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Instructional Strategies for Elementary Students with TBI Susan J. Roland
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Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Mar 26, 2015

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Page 1: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Instructional Strategies for Elementary Students with TBI

Susan J. Roland

Page 2: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Everyday Instruction/Best Practices Executive Functions

OrganizationCognitive FlexibilityOrientation IssuesProblem Solving

Memory and New Learning Attention Some Specifics for Behavior

Page 3: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Interventions for Students with TBI Follow principles of good instruction Are often beneficial to entire group Are highly specific to the individual needs

of the student

Page 4: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

4 Facts on Long-Term changes:

No 2 students will be alike.

Changes are unlikely to disappear fully over time; the student’s recovery will most likely only be partial.

Negative consequences may not be seen immediately but only emerge when developmental demands reveal deficits and problems.

An injured brain is less likely to meet the increasingly complex tasks all children face as they get older.Hibbard, M., Gordan, W., Martin, T., Raskin, B., Brown, M. (2001) Students with Traumatic Brain Injury: Identification, Assessment and Classification, Assessment and Classroom Accommodations : NYC, NY

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Page 5: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Best Practice for Instructions

Demonstrate what you want the student to do (pair visuals with verbal)

Use many positive and negative examples○ Show an example of what you want AND don’t

want

Point out how the positive examples are the

same - Point out the obvious - it most likely is

NOT obvious to some

Page 6: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Best Practice: InstructionUse consistent language to reduce the chance for error

Use Rubrics for grading - this is the easiest way to modify grades for the teacher and the best way to lay out expectations

Monitor student performance to prevent errors in practice and responses

Provide positive corrective feedback (“The more we work on this, the easier this is going to get!”)

Include systematic reinforcement and correction in a positive way

Page 7: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Best Practice: Instruction Evaluate Your Teaching

Starting level correct?Did you

○ monitor the student’s performance?○ record the student’s progress ○ Review student progress○ Change the instruction as needed until the student

is making progress in the designated curriculum

Madigan, K., Hall T.E.,& Glang, A., (1997). Effective Instructional Practices for students with ABI in Students with Acquired Brain Injury: The school’s response. Glang, A., Singer, George, Todis, B. Eds. Brookes: Baltimore

Page 8: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Executive Function Strategies planning, organization, initiation, time

management, working memory, flexibility cognition, memory, attention, reasoning, abstract thinking; judgment; and problem-solving

Page 9: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Key Components of an Intervention Plan for EF:

Get information from a variety of sources:interviews, behavior checklists, observations,

and work samples along with formalized assessment

List problem areas Link problem areas to the executive function

that best describe the problem Match information across and between

settings and domains Choose an executive function to work on,

that will be meaningful to the student

Page 10: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

PaulPaul has been having a difficult time at school

socializing with his peers. He enjoys socializing and talking but classmates get frustrated with him because he only wants to talk about himself. When he tries to talk with his peers, they just ignore him. What has been observed is that he talks at length without allowing anyone else to speak. He only speaks about himself.

Using his goal of wanting to talk to others and addressing Paul’s needs to listen, and be more flexible in topic choice

The areas are linked to help create Paul’s intervention

Page 11: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

What might be an intervention to try with Paul?

Page 12: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

PaulPaul might set a goal of talking to others

about something of interest to them.Paul works with the speech pathologist to

generate a list, of topics of interest, specific to a targeted peer/individual

He role plays/practices speaking to the target person with the guidance of the speech pathologist or other mentor

Paul practices with other people using less and less adult coaching for increased flexibility in a variety of situations.

Page 13: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Evaluation of Paul’s Intervention

Examine the effectiveness of the intervention by documenting the following:

Were the intervention and supports put into place?○ Duration○ Frequency

How did it work?○ How many teacher prompts were needed?○ How natural was the conversation?

What’s the plan for reducing the number of supports?

Page 14: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Students may grasp the main concepts but may be unable to show their knowledge because of EF difficulties

Page 15: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Teach Routine○ The day should be predictable but still fun!○ Routines within your daily schedule

(stimulation breaks, set restroom breaks)○ Visual schedule (on the board for all, on

desk for a few, or an individualized picture schedule - use clock faces if you need to)

○ Creeds, chants, songs○ Utilize school organizational materials

(planner, etc)

Page 16: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Moving to the Large Group Explicitly teach the EF skill needed in an

applied setting○ Fade supports as soon as the student is able to

accomplish the skills○ Use external reinforcements only as necessary

Explicitly teach the skill needed in other settings to assist in generalization of skills

Guide practice of skill through group coaching or mentoring

Fade guidance as skill becomes internalized and guidance is no longer needed

Page 17: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Classroom Interventions for Executive Function

 Changes in the EnvironmentChange the physical or social environment by

○ Changing the level of background noise○ Changing the level of visual stimulation○ Changing the physical restrictions (walls, room

size etc.)○ Use of lists or visual reminders ○ Changing the amount of organizational

structures

Page 18: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

○Can they answer the BIG 5?

