School can become more difficult for a child after a traumatic brain injury (TBI), regardless of the severity of the injury.

Cognitive-communication, the way a child communicates by combining language with skills such as memory, attention, organization, problem solving, and self-awareness, can be greatly impaired by TBI.

Since children’s brains are still developing and maturing, the full impact of a brain injury may not be evident until months or even years after the accident as schoolwork and demands become more challenging.

Even if a child seems to return to how he or she was doing in school before the TBI, changes in the way the brain functions after an injury can affect how children learn new information.

When a child returns to school, a speech-language pathologist (SLP) can work with the child, family, and teachers to determine cognitive-communicative strengths and challenges. A SLP can help create a plan including strategies and suggestions for the classroom to make return to school a success.

Potential Difficulties for Students with TBI

Areas of difficulty that may arise in the school setting include:

• Organizing school assignments
• Solving problems
• Paying attention (especially in the presence of distraction)
• Reading and writing
• Remembering and learning new information
• Starting activities
• Interacting with peers
• Understanding jokes and non-literal information

Quick physical recovery after brain injury can make true assessment of behavioral and cognitive impairments challenging.

Since trouble with learning and academics can occur months or years after a TBI, it may be difficult for family, teachers, or clinicians to realize their relationship. For example, a child that has a TBI in kindergarten may not have noticeable difficulty in school until second grade when the academic material becomes more challenging.

Therefore, it is important to be aware that TBI can cause immediate or delayed learning difficulties and can affect how a child performs in school in the future.

Read a more detailed list of potential difficulties and possible strategies to help students with TBI.

Preparing to Return to School

Planning for a child’s return to school should carefully address these issues to assist with academic success.

When a child with a TBI returns to school, it may be appropriate to establish an Individualized Educational Plan (IEP) or 504 Plan if he or she is having difficulties. It can be challenging to develop and support an IEP for a student with a TBI because a child’s difficulties may not be represented through testing.

A child may need specific additional services (e.g. speech therapy, occupational therapy, resource) or may need some special considerations in the classroom to succeed.

Parents and teachers may want to consider additional services for children with TBI, including:

• Shortened school day
• Frequent rest periods
• Changes in how schoolwork is presented
• Help with daily activities
• Assistance with appropriate ways to deal with frustration
• Assistance with organization of assignments and deadlines
• Tutoring
• Additional time and assistance to complete assignments and tests
• Decreased environmental distraction with testing

Ongoing Assessments of Students with TBI

Ongoing assessment of students with TBI is important. Many children return to normal functioning with initial return to school, but as material becomes more advanced or as new learning is required, they can struggle.

Re-evaluation of skills is recommended approximately every six months following a TBI. The speech-language pathologist’s role in a child’s transition to school will depend on the learning and communication needs of the student.