Gragg,+Carrie++Traumatic+Brain+Injury

= **Welcome to my Wiki on Traumatic Brain Injury!!** **Hi! I'm Carrie Gragg!** **This is a picture of me with my three children, Talia, Hunter and Neil at my graduation from SOU in June, 2011.** ** My academic journey began in September of 2006 when I enrolled in the Moving On program at RCC in Grants Pass. I was unsure of my goals and my ability to succeed. The program was wonderful and I discovered that college was the thing for me! I earned my Associate of Arts degree from RCC in June, 2009 and then earned my Bachelor's degree in History from SOU in June, 2011. **** Something about me that is interesting is that **** I was honored by the History department; they named me Student of the Year in History, 2010-2011 and also Female Graduate of the Year in History by the American Association of University Women, 2010-2011. **
 * Of course, none of this would have been possible without the love and support of my family. My husband, William, has been instrumental in my every accomplishment. My children: Talia, age 16; Hunter, age 12; and Neil, age 9 have been supportive and wonderful throughout this process. **
 * My educational career and goals: **** I was accepted into the Master of Arts in Teaching program at SOU in April of 2011. My goal is to complete this program in June of 2013 and embark on a career in teaching. I hope to instill a love of education and maybe even a love of History in future students! **
 * What brings me joy? **** My joy in life is my family. Without them, I would be unsure of my purpose in life. That being said, I have new joys, as well. As part of the Masters program, I now volunteer for two hours every week in a third grade class, and two hours per week in a fifth grade class. My new joys in life are "my" students. I never thought I would feel such a bond to them. They, each and every one, are a treasure and I feel privileged to have the opportunity to be a part of their education and their lives. **** What is my greatest fear about being a teacher? **** My biggest fear, paradoxically, is that I might miss something and unintentionally not do well by a student. **
 * Did you ever experience a time when something was extremely difficult to learn? Explain that time and how it made you feel? **** One of the greatest challenges I faced, as a student, was the Math class I needed for my degree. I place tested into the class, but, by the end of day one, I realized I was in way over my head. I persevered, however; I got help from tutors and teachers and, somehow, muddled through. It was the only class in which I did not receive an A, but I know that it was a class in which I put in everything I could to succeed. I felt like a loser and there were many days I just felt hopeless. **** How might this piece of history help you connect with your students? **** I would hope that having gone through those difficult times will make me more understanding and empathetic to the challenges my students are facing. **
 * What do I hope to learn in this class? **** I hope to learn all I can about inclusion and all that it entails. I hope to learn strategies to make me the best teacher I can be to those who may need a little extra in this world. I also hope that I either have, or will develop, the right kind and amount of compassion and empathy to promote the best level of results in all students with whom I have contact. **

**Traumatic Brain Injury ** A Traumatic Brain Injury (TBI) is an external injury suffered to the head. It usually occurs because of accidents, but can also occur as a result of child abuse. Traumatic Brain Injuries are most likely to occur in children 4 years old and younger, adolescents age 15 to 19, and seniors over the age of 65. Approximately 4% of boys and 2.5% of girls will sustain some type of TBI prior to age 16. There are almost a half million emergency room visits for TBI made annually by children age 14 and under. About 75% of TBI cases are concussions, or mild forms of TBI. The disabilities that result from TBI can range from mild to severe and include physical, cognitive, attention, memory, problem-solving and psychosoclal difficulties. This particular subject matter has no personal connection to me, I nor anyone close to me has suffered a TBI; I chose this subject out of interest and was happy to discover that March is Traumatic Brain Injury Awareness Month and I am pleased to bring some awareness about this disability to the class!



