Psychology of Learning
A traumatic brain injury refers to injuries that a person sustains when they get a brutal blow on the head or the body. Different incidents may cause injuries such as being shot, falls or objects that may pierce the skull or shatter it. There are different types of traumatic brain injuries, such as closed or penetrative injuries. In this case, the object does not enter the brain, but the brain hits the skull at the point of impact. There are also concussions and contusions where in concussions, there is no single point of brain damage, and the bruise is widespread, but in contusion, there is a single point where the brain sustains a bruise. In some cases, traumatic events result when the brain does not get sufficient oxygen. The diffuse axonal injury occurs when the head is revolved at a very high speed, and this results in multiple brain damage. A student who has experienced any form of traumatic head injury can be identified by changes in their behavioural, emotional and personality changes (Prasad, Swank & Ewing-Cobbs, 2017). They exhibit an increase in anxiety, lack of motivation, augmented impulsivity and impaired judgment. They also show lessened cognitive abilities such as a reduction in the level of concentration span, challenges remembering what they learned, difficulty in solving problems and also finding it hard to comprehend new information. In some cases, head injuries may lead to loss of some senses, such as vision, hearing and loss of balance. The students may experience some physical changes, such as difficulty in walking, completing some physical duties, and they experience sleeping problems. These factors impact the ability of the student to learn, and therefore this essay will focus on the impact of head trauma or injury on learning.
Purpose
The traumatic head injury is among the leading causes of disability among children. Traumatic head injuries have been categorized as being a chronic illness that induces an ongoing and possibly a life change to the organs of the body. Some of the possible consequences that have been occasioned by traumatic head injuries include impairment in cognition, inability to adapt, psychological health of the student is affected, and the student has challenges academically. The educational functioning of the student is vital since it is among the most critical development aspects of a child. Therefore, it is paramount to understand the impact of head injuries on the learning outcomes of students. By understanding the impact of the traumatic head injuries on learning, it will be instrumental in earmarking areas of improvement in the learning environment of such students, such that they benefit to the maximum from the school curriculum. Therefore, this essay will focus on traumatic head injuries and try to establish whether there is a connection with the learning outcomes of the student.
Research methods
Prasad, Swank and Ewing-Cobbs (2017) studied the long term school outcomes of children and adolescents with traumatic head injuries using a cross-sectional research design. This method was vital for this research since it helped to establish whether the impact of traumatic head injuries was permanent, or it changed along the academic ladder. The researchers corrected the academic records of the students at the kindergarten level, and later, they traced their progress at the upper level. The researchers further determined the severity of the traumatic head injuries using the Glasgow Coma Score (GCS), which measures the lowest post-resuscitation time. The severity was classified using the acute computed tomography or the brain Magnetic Resonance Imaging (MRI). This helped to classify the students so that recording and comparison could be possible. The classification was either mild, moderate or complicated. The performance level was compared with that of the healthy students to identify any deviation in the academic outcomes.
Ewing-Cobbs et al. (2006) investigated the impact of late intellectual and academic outcomes that resulted from head injuries that a student sustained from an early age. This study used a longitudinal research design. The study traced the progress of children who had incurred traumatic head injuries. The longitudinal intelligence scores were conducted at the age of 2,12, and after 24 months. The investigation was continued after the children enrolled in schools. The researchers also tracked their long term IQ, their academic achievements and the extent of classroom placement to identify the changes that were taking place in a child. Taylor et al. (2008) also investigated the impact of brain injuries on children, its impact on cognitive abilities and readiness of the child for school using a longitudinal approach. Through this method, the researchers were able to make a comparison of post-acute neuropsychological and the academic skills that the students demonstrated. This research investigated students who had varying degrees of severity of the brain and head damage. Fulton et al. (2012) also used a multi-site longitudinal research design to investigate the cognitive predictors of academic achievements in children after one year since they suffered traumatic head injuries. The use of a multi-site approach was pivotal in enabling the researchers to identify whether there were significant changes in the cognitive abilities of the children after one year since they suffered traumatic head injuries.
Arnett et al. (2013) used a randomized clinical trial technique in identifying the behavioural and cognitive predictors of educational outcomes in children who suffered from head injuries. This technique enabled the researchers to compare the efficacy of two interventions of the Counselor Assisted Problem Solving (CAPS) and Internet Resource Comparisons (IRC) to identify whether the intervention would influence the educational outcomes of the students.
From the studies reviewed, they show that traumatic head injuries are studied using cross-sectional and longitudinal study designs. In a few cases, it is also studied using randomized clinical trials.
