By Adam Stone, Phd Student (SLaLS)
While Traumatic Brain Injury (TBI) can be a source of significant impairment toward learning in the classroom, there are several measures put in place at Carleton University that help accommodate those who face obstacles to their academic success. In practice however, there are several challenges to effectively accommodate students with TBI, first and foremost due to the high variability of symptoms and prognoses. In my own experience as a Teaching Assistant, a student’s long recovery time required the instructor and I to make significant adjustments to their involvement in group activity work and adherence to due dates, necessitating extensive communication and improvisation. To be better prepared to accommodate students with TBI and impairments of a similar functional nature, I would wish to implement strategies that are tailor-made, flexible in nature, and permit alternative assignments and due dates that extend past what is typically acceptable for the end of a semester.
Carleton University has a long and evolving tradition of accommodating those who have different learning and working needs, starting with the Attendant Services Program in 1986 followed by (and not limited to) the Carleton Disabilities Awareness Centre (CDAC) in 1988, the Paul Menton Centre for Students with Disabilities (PMC) in 1990, and Carleton’s Co-ordinated Accessibility Strategy in 2018. Furthermore, online training modules such as Accessibility for Ontarians Employment Act (AODA) Training better equip workers and educators to create accessible spaces, while the Universal Instructional Design (UID) approach provides individualized and flexible means to accommodating individual needs. However, much of the Carleton discourse surrounding the accommodation of disabilities in the classroom appear to consider learners’ needs as fixed and stable, at least to the scale of a single semester. While this is of no doubt reasonable for many learners, others may face more transitionary challenges that are significantly impairing in nature but change rapidly over time. As a Teaching Assistant, I encountered one such case in which a student of mine suffered from a serious concussion.
Traumatic Brain Injury (TBI) can be defined as damage to the brain due to either a contact injury (such as a fall), or rapid acceleration or deceleration, such as an automobile accident (Werner & Englehard, 2007, p.4). Importantly, Langlois, Rutland-Brown, and Wald (2006, p.376) note that TBI can result in long-term physical, cognitive, behavioural, and emotional impairments. During the 2019 Fall semester, a conscientious and motivated student—enrolled in the class I was a Teaching Assistant in—suffered from a mild TBI, commonly referred to as a concussion (Hayden et al., 2007, p.431). While the long-lasting extent of the injury was (and remains) unclear, this student was unable to read or interact with any digital devices for two weeks and could not physically attend lectures for a further two weeks.
As group activities, coursework, and regular assignments involving intricate software were major components of the course, my instructor focused on making changes to the student’s deadlines and assignment requirements, while I negotiated alternative ways of contacting her so that she was not required to read or make use of device screens. Upon returning to class however, this student faced new participation challenges in the classroom environment, including attentional deficits, behavioural control issues, and impaired memory, requiring my instructor and I to assume entirely new accommodative approaches. While this student was eager to continue as an active member of the classroom and complete coursework, several logistical issues soon became apparent. Much of the coursework had a digital component, meaning that alternative assignments had to be devised to enable the student to achieve comparable credit. Once the student returned with a different set of needs however, additional accommodations had to be made in the form of deadlines that—all other things being equal—would have needed to have been extended past the final examination period into the Winter semester.
These shifting and dynamic learning needs effectively meant that my instructor and I needed to improvise our approach extensively to facilitate accessibility in a constructive manner. However, our ability to accommodate the student successfully was hampered by the rapidly changing conditions and rigid systemic factors such as the due dates. While the student was able to complete the course with a passing grade, it was lower than it would have been were TBI not present, given the student’s academic record. Instead of being the fault of the instructor, who worked tirelessly with the student to devise an appropriate accommodation strategy, I believe the difficulties encountered in accommodating this student stemmed from a lack of available procedures surrounding the facilitation of accessibility in such rapidly changing circumstances.
Were I given the opportunity to teach in a classroom setting, I would wish to have access to procedural resources specifically developed for dynamic obstacles to learning, such as TBI; indeed, many of us with and without current disabilities will get a concussion in our lifetime. Similarly, I would wish for such resources to be made readily available for any Teaching Assistants in my roster. Such resources would need to include aspects from existing resources available to the Carleton community, such as the flexible instruction component of UID (Rose & Meyer, 2002) and the collaborative aspect of the READ Initiative’s Trends and Best Practices Environmental Scan (Stevenson & Mellway, 2016). Additionally, I would wish for greater flexibility from the university’s administration in terms of when grades could be uploaded and finalized. While each case of TBI (and other arguably dynamic learning impairments) is unique and requires individualized approaches, dynamically oriented procedural resources would ideally act as a general template from which appropriate and collaborative measures could be effectively and confidently enacted.
While every learner has unique strengths and challenges, those with conditions such as TBI encounter regularly changing and unanticipated obstacles that require improvisation and collaboration from learner and instructor alike. With flexible and individualized procedures that account for changing circumstances, specific obstacles to learning could be minimized and educators could more effectively deal with unexpected challenges. At the same time, additional flexibility on part of university administrations would augment such a procedure’s efficacy. While this article serves to identify this issue and propose general forward-looking ideas, future work in this area must devise more concrete and tangible means for addressing Traumatic Brain Injury in the classroom and would ideally be integrated into existing action plans.
Hayden, M. G., Jandial, R., Duenas, H. A., Mahajan, R., & Levy, M. (2007). Pediatric concussions in sports; a simple and rapid assessment tool for concussive injury in children and adults. Child’s nervous system, 23(4), 431.
Langlois, J. A., Rutland-Brown, W., & Wald, M. M. (2006). The epidemiology and impact of traumatic brain injury: a brief overview. The Journal of head trauma rehabilitation, 21(5), 375-378.
Rose, D.H., and Meyer, A. (2002). Teaching every student in the digital age: Universal Design for Learning. Alexandria, VA: Association for Supervision and Curriculum Development.
Stevenson, D., & Mellway, D. (2016). Preparing for Employment – Trends and Best Practices: an environmental scan of programs and collaboration between Disability Service Offices (DSO’s) and Career Service Offices (CSO’s) at Colleges and Universities across Canada. Report by the READ (Research, Education, Accessibility, and Design) Initiative. Carleton University.
Werner, C., & Engelhard, K. (2007). Pathophysiology of traumatic brain injury. BJA: British Journal of Anaesthesia, 99(1), 4-9.