The Top 5 Things I Learned About Traumatic Brain Injuries 1. When a child starts to have problems in school and parents and teachers are searching for a cause, old injuries are frequently not remembered and therefore old TBIs are not a usual "go to" cause of disability. 2. Executive functioning skills are affected by Traumatic brain injuries. 3. There is no cure for a TBI; prevention is the key. 4. There are some interesting new research about TBIs, including an old flu drug being revamped as a new help for those suffering from a TBI and new thinking about many cases previously diagnosed as ALS now thought to be TBIs. 5. Traumatic Brain Injuries come in varying degrees with varying degrees of effects and teachers need to understand that TBI and Specific Learning Disabilities are not to be treated the same. While they have similarities, the learning process can be quite different. media type="custom" key="12767160" align="center"

This is my best resource on TBIs. It is the website [|www.brainline.org]. I give this site a 5 out of 5 because it covers just about everything a parent, teacher, medical professional, and people suffering from a TBI might want to research. It has all the latest research about TBIs as well as videos, resources, updates, personal stories, and experts available to answer questions about TBIs.

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This is a YouTube video about recognizing a TBI in the classroom. When a younger child suffers a TBI and then apparently recovers, people don't generally tend to recall that injury later on when the child is having trouble in school. Because the symptoms and behaviors may look like many different things, an old injury is often forgotten. I give this video a 4 out of 5 because awareness of a TBI is key to determining how to best help the student.

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This is a You Tube video with some personal case histories from people with TBIs. There is one from a young woman who, at age 15, was in a car accident and woke up from a coma with the brain of a 5 year old. Her story of success is rather inspirational. There is another personal story from a young man who is pursuing his college degree with the hope of someday becoming a researcher in the TBI field. Peppered in with these case histories are some experts discussing the latest in research. I give this video a 5 out of 5 because it is very engaging as well as informative. media type="custom" key="13063696"This entry is a slideshow from Slideshare.net. It's fairly short, only 12 slides, but there is a good slide describing educational strategies that teachers can use for students suffering from a TBI and another good slide describing assistive technologies. For those reasons I give this slideshow a 3 out of 5.

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This is a You Tube video about a teenager named Josh who suffered a TBI as a result of a skateboarding accident. This honest and articulate young man describes his sense of loss and feelings of hopelessness as he struggled to recover and move on with his life. I include this video for my classmates who will be teaching in high schools because I think it's important to understand how teens might cope after suffering a TBI. I give this video a 4 out of 5 for the insight that Josh gives us.

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<span style="color: #800000; font-family: 'Comic Sans MS',cursive; font-size: 150%;">This is a great You Tube video out of Texas that gives lots of facts and figures about TBIs. It also debunks some myths about TBIs, for both children and adults. It also goes over the varying degrees of brain injury and the varying degrees of effects of TBIs. I give this video a 5 out of 5 for having a lot of information.

media type="custom" key="13070308"<span style="color: #000080; font-family: 'Comic Sans MS',cursive; font-size: 150%;">This is an NPR article about how an old flu drug, Amantadine, is now being used, with good results as medicine for those who've suffered a TBI. I give this article a 5 out of 5 for being new and interesting information.

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<span style="color: #ff00ff; font-family: 'Comic Sans MS',cursive; font-size: 150%;">This is a You Tube video about differentiating between TBI and Specific Learning Disabilities when using educational strategies. I give it a 3 out of 5 because it's too short; more information would have been nice.

<span style="color: #ff00ff; font-family: 'Comic Sans MS',cursive; font-size: 150%;">media type="custom" key="13200640"<span style="color: #00ff38; font-family: 'Comic Sans MS',cursive; font-size: 130%;">This is an article that I found on Edutopia.org. It's not really about TBIs; it's about the connections between brain function and storytelling as a learning tool. The article does mention that children with brain injuries tend to be unable to have the higher functioning that is required to tell stories because storytelling involves using the various areas of the brain simultaneously. I give it 4 out of 5 because it's very interesting even though it's not strictly about brain injuries.

