Nebraska has regional Brain Injury
School Support Teams (BIRSST). ESU 10 is a part of the
Central Region BIRSST. These teams are available to provide consultative
services to schools that teach students who have sustained a brain injury. The
teams can provide Nebraska educators with materials, training and
consultative services to support those students.
Information about brain injuries
Brain injury is a leading cause
of death and disability for children in the U.S. (Dise-Lewis, Calvery, & Lewis,
2002) Brain injuries can be traumatic or acquired, and may involve loss
of oxygen to the brain, bleeding in the brain, tearing of brain cells, or
neurochemical disruptions. "Acquired" brain injuries occur as a result of acute
health difficulties, such as stroke, substance inhalation, near drowning, or
illnesses such as meningitis or encephalitis.
Common causes of "traumatic" injuries include motor vehicle accidents,
auto/pedestrian accidents, child abuse, falls, or sports related injuries.
About 85% of traumatic injuries
are classified as MILD, and up to 80% of these are not initially identified (Terryberry-Spohr, 2007). Mild traumatic brain
injuries include concussion, brief loss of consciousness, or amnesia without
loss of consciousness, but only 15% of mild injuries involve obvious symptoms
and often result in negative routine neurological evaluations. On the other
hand, 85% of mild injuries involve microscopic injuries that do not appear on
CT scans or MRIs (Terryberry-Spohr, 2007).
MODERATE traumatic injuries include loss of consciousness for less than 24
hours, while SEVERE injuries involve loss of consciousness for longer than 24
Unfortunately, the strongest
predictor of a head injury is a previous head injury, and 90% of repeat
injuries occur within ten days of a previous injury due to subtle changes in
balance and reaction time (Terryberry-Spohr,
2007). Recovery time for a mild injury with no loss of consciousness may
last four to eight weeks; while for a more severe injury, the recovery time may
extend a full year or longer.
Observable changes in students
who have experienced brain injury include changes in attention, memory, and
personality. Sometimes students become more restless, more easily confused, or
more easily upset. Sometimes they experience physical symptoms, such as
headache or fatigue. They may have more difficulty learning, completing school
work, and maintaining interest in school. Students who have suffered a brain
injury may benefit from a variety of instructional strategies and
accommodations, dependent on their particular symptoms. Students who have
suffered a brain injury may be eligible for accommodations and instruction
through an IEP or through a 504 Plan.
* Dise-Lewis, J. E., Calvery, M. L., & Lewis, H. (2002). BrainSTARS
Brain Injury: Strategies for Teams And Re-education for Students. Denver,
* Terryberry-Spohr, L. (2007). Mild Traumatic Brain Injury and Sports
Related Concussions. Nebraska Brain Injury Conference. Grand Island, NE
Brain injury symptoms
Children and students
may have had a brain injury known by the school; others may be "hidden" as
often the parents and the child are unaware that a brain injury has
Has the child experienced any of the following?
- Bicycle or motor vehicle accident
- Playground fall or sports-related injury
- Serious illness
- Oxygen deprivation
- Shaken as an infant
Have you noticed any changes following a possible brain injury?
- Physical (fatigue, lack of interest, headaches, slowed reactions,
heightened sensitivity to light or noise, nausea or vomiting, balance, blurry vision)
- Cognitive (forgetfulness, word-finding difficulties, inattention, distractibility, confusion)
- Emotional (moodiness, depression, anxiety)
- Behavioral (irritability, aggressiveness, frustration over minor incidents)
Has the child struggled with any of these challenges?
- Information and processing speed (processing visual and/or auditory
information more slowly than others)
- Memory (difficulties with short-term memory, or with learning, storing, and
retrieving new information)
- Executive function (reduced ability to prioritize, organize themselves, plan ahead, follow through)
- Attention/concentration (problems sustaining attention over time;
inability to do two tasks at the same time)