What Is A TBI?

  • The Center for Disease Control and Prevention (CDC) defines a TBI as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head or a penetrating head injury (Centers for Disease Control and Prevention, 2014). A disruption in the normal functioning occurs when any one of the following symptoms occurs:

    • Any period of loss of or decreased consciousness;
    • Any loss of memory for events immediately before or after the injury;
    • Neurologic deficits such as muscle weakness, loss of balance or coordination, disruption of vision, change in speech and language, or sensory loss;
    • Any alteration in mental state at the time of injury such as confusion, disorientation, slowed thinking, or difficulty with concentration. (Centers for Disease Control and Prevention, 2014)

    There is a difference between Acquired Brain Injury (ABI) and Traumatic Brain Injury (TBI). An acquired brain injury is brain damage caused by events after birth, rather than as part of a genetic or congenital disorder, while a traumatic brain injury occurs only when an external force traumatically injures the brain. A traumatic brain injury is a type of acquired brain injury, but all acquired brain injuries are not traumatic brain injuries.

    A TBI can be classified as mild, moderate or severe, depending on the extent of damage to the brain. However, the term “mild” can be deceiving. Even a concussion can have long-term effects, especially if additional concussions occur. The effects can be cumulative. With any TBI, symptom manifestations can be delayed or intensified as the student ages and reaches the next developmental level, where cognitive tasks become more complex. For this reason, many times parents and educators may not associate the student’s academic struggles or behavioral changes with a traumatic brain injury that occurred years before.

    When a student sustains a brain injury, his/her educational and emotional needs are often very different than before the injury. As a result, some, but not all students, may require special education services. Federal regulations and state rules define TBI as a special education eligibility category.

    Federal Definition:

    Individuals with Disabilities Act (IDEA) 2004 34 Code of Federal Regulations (CFR)

    • 300.8 Student with a Disability (c)(12)

    Traumatic brain injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a student’s education performance.

    Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative or to brain injuries induced by birth trauma.

    State (Texas) Definition:

    Texas Commissioner’s Rules 19 Texas Administrative Code

    • 89.1040 Eligibility Criteria (c)(11)

    Traumatic Brain injury: A student with a traumatic brain injury is one who has been determined to meet the criteria for traumatic brain injury as stated in 34 CFR, §300.8©(12). The multidisciplinary team that collects or reviews evaluation data in connection with the determination of a student’s eligibility based on a traumatic brain injury must include a licensed physician, in addition to a licensed specialist in school psychology (LSSP), an educational diagnostician, or other appropriately certified or licensed practitioner with experience and training in the area of the disability.

    Additional State Law Related to Concussions

    The Texas Legislature passed HB 2038, and it was signed into law in 2011. HB 2038 defines a concussion as “a complex pathophysiological process affecting the brain caused by a traumatic physical force or impact to the head or body, which may: a) include temporary or prolonged altered brain function resulting in physical, cognitive, or emotional symptoms or altered sleep patterns and b) involve loss of consciousness.” It mandates that each school district have a concussion oversight team that designs and implements the protocol for the diagnosis, treatment, and return to play of any student athlete who sustains a concussion. Texas Education Code (TEC) Section 38.151 – 38.160 clarifies the related expectations for school districts.  The University Interscholastic League (UIL) has developed a guidance for compliance document.