<span style="color: #ff00ff; font-family: 'Comic Sans MS',cursive; font-size: 150%;"><span style="color: #00ff38; font-family: 'Comic Sans MS',cursive; font-size: 130%;">media type="custom" key="13201354" <span style="color: #800000; font-family: 'Comic Sans MS',cursive; font-size: 130%;">This is the website for the Center for Brain Injury. There is a lot of good information for teachers here. There is a section on inclusion and teaching strategies as well as assistive technologies and more. I give this site a 5 out of 5 for being a quick and easy "go to" place for teachers who need ideas on how to help a student with a TBI.

**<span style="font-family: 'Comic Sans MS',cursive;">Speech/Language Pathology **  **<span style="font-family: 'Comic Sans MS',cursive;">A CBL Project **   **<span style="font-family: 'Comic Sans MS',cursive;">by ** **<span style="font-family: 'Comic Sans MS',cursive;">Carrie J. Gragg **

Carrie Gragg

ED 571 Inclusion Strategies

Instructor: Crum

January 27, 2012

CBL Project

** Speech and Language Pathology **

I chose Speech/Language Pathology for my project because I’ve always been interested in how specialists work with children with speech and language difficulties. One of the teachers for whom I volunteer, Mrs. Kimberly Wilson, arranged for me to meet Ms. Mary Berns, the Speech/Language Pathologist atParksideElementary SchoolinGrantsPass.Ms. Berns was more than accommodating, allowing me to interview her and sit in while she conducted sessions with students. We scheduled a date and time: January 23, 2012 at 10:00 a.m.

I arrived a few minutes early and was able to sit in while she finished up with “Douglas”* a first grader, who “does not learn well” according to Mary, in large part because of frequent absences from school. Mary explains to me that “Douglas” was evaluated several years ago at Head Start, but he “didn’t want to go” and his parents did not force him. She tells me that “Douglas” had only 11 consonant sounds as a Kindergartner, whereas 80% of most Kindergartners have all of their consonant sounds. Mary explains that there are “parent issues” with this student, but “Douglas’” sister, now a 4th grader, has been dismissed from Speech/Language services, having successfully accomplished her goals. “Douglas” is a cute and friendly child, with blue coloring in his hair and a welcoming smile. Today, Mary is working with him on “sp” sounds. She shows him a captioned picture of “a tiny sparrow”.

MB: “A tiny sparrow.” Get all the sounds in there and use good production”.

D: “A tiny parrow.”

MB: “Try again.”

D: “Spario.

“Douglas” recognizes his error and laughs.

MB: “Look at my mouth.”

D: “Spario.”

MB: “You got the “sp” in there-good.”

“Douglas” repeats the word many times.

MB: “Good, that’s not bad at all.”

Mary looks at a new phrase on the page.

MB: “Hold up one finger for each word. A-bowl-of-spinach. Where did you hear the “sp” sound, which word? And where did you hear the “ch” sound, at the end of which word?”

“Douglas” identifies where the “sp” and the “ch” sounds are found.

MB: “A bowl of spinach”. She moves her mouth with him as he repeats the phrase.

D: “A bowl of pinach”.

MB: “Do you want to correct that? Use your brain and feel your mouth.”

“Douglas” repeats the phrase several times, some of them came out quite well.

MB: “Very good-nice thinking!”

Mary then focuses on a new phrase: A space suit. She starts, again, by holding up one finger for each word and asks “Douglas” how many words there were. He correctly identifies three words. She then asks him to say the phrase.

D: “A space uit.”

MB: “A space uit?”

“Douglas” smiles, laughs and says no. Mary has him identify which word has the “sp” sound.

D: “A pace suit.” He makes this error several times.

MB: “What are you missing?”

D: “A “s”.” He clearly understands what is not right.

MB: “Good.”

At this point “Douglas’” session is over and he returns to class. Mary has a few minutes to explain his situation to me and then it’s time for “Evan’s”* appointment. He’s not at her office so we go off in search of him. His class has gone to P.E., but we run into him in the hallway. He knows me because I work in his classroom and he’s fine with me sitting in on his lesson. Today “Evan” is working on naming and grouping categories.