1. Know when to start

2. How much to do

3. How to do it

4. What finished looks like

5. What to do next

Page 19: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Specific strategies for ORGANIZATION

Page 20: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Organization

Use a planner or “back and forth” notebook with check-in and check-out system

Help students develop methods to organizeMaterials

– According file folders– Box on the floor rather than in the desk

Easier to access and less of an opportunity for the “black hole”

Ideas and information– Provide choices rather than open ended suggestions

Page 21: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Organizational strategies for note taking from lectures

Cornell notes or two column notesGraphic organizers (i.e. Thinking

Maps)Teacher provided note-taking

templatesTeacher provided guided notesFocused notes (main points - not

everything)

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Page 22: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Use of rubrics or other systemic methods of informing a student exactly what is expected for a job well done

Show/display positive examples of completed assignments and products

Strategies for writing○ Structured and organized○ Show/display examples and non-

examples

Page 23: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Specific strategies for COGNITIVE FLEXIBILITY

Page 24: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Strategies to Help with Cognitive Flexibility: Develop a daily routine that is maximally

functional.homework in plannerwhere and when to turn in homework

each dayschedule What is most important to you as the

teacher, parent or student?

Page 25: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Practice identifying multiple meanings in words, jokes, and riddlesTake advantage of on the spot teaching

when ever the opportunity arises! Encourage students to generate multiple

ways to solve problems or settle disputes Anticipate and plan for situations that

require mental flexibility and thinking on one’s feet (practice)

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Page 26: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Encourage students to compare current problems to previous problems and look for similarities and differences (facilitate making those connections!)

Shifting from one topic to anotherPicture or written schedules

Verbally assist students with metaphors EXPLAIN commonly used slang assume they do

NOT understand it

Page 27: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Self Monitoring and Checking

Helps students learn self regulation Students need to know

types of errors to look forhow to check for these errors exactly how to correct the errors

○ Give EXPLICIT instructions show an example hand-over-hand or after showing the class the example, go over to Mary and ask her to show you an example of how to “correct” an error”

Page 28: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Cognitive Scripting Specifics Help children understand what it looks

like to learn Teach turn taking Teach asking for help Use social stories (autism.org) SHOW what it looks like

Page 29: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Educational Accommodations for Orientation Issues Have student use assignment book or pl

anner. Use peer buddies Maintain consistent room arrangement,

materials. Label significant objects and materials. Teach child to look for permanent

landmarks.

Page 30: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Educational Accommodations for Orientation Issues (Continued)

Provide charts, schedules, maps, that describe daily routines and routes.

Have child verbalize how to get a to place before going.

Allow extra time in moving from one location to another.

Page 31: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Educational Accommodations for Problem Solving Role play cause and effect scenarios. Teach the structure and format of an

activity. Raise questions about alternatives for

behavior. Demonstrate application or problem

solving skills across daily routines. Provide ongoing feedback.

Page 32: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Educational Accommodations for Problem Solving (Continued) Provide a highly structured learning

environment. Provide assistance with alternate

solutions and courses of actions. Provide assistance with sequencing tasks

and prioritizing objectives. Provide clear expectations.

Page 33: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Commonsense Guidelines Always make your expectations clear. Keep focused on task on hand. Praise effort, not outcome. Pick your battles, do not force

confrontations. Don’t say “no”, say “try again”. Ask questions and give choices.

Page 34: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Commonsense Guidelines cont.

Speak with respect: give choices not orders; speak calmly and firmly; and do things to help the child learn.

Make a plan prior to every activity. Evaluate activities and outcomes

frequently. Create an organized, structured learning

environment. Describe and model behaviors that you

want.