Research Results
Taylor et al. (2008) appreciated that some cognitive measures are essential to assess the extent of the injuries. According to Tylor, the tests that should be used in assessing cognitive impairment in children include the copying designs, ability to recall digital tests, sentence memory tests, ability to remember picture’s, capacity to remember a story and shapes depicted in schools’ switchboard. These tests can identify the severe cases, while in less severe cases, the memory measures and using different shapes may be used. In assessing school readiness skills, some tests can be sued, such as GCS score, the coma duration tests, and neuroimaging abnormality may be used.
From the research findings, it was observed that educational issues that arise from injury to the head become more visible as children progress and as they grow old. It has been found out that such children are at a higher risk of falling behind their peers academically. This situation is exacerbated by a lack of support services for such students. This is the case with students with mild and complicated traumatic head injuries. Furthermore, there are also cases where educators do not identify the needs of such students, and this makes the students have challenges in learning (Prasad, Swank & Ewing-Cobbs, 2017).
Prasad, Swank and Ewing-Cobbs (2017) recognized that educational issues are evident when the students encounter more demanding tasks. Furthermore, research has shown that children are likely to be more vulnerable to the adverse educational effects of traumatic head injuries. However, such children are likely to benefit from educational support services than students who get injuries when they are grown. Furthermore, children who suffer from head injuries when they are young can be educated in a self-contained room, which offers less restriction than the regular classrooms where there is a lot of restrictions. However, these children have been found to have reduced functional skills such as readings, writing and calculation capabilities. Even as students’ progress they continue to show poor academic outcomes, they have poor grade retention, and their scores are generally lower than the normal students,
There has also been an issue where some children get head injuries, but they are not recognized at the right time, and this limits the chances of getting assistance academically. This makes the student continue having educational challenges as they progress.
It has also been recognized that the parents of students with traumatic head injuries do not connect with schools to identify how the children are progressing and how to help such children. Thus, the parents are not aware of the long term effects of head injuries on their children until it is manifested in academic failure or when peers segregate their children. In this case, the adverse effects of the students with traumatic head injuries are underestimated, and thus they end up failing in their academics (Prasad, Swank & Ewing-Cobbs, 2017).
Further investigations revealed that children who had experienced head injuries were more likely to fail a grade. The student with severe head injuries required to be kept in a separate room for at least two major subjects. They were also required to be in a separate room for at least a full or partial day to learn. In some cases, because of challenges in learning, the students required to get content mastery services or they necessitated the mode of instruction to be changed within the regular classroom setting so that the children could be able to catch up with the others. Furthermore, some of the students required that they receive some rehabilitation services that would enable them to cope with classroom requirements. Some of the services they received include speech, physical and occupational therapies in school as they continue with learning (Ewing-Cobbs et al., 2006).
A study that was conducted assessing students from the same sociodemographic circumstances indicated that students with traumatic head injuries scored lower in tests that involved the vocabulary mastery, the verbal short term memory and also visual-spatial learning abilities were too low. The reduction in academic performance for the students was observed in areas such as poor word decoding, lack of writing fluency, difficulties in understanding passages, and challenges in the retrieval of mathematical concepts. Children with traumatic head injuries were also seen to show challenges in demonstrating critical reasoning that was required after reading a passage to understand the content and do a mathematical calculation. Notably, the influence was observed to be low in all the areas of academics (Ewing-Cobbs et al., 2006). The challenge in academic performance for the children who had traumatic head injuries were observed to be lower by 18 times than those of normal children.
According to the research conducted, it was recognized that some factors worsened the academic outcomes of children who had traumatic head injuries, which included the social, economic and the family environment of the child. If the child with a traumatic head injury was brought up in such a situation, they had a reduced probability of improving, and this made them experience difficulties in learning. The research also established that there was a correlation between the extent of the injury and the academic outcome of the child. Furthermore, the age at which the student sustained the injuries was not significant, including the educational outcome. Students who suffered the injuries as infants or during the preschool years showed the same extent of deterioration in academic performance. Furthermore, the families that had access to financial resources and the social environment was suitable for the child, there was a slight improvement in the cognitive and reading scores, but this did not affect much the mathematics and the academic performance of the children (Ewing-Cobbs et l., 2006).
Taylor et al. (2008) also established those head injuries that are sustained by children when they are young impair their cognitive abilities, and this makes them have a deficiency in demonstrating school readiness skills. Taylor observed that some skills are more affected than others, such as spatial reasoning, executive functioning, and memory are more likely to be adversely affected than language skills.
Furthermore, Taylor also observed that children who had moderate head injuries exhibited impairment in fewer areas than those who sustained severe injuries. Therefore, the number of areas where children with moderate impairment showed difficulties were less as compared to those with severe traumatic brain injuries. Additionally, the age of a child was not a substantial factor in showing the degree of injuries that were sustained when a child was young.