MB: “Remember that category means group, Evan. I will list three items and you name the group. OK, 3-10-4.”

E: “Numbers!”

MB: “Red-green-blue.”

E: “Colors!”

MB: “Sherry-Cindy-Lisa.”

E: “Names!”

MB: “What kind of names?”

E: “Girl names.”

MB: “Good. Swing-seesaw-slide.”

E: “Things you play on.”

MB: “Clue-Monopoly-checkers.”

E: “Board games.”

MB: “Sleeping bag-lantern-tent.”

E: “Camping stuff.”

The clues are getting more difficult and he needs to put more thought into the activity.

MB: “Salt-pepper-oregano-cinnamon.”

“Evan” struggles with this one; finally he suggests that these are foods, and with some help from Mary understands that these are things that flavor food. He’s not at all sure of the word “spice”.

MB: “Saw-knife-scissors.”

E: “They’re all sharp.” Mary discusses with him that while these are all sharp things, there are other sharp things, and eventually they arrive at the conclusion that these are all things that cut.

MB: “Santa Claus-Peter Pan-Easter Bunny.”

E: “They’re all people.”

MB: “The Easter Bunny isn’t a person!” She says this with great humor and we all laugh. She then discusses with “Evan” that all in this category are imaginary beings. Should she have told “Evan” that Santa Claus isn’t real? I’m not sure, but he took the news well enough.

MB: “Heart-liver-lungs.”

E: “All things in the body.”

MB: “Bicycle-skates-wagon.”

E: “Things you ride on.”

MB: “No.” She tells him that people don’t ride on skates. “Evan” gives this some thought and finally arrives at the answer.

E: “Things with wheels.”

MB: “Good! Basement-porch-attic.”

E: “Things you go in?”MB: “No.”

E: “Things you step on?”MB: “No.” She adds two clues. “Ceiling-wall.”

E: “Parts of a house.”

MB: “Right!”

E: (Smiling) “I’m getting everything right!”

I find myself wondering if the fact that I am present is affecting “Evan’s” lesson. Mary decides to move on to something new. She will give words in a category and “Evan” is to add something else in that category without naming the category.

MB: “Apple-cherry-banana.”

E: “All fruit.”

MB: “Add to the category.”

E: “Grapes!”

MB: “Good. Ankle-foot-neck.”

E: “Parts of the body.”

MB: “What are you supposed to do?”

E: “What again?”

MB: “Add to the category.”E: “Arm.”

MB: “Chalk-desk-notebook.”E: “Pencil!”

MB: “Ice-snow-popsicle.”E: “Ice cream.”

They discuss “Evan’s” thoughts on this. The clue “popsicle” following “ice” and “snow” threw him off, but he soon realizes what went wrong.

MB: “Do you know what you’re doing? Thinking!” She is quite pleased with him and he seems quite pleased with himself.

E: “Uh-huh.”

MB: “Yes, you are! Water-juice-milk.”

E: “Ocean.”

MB: “What’s the category?”

E: “They’re all wet.”

MB: “Right, but ocean doesn’t really fit. Try again.”

E: “Soda.”

MB: “Cake-pie-pudding.”

E: (Pauses).

MB: “I see you’re thinking-good!” She repeats the sequence. “What are they?”E: “Desserts. I can’t think of another one.”

MB: “Cookies?”

E: “Yes! Banana sundae!”

MB: “Cat-dog-skunk.”

E: “Rat!” He laughs at this one.

MB: “Brick-barbells-bowling ball. This is a hard one.”

E: “You use them?” Mary explains what barbells are to help him understand.

E: “Things that are metal?”

MB: “Bowling balls aren’t made of metal.”

E: “What are they made of?” We have a brief discussion about bowling balls.

E: “Things that are heavy?”

MB: “Ring-bracelet-locket.”

E: “Necklace.”

MB: “Nice! Very good!”