Page 35: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Specific Strategies for Memory & NEW LEARNING

Page 36: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Practice, Practice, Practice repeated practice

○ spaced and varied intervals○ spiraled practice (come back to it in 1-3

months) Include pictures or visual cues with verbal

information Provide a schedule of tests, reports, and

assignments to parents several week prior to due dates

Page 37: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Due to difficulties of free recall of information, allow use of aids such as: a vocabulary list or a word bankopen-book and open-notes test formats

(with highlighted information)test questions in a multiple-choice or

matching format

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Page 38: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Focus the student’s attention on specific information: “ I’m going to read a story and ask WHO is in the story.”

Draw connections between new information and prior knowledge

Reduce the amount of information that you student is studying or working with to 5 or 6 main point rather than 9 or 10.

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Page 39: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Reading

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Pair visual with audio Label everyday objects Write pg. # next to Q’s to find answers Decrease independent silent reading

Start-to-Finish Books

Page 40: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Reading (Continued) Injury prior to learning to read = early

intervention to develop:To develop sound-symbol correspondencePre-reading competenciesTeach pattern word lists and sight words

Pre-teach vocabulary Color code highlight (i.e. yellow for Main

Idea or Topic Sentence, green for details, orange for explanations or definitions, etc.)

Page 41: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Math

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Practice in natural settings Figure out when lunch or recess will beginFigure out how many bills and coins lunch will

cost with 2 snacks

Do not require copying from board Provide space for ALL computations - have

student circle final answer at the end - no separate answer sheets

Page 42: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Math (Continued)

Provide fact tables and number lines Provide lists of rules, formulas, steps to

follow and examples - examples - examples

Use MANIPULATIVES and visuals Use graph paper to enhance

organization and spacing

Page 43: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Written Language

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Use a clipboard to stabilize paper Dictate “notes” for the student to “bring”

to your teammate down the hall Use of a scribe, fill-in-the blanks, true-

false, and matching formats for test Assistive Technology

Co-WriterWrite Out-Loud

Page 44: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Written Language (Continued) Allow student to dictate the first draft of a

writing assignment for a parent/teacher to type (word-for-word) student revises, makes additions and edits from this first draft

Allow alternatives for written assignments:http://blabberize.com/dioramatheatrical presentationa modelillustration

Page 45: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Educational Accommodations for Memory and New Learning Develop active learning situations Have child utilize visual imagery.

Visualizing and Verbalizing (SRA) Have child use verbal rehearsal or self-talk. Use a sufficient range of examples:

visualnon-examples

Use all resources of the curriculum ex. CD’swww.BookShare.orgStart-To-Finish Books

Page 46: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Have child role-play stories Provide sufficient practice. Provide cumulative review of

previously taught material. Picture Schedule Clock face schedule Materials checklists Schedules and lists on a key ring or

clipboard

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Page 47: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Specific strategies for Attention

Page 48: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Educational Accommodations for Attentional Issues Limit Noise Remove distractions Provide concrete visual cues Limit amount of info on a page. Adjust assignments. Focus on most salient aspect of

lesson. Maintain brisk pace. Repeat instructions

Page 49: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Use short and concise instructions. Reinforce on-task behavior. Give frequent breaks. Break assignments up. Set up personalized cuing system

based in classroom system(s)

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Page 50: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Emotional, Social Skills and Behavior: Strategies for Intervention

Page 51: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Reminders from previous presentations:For Younger Students Give clear and simple

directions Avoid time outs (the

student is NOT likely to independently regroup or calm down)

Label the emotion and direct the student to show the acceptable behavior

Page 52: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

For Older Students: Teach strategies and how to use them

rather that offering assistance Discuss and practice age-appropriate

behaviors in real life situations Assume limited ability to generalize from

one setting to another

Page 53: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Proactive Communication

Always give information. Tell

the person:

○ Where you are going.

○ How much you want the

person to do.

○ How long you want the

person to do something

○ What does finished look

like?

○ What is next….

Write things down.

Don’t say “no”, say “try

again”.

Page 54: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Even More Proactive Communication Ask Questions & Give Choices

○ “What did I say?”

○ “Do you remember?”

○ “What can you do now?”

○ “What should you do now?”

○ “Is this going to help you?”

○ “How do you want me to help you?”

○ “What do you want?”

Page 55: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Coaching to help wit self image

Page 56: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Sometimes

mis-perceptions can lead to a lot of misunderstandings. Thank you for taking the time to learn more about some of our most misunderstood and disguised kids.

Page 57: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

PBS &TBI Often an excellent match Uses built in

RoutinesPositive momentumNaturally occurring rewards and

consequences that can make sense to students

Page 58: Instructional Strategies for Elementary Students with TBI Susan J. Roland.

Questions?