Brain Injury Awareness Month Pt. II: Classroom Accommodations for Physical Symptoms

Brain Injury Awareness Month Pt. II: Classroom Accommodations for Physical Symptoms

According to the Brain Injury Association of America, “Brain injury is the leading cause of disability in children and adolescents in the U.S.” Since every child is different, and every brain injury is equally unique in its complexity, brain injuries and their impact on learning will vary greatly from student to student. Because of this, educators will want to follow the specific guidelines and recommendations provided by the child’s family and team of doctors with regard to necessary adjustments and accommodations. However, teachers may find that additional strategies are beneficial to that child’s learning as well.


Accommodations for physical symptoms

  • Because speech could be impacted, teachers may want to consider a basic set of classroom hand signals or symbols for all students to use universally—that way students who need this form of communication are not singled out.
    • Use a raised hand to signal assistance; a closed fist to ask to use the restroom; a pointer finger up to signal a need for a break; etc.
    • A sticky note system also works well for these nonverbal cues. Teachers can designate certain colored sticky notes for specific needs or questions.
    • Be sure to put a poster up in the classroom to remind students of what each hand signal or sticky note means. This is a good visual reference for parents, substitutes, or support staff who enter the room as well.
  • Balance, coordination, and motor skills can also be impacted by a brain injury. Educators should consider where in the room the student will be most physically comfortable.
    • Ask about desks without chairs attached, as the metal bar that attaches chairs to the desks can make mobility difficult and restricting.
    • Tennis balls or foot pads for the bottom legs of chairs can make for easy in and out as children slide the chair to get up or down.
    • PE teachers will definitely want to adapt instruction and equipment to suit the student’s physical needs and limitations. The accommodations should of course be the least restrictive to allow for as much participation and inclusion as possible.
    • Simple pencil grips can make writing less exhausting for students with poor motor control. If writing is exceptionally challenging, teachers can opt for use of a laptop or speech-to-text device that allows students to speak into a microphone while the laptop types out as they go.
    • Parents may want to request an elevator pass or ask about ramp access for children whose mobility is hindered by stairs.
    • For school-aged children who move from class to class throughout the day (middle/high school), teachers may want to allow extra passing time for students to navigate through the hallways without having to worry about being marked as tardy to class.
  • Headaches and fatigue are typically reported with brain injuries in children, as well as in adults. Parents and teachers will want to discuss realistic amounts of time for frequency and duration of “brain breaks.”
    • Using the doctor’s recommendations, teachers and parents should map out specific times in the student’s school day to take brain breaks, get a drink of water, rest eyes, etc.
    • Guidance counselors and/or the special education team should make sure that all staff members who interact with that student are aware of the agreed upon brain break system.
    • Because the recovery time and symptoms are unpredictable, teachers should also allow for spontaneous breaks for when headaches or fatigue come on suddenly or unexpectedly.
    • Ask about options to dim the fluorescent lights or opt for natural light when possible, as bright lights could trigger or exacerbate the physical symptoms.
    • Limit screen use—many doctors will actually recommend that screen use, such as with laptops, televisions, and smartphones, be postponed during the initial recovery period. Teachers should be ready to offer paper copies of class materials and handouts.
  • Hearing and vision could also be impacted by a brain injury. Educators will want to consider how to best accommodate a student whose sight and hearing has been temporarily or permanently limited.
    • Plan to print handouts using larger font to put less strain on the student’s eyes.
    • Limit the amount of text per page, especially for lengthy readings or homework sheets.
    • Use italics, bolded, or highlighting functions to bring attention to significant sections or terms in the text. Teachers may also want to provide adapted or reduced versions of the class texts for ease.
    • Audio texts, podcasts, and Screencastify recordings are easy tools for teachers to utilize when students are struggling to access or view print texts.
    • Preferential seating should be used for students whose vision or hearing has been impacted by a brain injury as well. Teachers should consider placing students towards the front of the room or wherever instruction typically takes place. They may also want to seat the student away from the doorway and close the door to limit hallway noise and other audible distractions.
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