Mary begins a new activity. She pulls some cards out of a desk. Several objects are pictured and “Evan” is to identify which doesn’t belong and why. On the first card are an elephant, a tiger, and a dog. “Evan” says that the dog doesn’t belong because it’s a pet and the others are circus animals. Mary shows another card; on it are a dog, a bone, and a hat. “Evan” says this one is tricky and then he picked the hat. When asked why he replied that the others were pets. Mary tells him that a bone is not a pet and explains. “Evan” replies that the dog chews on the bone and the dog would chew up a hat, too. Perhaps his experience with dogs makes this true and makes his reasoning make more sense. Mary then shows a picture of a lion, an elephant, and a toaster. “Evan” says that the toaster doesn’t belong because it’s not an animal. The next picture is of silverware and “Evan” needs some explanation about the difference between silverware and plates. The last picture is of instruments. After he answers correctly, Mary asks him to name some other instruments. He names the violin, the viola and then says “computer”. Mary tells him that the computer is not an instrument. I understand (because my son is in his class and they’ve been studying instruments and are starting to play recorders) that he meant “recorder”. I made a mental note of this and said something to Mary afterward. She immediately understood that must be the case and she believed that he was trying to say “recorder” (the whole class is very excited about recorders right now). Mary then talks to “Evan” about making mental pictures of things that he sees so that he can recall them later. He listens intently to her. The lesson is over now and “Evan” is smiling; he seems to feel really good about today’s progress. Mary and I say goodbye to him.

MB: “Good, Evan!!”

E: “It’s easy!”

After “Evan” leaves, Mary fills me in on his case. He’d been in and out of different schools from Kindergarten through 2nd grade. He started at Parkside at the beginning of this year (3rd grade). His mother had him assessed at CDRC (Child Development andRehabilitationCenter) inGrantsPass. An IEP was created for him just prior to the Thanksgiving holiday and he began receiving special services right after the holiday. He has an expressive communication disorder that is impacting his ability to learn in the classroom. She says he is responding to therapy quite well and is progressing.

Mary’s next appointment is with “John”*, another 3rd grader. He, too, fails to arrive at the appointed time, so we go in search of him. We find his class in the music room and Mary pulls him out for his lesson. Before we get to him, Mary tells me that I will see quite a difference between “John” and “Evan”. “John” has trouble pronouncing his “R” sounds for one thing, and is also developmentally behind “Evan”. Once again, Mary starts with naming categories. She must explain to him that the items will have “something in common”.

MB: “Red-blue-green.”

J: “Colors.”

MB: “I’m so proud of you, John. Let’s keep track of how many you get!” She makes a chart on her white board.

MB: “B-Q-R.”

J: “Letters!”

MB: “3-10-4.”

J: “Numbers?” He’s not sure.

MB: “That’s right. You are good! Doll-truck-ball.”

J: “This is hard.” He hesitates.

MB: “Let your brain think, John.”

J: “Toys.”

MB: “Meat-cereal-fruit.”J: “Food.”

MB: “Chair-table-bed.”

J: “Soft-no.” He pauses.

MB: “Why is it not soft?”

J: “Because table isn’t soft. Things made of wood.”

MB: “Does that go with all three?”

J: “The bed is not made of wood.” We discuss what beds can be made of. Mary tries a new one.

MB: “Sherry-Cindy-Louise.”

J: “Girls.”

MB: “Girls what?”

J: “Girl’s names!”

MB: “Good! Spot-Rover-Blackie.”

J: “Dog’s names!”

MB: “Slipper-boo…”

J: “Shoes!”

MB: “Wait for the whole list, John. Slipper-boot-sandal.”

J: “Shoes!”

MB: “Shoes can be part of this group.” He hesitates.

MB: “What can we do with them?”

J: “Put them on our feet!”

MB: “Diamond-square-pentagon.”

J: “Shapes.”

MB: “Peanut butter-ham-egg salad.”

J: “Food.”

