challenges & strategies for veterans with tbi returning to school laurel schaefer, bfa regional...
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CHALLENGES & STRATEGIES FOR VETERANS WITH TBI RETURNING TO SCHOOL
Laurel Schaefer, BFA Regional Education Coordinator
Defense & Veterans Brain Injury Center
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VETERANS RETURNING TO SCHOOL
Traumatic Brain Injury is signature wound of this war. *2000 to date, 294,000 SM’s have been diagnosed with some level of TBI. AKA: The Invisible Wound
Colleges/Universities are reporting increases in Student Veterans with TBI& PTSD.
MISSION: Not only to GO to school but to SUCCEED at school!
Student Veterans are not the only people struggling…so are the instructors!
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WHAT YOU WILL LEARN TODAY
Concussion Basics
How TBI Can Affect Learning
Challenges & Strategies
Other Considerations for Educators
Resources: Websites & Apps
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WHAT IS A TBI ?An external force or blow to the head causing
adisruption to the normal function of the brain.
TWO CONDITIONS MUST OCCUR!
1) INCIDENT Blast ~ Falls ~ Motor Accident ~ Assault ~
2) SYMPTOMS – immediately upon occurrence
** Not all blows to the head result in a TBI
** A mild TBI is also known as a concussion
** You don’t have to be knocked out to have a TBI
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SEVERITY OF TBI
Mild TBI (mTBI) Moderate TBI Severe TBI
-“dazed” to brief -unconscious -unconscious
unconsciousness 30 mins-24 hours over 24 hours
* Concussion * Unconscious * Coma
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Common Symptoms Seen in TBIPhysical:•Sleep difficulties•Fatigue•Headaches•Dizziness•Blurry or double vision•Balance problems•Sensitivity to sounds &/or light•Ringing in the ears•Nausea
Cognitive:•Poor concentration•Memory problems•Trouble thinking•Slowed performance•Difficulty putting thoughts into words•Poor judgment & impulsivity
Emotional:•Anxiety•Depression•Irritability•Mood swings•Personality changes•Anger outbursts
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PTSD TBI
Post Traumatic Stress Disorder and TBI
Flashbacks
Avoidance
Hypervigilance
Nightmares
Re-experiencing phenomenon
Cognitive Deficits
Irritability
Insomnia
Depression
Fatigue
Anxiety
Headache
Sensitivity to light or noise
Nausea/vomiting
Vision Problems
Dizziness
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TRANSITIONING TO ACADEMIC ENVIRONMENT FOR STUDENT VETERAN
REQUIRES:• UNDERSTANDING AN OFTEN
COMPLICATED SYSTEM
• ADAPTING NEW SKILLS
• DEVELOPING SUPPORT SYSTEMS
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TBI can affect: Cognition-memory, attention, organization, & problem solving
Speech
Auditory comprehension, processing, naming, reading, and writing
Visual scanning and spatial skills
Social interactions
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Level the Playing Field• Disability Support Services (DSS)(Disability Student Services, Academic Support Services, Student Success Center, Student Access Center)
• Academic Advisor, Registrar, Counselors, Vet Center• Assistive technology• Campus access, map showing disability campus features • Library access• Accommodations plan (seating, test taking, etc.)
• University Learning Center• Tutors-Math , Writing and Subject • Writing & Math Labs • Supplemental Instructors
• Student Veteran’s Organizations
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Challenges and Strategies when Returning to School with TBI and/or PTSD
Transitioning from Service to School:
• Regimented environment into college environment that has less direction
• Difficulty adjusting to campus culture and relating to younger students which may lead to isolation
• Adjusting to civilian life
• Minimizing impact of disability
• Uncertainty of academic long-term goalso “I feel like I have been placed on another planet.”o “This class is scarier than my deployment.”
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Student Veterans with TBI may: Have headaches or physical pain which may make it difficult for them to concentrate during class
Have difficulty absorbing/comprehending the information at the speed in which it is presented in the classroom.
Instructor’s Observations
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Not ask questions because they do not want to call attention to themselves as others may view them as stupid, crazed or even dangerous.
Compromised communication skills (slurred speech, difficulty forming thoughts into words or questions).
