBI may include:

Vision blurred vision, double vision, or loss of field.

Hearing Tinnitus or hearing loss.

Health/Motor - Seizure activity, physical function impairments such as paralysis, spasticity, ataxia, apraxia, or physical performance impairments such as strength, stamina, or slowed motor speed.

Cognitive/Adaptive Behavior and Academics (includes readiness and transition) - Deficits in attention, concentration, short-term memory, capacity for new learning, retrieval of old learning, comprehension, calculation, organization, problem solving, generalization, initiation, and/or rate/efficiency of information processing. Inconsistent performance, increased mental fatigue, and reduced functional daily living skills may also be noted.

Speech/Language - Disturbances in receptive/expressive language functions and/or motor speech abilities including, but not limited to, aphasia, dysarthria, and/or apraxia.

Social/Emotional - Mood swings, lack of impulse control such as aggressive or sexual acting-out, inappropriate child-like behavior, decreased judgment and frustration tolerance, emotional responses to the injury and sequelae, memory of normalcy including denial, anger, or depression.

Comment:

External physical events would include, but not be limited to, physical force or abuse, gunshot wounds, motor vehicle injuries, sports injuries, or anoxia.

Initial Eligibility Criteria for Traumatic Brain Injury

After completing all previous steps required in the special education process, the multidisciplinary team may determine that a student has a TBI if all of the following criteria are met.

1. The student has a medical diagnosis of head injury.

2. The student's educational performance is adversely affected by deficits in acquisition, retention, and/or generalization of skills. Students with a brain injury may have rapidly changing profiles, therefore, educational assessment should include current documentation of the student's functional capabilities and indicate deficits in one or more of the following areas:

a. building or maintaining social competence,

b. performance of functional daily living skills across settings,

c. the ability to acquire and retain new skills, and

d. the ability to retrieve prior information.

3. The educational deficits are not PRIMARILY caused by:

Visual, auditory acuity, or motor deficits
Behavior Disorder/Emotional Disturbance
Mental Retardation
Language or learning disability
Environmental or economic disadvantage or cultural differences

It must be emphasized that the presence of criteria can only be determined by "appropriate diagnostic information" which would include a comprehensive medical report from a licensed physician and a comprehensive multidisciplinary evaluation by qualified personnel as specified in the evaluation plan. Personnel with an understanding of the sequelae of TBI may be helpful in the assessment process.

Note: If steps 2 and 3 of the criteria have been met and there is:

a. Substantial data to document a medical basis for a head injury other than a medical diagnosis, or:

b. A neuropsychological assessment;

and this diagnostic information supports the conclusion that a head injury did occur, the multidisciplinary team may use this information in the absence of a medical diagnosis of head injury by a physician.