MB: “Be more specific. What do they have in common?” He hesitates and we discover that he doesn’t know what egg salad is. Mary explains and he finally understands that they are types of sandwiches. Next Mary gives him three items in a group and “John” must say another item in the category.

MB: “Apple-cherry-banana.”

J: “Peach!”

MB: “Ankle-foot-neck.”

J: “Bones. I mean, body.”

MB: “Remember, give me another one in the group.”

J: “Arm.”

We do several more of these and “John” has a tendency to try and give answer before hearing all three clues. He also needs continual reminding to not name the category, just give a fourth example.

MB: “Candy-chips-pretzels.”

J: (Thinking hard) “Chips?”

MB: “We said that.”

J: “Candy bar?”

MB: “We said candy.”

J: “Snacks?”

MB: “Good.”

MB: “John, that was really, really good!” He is pleased that the tally marks on the board are mostly on the plus side. Next, Mary has “John” look at a page with 5 pictures on it. Mary tells him that the directions are to 1) listen, 2) use your brain to think, and 3) do it.

MB: “Color the hat of the man who builds walls blue.” He does this. She continues on with the task directions. He must identify the correct picture, then remember which part to color and what color to use. At one point he identifies a farmer and joyfully exclaims, “I just said an R word!” We finish out his lesson on this page and then “John” returns to class. Mary tells me that he is quite a bit behind his grade level and is not progressing as fast as she would like. She says he has issues with making word connections.

We conclude the morning with my interview about Mary and her job. She tells me that she got her undergraduate degree and her master’s degree in Communication Disorders and that she’s been doing this work for 34 years. Her formal title is Mary Berns, MA, CCC-SLP. She absolutely LOVES her work and finds much satisfaction in it. She’s been in the field since 1978 and has spent time overseas working in places such asHolland(which she loved) andSingapore. She says the pay is quite good, as well. She says that with such degrees as she has, she can find work not only in Education, but also in fields such as Physical Therapy, Occupational Therapy, hospitals, private home visits, nursing homes, medical centers, and other types of educational areas. She has worked with people who have problems with speech and language due to accidents, stroke, drug and alcohol issues, cancer, tracheotomy and other issues. She says there is a big need in this field right now.

I asked about her work at Parkside (and schools, in general). She enjoys being autonomous and likes the huge variety of situations she deals with as well as the one-on-one work with students. Right now, she is working at Parkside almost full-time, but she also has students atGrants PassHigh Schooland she is helping out part-time atAllendaleSchoolandRedwoodSchoolbecause the case loads are more than their staff can handle. She said that a yearly average of students with whom she works at Parkside is about 10% of the school population. Parkside has between 400 and 500 students this year. She says that the best caseload size is 40-50 kids so she is kept quite busy. She tells me that she is her own district representative and works on IEPs for students throughout the year. She says that evaluations are done if there are issues in the classroom and that services are rendered if, and only if, a student’s education is being impacted. She showed me some IEPs and the disability and disorder codes by which the special education teachers figure out eligibility for services.

I enjoyed my morning with Mary very much. I found her type of teaching and helping students to be rewarding, interesting, and very valuable. I could very much appreciate the one-on-one aspect of working with students. I learned a lot about Speech/Language Therapy and how it’s much, much more than helping student’s speak properly. There are many aspects to this job. Mary said to me that she was pleased to be able to share what she does; she’s noticed that many people are rather unclear about the depth and variety of services she provides. In fact, she told me that once, years ago, a principal said to her, “Don’t you just work on S’s and R’s (lisps)?” I think she enjoyed discussing her beloved career as much as I enjoyed learning something new. I thanked Mary for sharing her work and her students with me, and, with her permission, got her email address for any follow-up or questions. She was eager to answer any questions I might have and encouraged me to come see her again. I followed up with a “thank you” email and I’m sure I’ll be seeing and talking to her at Parkside in the future.


 * To maintain confidentiality, the names of the students have been changed.

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