Not questioning the professor because one doesn’t question authority in the military!
Instructor’s Observations
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EDUCTOR’S INTERVENTION WITH STUDENT VETERAN WITH PTSD/TBI
REQUIRES:
• UNDERSTANDING of ALLOWABLE OPTIONS & TOOLS
• ADAPTING TO THE SPECIFIC ACCOMODATIONS NEEDED BY THE STUDENT VETERANS
• UTILIZING SCHOOL’S SUPPORT SYSTEMS
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Sometimes the individual might feel uncomfortable around crowds;
Being in a classroom (with a lot of other students)
Being in a public place with crowds of people.
CHALLENGE #1
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Managing discomfort with crowds in the classroom: The Student Veteran might feel more comfortable sitting in a place where they feels safe.
They may like to sit where they can see the door or a place where they can scan the entire environment.
STRATEGY
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A Veteran returning to school may have an overactive startle response.
The Veteran may be easily startled over loud noises or if someone approaches them from behind.
CHALLENGE #2
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Managing an overactive startle reflex: 1) Keep Calm ~ if you see a Student Veteran over-reacting
Do not laugh or make fun of the individual even if the situationseems humorous
2) Use healthy distractions Distraction can be a useful way of coping with stressful thoughts or feelings that seem
overpowering
3) Don’t put the focus on him or her
STRATEGY
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A Veteran returning to school may be socially withdrawn. Especially those with TBI/PTSD symptoms. Often they feel disconnected or detached from others, even people with whom they once were close.
CHALLENGE #3
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Encourage students to identify and take part in positive activities
People with brain injury, depression and/or PTSD symptoms may find that certain activities are no longer pleasurable, or that they may be afraid to go out and do the things they once enjoyed.
However, this avoidance only maintains feelings of despair and depression. Suggest recreation activities or acts of altruism where they can focus on the needs of others and not the deficiencies of themselves.
STRATEGY
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UNTOLD EXPERIENCES
The Student Veteran may be a very private person who needs to gain complete trust from others before engaging
in general conversation.
CHALLENGE #4
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Encourage Student Veterans to seek treatment from a trained therapist and/or join a support group
A number of individual treatment options as well as support groups are available for Veterans with TBI/PTSD.
Listening to other peoples' experiences with TBI/PTSD can help validate the feeling they may be experiencing.
STRATEGY
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The Veteran returning to school might be experiencing pain such that they cannot tolerate sitting in the classroom for long periods of time
CHALLENGE #5
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Discuss with the student beforehand about specific needs Sitting in the back of the classroom Standing up as needed Taking brief breaks Stretching
STRATEGY
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Other Accommodations Professors May Offer:
• Tutors to assist in preparing for tests• Approve to have another student take notes• Allow extra time to finish test or assignments• Adapt a different test or materials format• Approve the use of assistive technology• Allow wearing sunglasses in class• Provide priority seating in class• Waive foreign language requirement
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•Put things in writing (class schedules, syllabus, etc.)
•Give breaks whenever possible
•Use visuals whenever possible
•Resist calling on Student Veterans to speak
•Be tolerant if the person repeats stories and experiences
•Encourage note taking & use media whenever possible
•Be understanding of sleep problems & attention problems
• Every brain injury is different. Respect, support & dignity.
• Minimize high pressure situations. No stress
Other Accommodations Professors May Offer:
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WEBSITES ~ APPS ~ DEVICES
www.dvbic.dcoe.mil
www.brainlinemilitary.org
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The Bottom Line……
…..Remember to use compassion and patience when working with our Student Veterans.
These men and woman have given much to our country protecting and defending our freedoms.
Knowing how to empower your Student Veterans fosters confidence in yourself and those you teach.
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QUESTIONS?
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ReferencesAaron Tull, Ph.D. (Department of Psychiatry and Human Behavior at the University of Mississippi Medical Center) and http://www.americasheroesatwork.gov/resources/factsheets/tips/
CDC Fact Sheet 3/05 www.cdc.gov Ponsfor, J. (2004) Information about Mild Head Injury or Concussion; Warden, D.
“Traumatic Brain Injury Guide for Patients and Families”
Also recommended: www.americasheroesatwork.gov