instructional strategies for secondary students with tbi randy thomas
TRANSCRIPT
Instructional Strategies for Secondary Students with TBI
Randy Thomas
Marathon vs. Sprint Building success with a student who has
a TBI takes consistent, focused, hard work.It is very difficult for the student.It is very rewarding for the student and the
teacher.Successes may require you to look back
over a semester or a year to clearly recognize.
Coaches don’t expect a kids in casts to run; their injuries prevent them being capable.
Overview
Everyday Instruction Executive Functioning Memory Attention and Focus Behavior
Everyday Instruction Follow principles of good instruction Are often beneficial to entire group
Target the Key ConceptsReview those key concepts regularly
Are highly specific to the individual needs of the studentAssess key concepts: pre,
formative, & summative
4 Facts on Long-Term changes: No 2 students will be alike.
Changes are unlikely to disappear fully over time; the student’s recovery will most likely only be partial.
Negative consequences may not be seen immediately but only emerge when developmental demands reveal deficits and problems.
An injured brain is less likely to meet the increasingly complex tasks all children face as they get older.
Hibbard, M., Gordan, W., Martin, T., Raskin, B., Brown, M. (2001) Students with Traumatic Brain Injury: Identification, Assessment and Classification, Assessment and Classroom Accommodations : NYC, NY
Effective Teaching Model
1. Task analysis – break the task down to steps with clear beginning and ending point.
2. Use Direct-instruction to prevent the acquisition of errors in newly developed practices. Examples and non-examples are beneficial. Paint a clear picture of expectations.
3. Frequent assessments: Baseline and regular formative assessments
4. Frequent reviews combining visual and verbal ques.
5. High rates of correct, practice trials: 5 trials is not enough, 30-50 practices with mass practices initially followed by consistent reinforcement practices.
6. Metacognitive strategy training: Self-evaluation of one’s own performance.
Effective Teaching Model
Executive FunctionsThose mental capacities
necessary for formulating goals, planning how to achieve them, and carrying out the plans effectively. (Leak, 1982)
Dysexecutive Syndrome Impulsiveness Poor social
judgment Difficulty interpreting
other’s behavior Perseveration Poorly regulated
attention Disorganized Ineffective planning
Decreased flexibility Slowed processes Limited divergent
thinking Concrete thinking Limited problem
solving Weak self-
monitoring Reduced attention
Metacognitive Strategies
Self-regulation (“Self-talk” or Social Stories)
A repeated phrase or narrative to help guide the student through a specific task – Student Planner:
Examples of External Aids A student may take 15 minutes trying to start but
perceive that it has only been 1 or 2 minutes.
Time ManagementKitchen or digital timershttp://www.online-stopwatch.com/Day planners
Task SpecificChecklist (homework, materials, readiness
routines)Color coding/labelingSet up all classroom binders exactly the same
Homework Helper
1. Pull out homework list (planner…etc.) 2. Make homework list in priority order 3. Start working now! Start my timer.
a. Find book, worksheet, & pencil. b. Read directions. c. Ask for help only if you need it.
4. Turn in completed work!
Great Job! Keep working hard!
Examples of Metacognitive Strategies
Self-monitoring of Attention Monitoring progress and/or success during
an activity Step-by-step task-specific checklist can be
used to support difficult tasks May include error checking and motivation
on the checklists Student self rates success during and after
task and documents successful strategies
The On-task Traffic Light!! Red Light
Stop!! Am I doing what I am supposed to be doing?
Yellow LightLook! What should I be doing instead?
Green LightGo!! Choose a new direction and move
forward!
Examples of Environmental Modification-Physical Set up
Seating – have the same seating in all classrooms if possible…i.e. front right side.
Sound management – ear plugs or head set
Distraction management – no irrelevant items
The more that a student’s environment is standardized across classrooms, the easier it is to focus on instruction in each class.
Examples of Environmental Modification-Physical Set up Structure task in step-by-step format. Give one portion of a task at a time.
Single step instructions
Routinize tasks. Put time estimates at the top of the
paper. Assign a peer buddy.
Natural Support
Modify instruction style to accommodate individual student.
Facilitate a supportive social environment. School counselors are a great resource to engage
classmates in creating a supportive climate.
Work towards common expectations and practices between home and school.
Combination Approaches External Aid + Metacognitive Practice
Digital timer combined with self-talk Natural Supports + External Aid
Classroom/school-wide culture and assignment completion system
Environmental Modification + Metacognitive Task accommodation and self-advocating
for help○ Model how to self-advocate & allow practice
Memory Short term memory is broken. Try carrying water using a tea strainer to
better understand their frustration. You look at the board, say in your head
what you need to write down, look down at your paper….what was that again?
Provide the aids necessary to compensate.Lecture notesCompleted graphic organizers
Attention and Focus
Students remember the beginning and end of a lesson.
Chunking limits the forgotten middle.
Break up the lesson with physical activities.Sensory diet
Crossing the midline engages both sides of the brain and causes both sides to communicate.
Situational Teachers
High CapabilityLow Motivation
Needs encouragement
Low CapabilityLow Motivation
Needs instruction and encouragement
High capabilityHigh motivation
Needs autonomy
Low capabilityHigh motivation
Needs instruction
Behavior Behavior is communication; am I listening to
understand? What is being communicated? I don’t know what I’m supposed to be doing. I don’t know how to do the work. I count using my fingers and can’t
remember my multiplication facts, and you want me to do what?
I don’t want to look like an idiot; I’d rather just be in trouble.
There are Two Plans
Plan AOh, let’s just sporadically provide
individualized instructions and make on-the-fly adjustments and hope it works.
Plan BObserve behavior, think through intervention
options, systematically apply the most feasible option, evaluate to determine effectiveness, make purposeful modifications.
Summary Everyday Instruction – Effective teaching
model Executive Functioning – Select the most
needed target. Memory – Provide aids as needed. Attention and Focus – Chunking and
physical activity Behavior – What is this kid saying?