Acquired Brain Injury (ABI)

Acquired brain injury (ABI) is any type of injury to the brain that occurs after birth. It can result from trauma, hypoxia, infection, substance abuse, degenerative neurological disease, or stroke.

Impact of ABI

The impact depends not only on the cause, but also on which area of the brain suffers damage. ABI can affect a person’s physical, cognitive or emotional functions or, in some cases, all three. This can have serious consequences for the person's level of independence.

It is common for many people with ABI to experience increased mental and physical fatigue and some slowing down in the speed with which they process information and solve problems. They may experience changes in their behaviour and personality, physical and sensory abilities, or thinking and learning. These changes can result in significant implications for full participation in education, employment and other aspects of life. Relationships with families, friends and carers can also be affected by behavioural personality and changes.

Teaching Strategies

There is a range of inclusive teaching strategies that can assist all students to learn but there are some specific strategies that are useful in teaching a group which includes students with ABI. Strategies used will need to address the student’s specific physical, cognitive or emotional limitations or a combination of these.

They include:

Provision of recorded lectures or a notetaker.
Provision of clear, detailed information (both oral and written) about the structure of the course, practical arrangements, assessment requirements and deadlines.
Clear course structure.
The provision of specialist tuition support, e.g. language skills, structuring work.
If group work is required, have clear expectations and instructions. If group-work proves too stressful, provide an alternative assessment method.
Flexible delivery of teaching material via electronic media is particularly helpful for students who are unavoidably absent from class or who cannot participate in classes for extended periods of time.
It may be helpful for the provision of individual orientation to laboratory equipment or computers to minimise the anxiety that is likely for some students in unfamiliar learning situations.
Some students with ABI may be over-sensitive to what they perceive as criticism from others. They may prefer verbal to written feedback on assignments.
Recording lectures will assist those students whose attentional processing is affected by their disability as well as those who, because of the effects of medication and/or short-term memory loss, may tend to misinterpret or misquote.
Students who tire easily, may be frequently late or absent due to the distance between teaching venues.
Academic activities which take place off-campus (such as industry visits, interviews or fieldwork) need to be accessible to people with a mobility disability.
Students with a mobility disability may sometimes wish to use their own furniture, such as ergonomic chairs or sloped writing tables.
Provision of assignment extensions and acceptance of class absence explanations due to disclosed condition, without the need for students to produce a medical certificate
Students who are anxious about performing in front of others may prefer to video-record any presentations which are to be assessed or deliver a one-to-one presentation.
Sometimes student behaviour may be challenging for teaching staff and other students. There are a range of strategies for addressing disruptive behaviour.
Absences due to hospitalisation or the effects of changes to medication may affect the number of assignments students are able to complete satisfactorily.

Assessment Strategies

Students with ABI may need particular adjustments to assessment tasks. Once you have a clear picture of how the disability impacts on learning you can consider alternative assessment strategies.

In considering alternative forms of assessment, equal opportunity, not a guaranteed outcome, is the objective. You are not expected to lower standards to accommodate students with disability, but rather are required to give them a reasonable opportunity to demonstrate what they have learned.

Students may benefit from the opportunity to look at the instructions and structure of examination papers before the exam so that any confusion can be dealt with and anxiety minimised.
Some students may need extra time in examinations or require a separate room free from distractions. Take-home examinations may be an option for these students.
A reader or an oral examination (either presenting answers on tape or participating in a viva) are alternatives to the conventional written paper. An oral examination is not an easy option for students. Extra time may be needed for the student to listen to and refine or edit responses. Allowance should be made for the fact that spoken answers are likely to be less coherent than written answers.
For some students the combination of written and oral examination will be most appropriate. Assessment should be based on both the notes and the spoken presentation.
Students may need to use a personal computer or a personal assistant in an examination. If so, it may be necessary to provide extra space for equipment, or a separate examination venue if the noise from equipment (e.g. a voice synthesiser) is likely to be distracting for other students.
Provision of extra time in examinations for students who have reduced writing speed. Some students with an ABI may need rest breaks. Take-home examinations and split papers may be options, given that some students may need double time to complete examinations.