Supporting children with brain injuries

Issue: Volume 98, Number 14

Posted: 16 August 2019
Reference #: 1H9x2J

Children living with brain injuries say it’s like running out of money when it costs 25 cents to get out of bed and you only have $1.75 left for the rest of the day. A new guide from the Ministry of Education helps teachers notice when children with brain injuries need support to rebuild their reserves.

Titahi Bay School principal Kerry Delaney has made provisions to help pupils with acquired brain injury (ABI), but she didn’t really understand the impact of this kind of injury until she had a bad fall, hitting her head in August 2017.

“I was taken to hospital in an ambulance. I left hospital the next day and thought I was fine, and of course I wasn’t. I went to my doctor who got me into the ABI clinic in Tawa and I started working with someone to get me back to work,” she says.

For the first three to six months Kerry was unable to work her usual long hours. She suffered from fatigue, had trouble with her speech and found going up and down steps difficult as her depth perception was impaired.

“I suppose I didn’t realise the impact, but other people around me did. I’m a principal, so I keep lots of things in my head at one time – I wasn’t able to do that.

“I didn’t attend a school assembly or pōwhiri in this school for six months because I couldn’t take all the noise. It would literally bring tears to my eyes. I couldn’t drive; one of my lovely staff would pick me up from home – because I needed to be attached, otherwise you feel quite isolated – and drop me off at school and we would just see how it went,” she says.

Recovery plan

The key to recovery after a brain injury is to act on how you’re feeling and what your body is telling you.

“It’s all very well to sit there with ACC and say I’m going to work an hour and a half a day,” says Kerry, “but some days you will work two-and-a-half hours and the next day only manage half an hour. My staff were really good; they realised they had to go to other people on our staff and my Board was stunning.”

An occupational therapist friend talked to Kerry and her family about the need for her to think about ‘banking’ time – like money – for a rainy day. Following this, Kerry made sure that she had downtime before and after social or work conversations or events.

“If I hadn’t had a plan from the beginning, I’d say it would have taken me a lot longer to get back to work. What you do in those early days is really, really important and actually, even now, if I’ve had a big day of meetings, I know that I need to have some quiet time” she says.

KURA – kindness, unity, respect and achieve

All around Titahi Bay School there are aspirational slogans relating to the school’s values, such as ‘KURA stands for kindness, unity, respect and achieve’. Kerry says these values are for children and teachers, who, along with her deputy principal, PA, community and the board, all helped her recovery.

“It’s not a broken leg; you don’t change how you look so it’s hard for people to realise it has an impact on you,” she says.

It took about 12 months for Kerry to get back on her feet. She says that even now, if she’s in a lot of meetings one after another, she needs to stop, have a cup of tea and some time to herself.

New awareness

Since her accident, Kerry has a whole new awareness of the challenges faced by children with ABIs. The school now notifies parents every time a child has a knock to the head.

“I have realised that little children normalise things really fast and so you don’t know the impact of what that’s done. If a child has had a concussion or something go wrong, I ring that parent and say, ‘no digital, no TV, make sure they have rest times’ – that sort of thing.”

Fatigue after a brain injury can be debilitating and impact a child’s moods and behaviour.

“If that child is overloaded and there’s too much sensory stuff – a school show, or a big assembly that’s really noisy – we take them out or give them the chance to have a break. We say ‘give us a little sign if you need a break…’.

“That’s another thing with our children who have had an injury – have a look; look at their eyes, how they are sitting and going, and say to them, ‘It’s time for you to leave’. The fatigue after a brain injury can knock you out.”

School support

Students at Titahi Bay School who have had a brain injury or concussion come under an individual education plan (IEP). If the child needs a teacher aide, funding is sought from the Ministry of Education or ACC, or the school will fund a position.

“It’s our job to make sure that that child is a success. They might have a sensory overload with what they are doing, so we will break the learning down into little bits.”

Before Kerry’s accident, a parent approached her to ask if the playground could be painted so his child with a brain injury could see the depth of the equipment. It was painted yellow, steps around the school were delineated in the same colour and handrails were installed.

“I now understand that when you are playing, you get tired and when you get tired, you struggle. And it won’t just be that child. Many children fall over, many children have concussions or injuries so it’s helping all of them.”

Silver lining

Kerry’s accident has changed the way she runs the school “I’m probably a better leader and that’s because I have a belief that there are others around me who can do the job just as well as I can and I don’t have to be in every space,” she says.

New brain injury guide

The Ministry of Education has released a guide for school leaders and teachers(external link) to help them support students to recover and return to learning after a brain injury.

The guide examines the impact of brain injury on emotions, social skills, behaviour, wairua, cognition, thinking and physical being. Ideas for transition plans and supporting students are given.

Students with ABIs may get lost, stuck, or be off-task more than most learners. The guidelines suggest ways to help learners who struggle to concentrate or get sensory overload. An organised and calm learning environment and a flexible, well-structured classroom programme can make a lot of difference for a range of students.

BY Education Gazette editors
Education Gazette | Tukutuku Kōrero, reporter@edgazette.govt.nz

Posted: 2:33 pm, 16 August 2019

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