Brain Injury Awareness Month Pt. III: Accommodations for Cognitive Symptoms

Brain Injury Awareness Month Pt. III: Accommodations for Cognitive Symptoms

Beyond the physical symptoms of a brain injury, children also experience a range of cognitive symptoms that can equally, if not more markedly, impact their learning. Again, just as each child is different, the symptoms vary—not only in severity, but in their duration as well. Some brain injuries will impact a child’s functioning permanently, which is why these accommodations are so important. They are not a temporary fix for learning and development; they are necessary strategies for assisting and enabling affected students throughout their entire education.


Accommodations for Cognitive Symptoms

  • Limited windows for motivation, concentration, and work initiation can be seen in students who have suffered a brain injury. To those unfamiliar with these conditions and symptoms, it may appear as though the child is simply aloof, indolent, or scattered. However, the truth is, the brain injury has caused a deficit in that child’s ability to regulate his/her own attention span.
    • Teachers should break larger tasks or exercises down into smaller, more manageable tasks to allow for spurts of focus and motivation. Couple these “to-do” items with regular brain breaks to allow students to mentally reset.
    • Consider a daily “menu” of options for students who lack motivation. Student choice, regardless of any condition, is a best practice for all learners. Allowing students with lower motivation to choose from a list of activities, readings, tasks, or practices can encourage intrinsic motivation and effort.
    • Teach students to recognize when their concentration breaks. Use sticky notes, hash marks, or tokens to represent any time that a student notices his or her own focus straying to something unrelated. Perhaps they move a token from the left side of the desk to the right any time that they notice that they’ve lost their focus. This allows students to begin to see how often their concentration breaks and other patterns of focus. It also puts them in control of how they might begin to regulate their concentration.
    • Use incentives (other than food or prizes) to help build intrinsic motivation in students. Instead of candy, offer students a reward such as a positive note home to mom and dad or a chance to introduce the class lesson or choose the story for the day.


  • Processing deficits are often seen in children who have suffered brain injuries as well. Students may struggle to comprehend tasks with multiple steps. They may struggle to comprehend or summarize lengthy texts. They may also have other executive functioning difficulties, such as the order in which they should do certain things, or how to organize their time.
    • Break tasks down into ordered steps to allow students to approach a task or assignment using a specific, chronological task board. Remind them to cross off or checkmark steps as they go.
    • Explicitly instruct students on organizational strategies. This could mean anything from recycling old handouts and homework to prioritizing their independent work time based on due date and level of difficulty.
    • Review the chronological order of certain processes and keep classroom routines consistent. For instance, if students are completing a warm-up every day, let them know where they will pick up the warm-up, where they can retrieve a pencil if they don’t have one, and about how long they will have to complete the warm-up. Specifically remind them that, when transitioning to a new activity or subject area, students will need to put previous materials away, place handouts in a folder or binder, and then retrieve the next subject area’s material, as to keep assignments organized and avoid misplacing items.


  • Literacy deficits in reading and/or writing are also common in children who have experienced a brain injury. Perhaps vocabulary or reading level is above grade level; however, short-term memory or the ability to summarize text chronologically is a struggle.
    • Resources for organizing thoughts into writing is beneficial for all students, but especially those with processing difficulties or deficits in executive functioning skills. Graphic organizers and capture sheets provide students with support while reading. Teachers should prompt students to capture characters’ names, significant events and details of the setting while reading.
    • Organizers for writing, summarizing, and assessing a text that they have read are also helpful for struggling writers. Model how to begin a written response with a claim statement, then move into evidence and reasoning of that claim.
    • Word choice lists and lists of transition words/phrases are helpful to students as well when beginning to connect thoughts and construct an organized response.
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