It was also confirmed that students who hail from families with higher socioeconomic status had better performance than those from low socioeconomic status. The race was also seen to be a contributing factor where some races showed more mediocre academic performance than others (Fulton et al., 2015). However, even though students from high socioeconomic status were able to show higher education outcomes, it was not clear why the observation was that way since this relationship is not known. However, it was hypothesized that probably the high intellectual capacity of the parents, access to a broader resource base, which allowed the parents to afford rehabilitation services might have contributed to such children showing better academic outcomes as compared to those from low-income families. However, this relationship did not hold in special schools for children with traumatic head injuries. Therefore, it meant that access to resources did not guarantee better education outcomes for the students, even if such families could have the ability to afford tutors who may help the students with their academics.
Dettmer et al. (2014) come up with several recommendations that may help to dress the challenge of poor educational outcomes for the students with traumatic head injuries. One of the advice was to expand the special education for those students. When students with traumatic head injuries are mixed with the other students, they may not learn at the same pace, and this contributes to poor academic outcomes. Therefore, the expansion of these services will be vital in helping them to perform better. Furthermore, identification of these students early enough will be critical in helping the students to perform better in school. One of the significant issues that have been identified in the research is that there is a late identification of students with traumatic head injuries, and this makes them continue to show poor academic performance. Addressing the problem will be crucial in promoting the performance of these students.
Conclusion
From the research, it has been demonstrated that traumatic head injuries result in poor academic performance of the students. They have problems with learning due to a deficiency in essential skills such as spatial reasoning and reading skills. Furthermore, it has also been demonstrated that such students have poor mathematical or computational skills that impact negatively on their academic performance in schools. The problem has been shown to be aggravated by low socioeconomic incomes, poor family support and late identification of the problem. When the problem is identified late, it means that such students do not get the essential support services. Because of the reduced learning ability, the students are forced to have separate rooms where they are coached or have the instruction modified in a typical class for them to understand. The effects on the academic performance correlate with the severity of the injury that a student sustained, with those with severe injuries being affected in most of the areas. However, the age at which the student suffered the injury was not significant in determining the academic performance for the students. There are various tests that can be used to teste the severity of the injury, and therefore there is a need to use those that relate to the symptoms of the students, whether mild, moderate or severe.
Limitations
One of the limitations of the findings is the cross-sectional investigation conducted by some researchers. It brings a limitation since it is not possible to track the progress of students from childhood to adolescence. Some of the findings on the result were based on a limited sample, and therefore it is not known whether the same results can be replicated if a larger sample was used. Since there are few students with a mild traumatic head injury, it is essential to establish a clear distinction of what happens in the various degrees of injury from mild, moderate to severe.
Future research can be made better by tracking the progress of the students from infancy to adolescence. In the future, there is a need to use a larger sample so that the results can be more credible. Future research should focus on identifying the changes that take place from the time the child is injured when they are out of school to ascertain the changes that take place. There is also a need to include the post-injury behavioural changes in students and further analyze the contribution of family factors in the entire process. This will help to show the role of socioeconomic status in better academic outcomes for students with a traumatic head injury.
References
Arnett, A. B., Peterson, R. L., Kirkwood, M. W., Taylor, H. G., Stancin, T., Brown, T. M., & Wade, S. L. (2013). Behavioural and cognitive predictors of educational outcomes in pediatric traumatic brain injury. Journal of the International Neuropsychological Society, 19(8), 881-889. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160234/
Dettmer, J., Ettel, D., Glang, A., & McAvoy, K. (2014). Building statewide infrastructure for effective educational services for students with TBI: Promising practices and recommendations. The Journal of Head Trauma Rehabilitation, 29(3), 224-232. https://sci-hub.tw/10.1097/HTR.0b013e3182a1cd68
Ewing-Cobbs, L., Prasad, M. R., Kramer, L., Cox, C. S., Baumgartner, J., Fletcher, S., … & Swank, P. (2006). Late intellectual and academic outcomes following a traumatic brain injury sustained during early childhood. Journal of Neurosurgery: Pediatrics, 105(4), 287-296. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2615233/
Fulton, J. B., Yeates, K. O., Taylor, H. G., Walz, N. C., & Wade, S. L. (2012). Cognitive predictors of academic achievement in young children 1 year after traumatic brain injury. Neuropsychology, 26(3), 314. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349431/
Prasad, M. R., Swank, P. R., & Ewing-Cobbs, L. (2017). Long-term school outcomes of children and adolescents with traumatic brain injury. The Journal of head trauma rehabilitation, 32(1), E24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967046/#:~:text=TBI%20is%20viewed%20as%20a,adaptive%20behavior%2C%20and%20academic%20functioning.
Taylor, H. G., Swartwout, M. D., Yeates, K. O., Walz, N. C., Stancin, T., & Wade, S. L. (2008). Traumatic brain injury in young children: post-acute effects on cognitive and school readiness skills. Journal of the International Neuropsychological Society, 14(5), 734-745. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733858/