Screening tool for traumatic brain injury helps kids succeed in school

Young children sometimes experience an accident such as a playground fall that can result in a head injury. Their resulting traumatic brain injury can go undiagnosed but lead to learning problems that crop up later.

Now kids are getting help with research being done by Pat Sample and David Greene, both faculty in CSU’s Department of Occupational Therapy. Two years ago, the duo received a $280,000 grant from The Colorado Traumatic Brain Injury Trust Fund to develop a screening tool for TBI. They have visited seven Colorado school districts to explore the ways in which students with TBI are identified and assisted in qualifying for necessary services, and to test a tool they developed called the Brain Check Survey. happy girl sliding down

Sample has a long history of working with individuals with TBI. She worked in the Center for Community Partnerships in OT as part of a team helping adults with TBI gain and maintain employment in the 1990s. The team then directed its work toward teenagers experiencing the transition out of school into adult life. Soon after, the team’s attention shifted to TBI in younger children. Sample found that this often “invisible disability” was not always evident to educators, which resulted in either underserved students, or students being identified as having a disability other than TBI.

Addressing different needs

“Our TBI team started working with kids who were in grade school, junior high and high school,” Sample said. “We helped them to succeed in school and made sure they were getting proper support. Sometimes the needs of kids with TBI are different from other children with disabilities. They have issues around fatigue, memory lapses and being overwhelmed by stimuli — things that aren’t normally addressed with kids who have other types of disabilities.”

Sample emphasized that for this reason, identifying students with TBI and meeting their particular needs is necessary for academic success.

As a result, Sample and her team began crafting the Brain Check Survey, a screening tool that detects whether the child’s behaviors and symptoms are indicative of a past TBI. The survey has been tested for validity and reliability, and has proven to be a very strong tool. It is now widely available to many schools throughout Colorado and educators in other states through the website. The site is sponsored by the Colorado Department of Education, the Colorado Brain Injury Program and the Brain Injury Alliance of Colorado. The BCS questionnaire aims to evaluate children appropriately so that their needs are met and they can thrive as successful students.

Employed by PSD

Donna Detmar-Hanna, occupational therapist for the Poudre School District, said that in PSD, the Brain Check Survey has been used to screen around 10 to 12 students, and the survey “has been helpful in providing additional information to school teams and assisting in opening the door to conversations about brain injury and the associated symptoms and behaviors.”

Previously, for students to be placed into special education with a TBI categorization they needed to present official documentation of a medical diagnosis. Now a handful of states will accept evidence of credible TBI history in lieu of a medical diagnosis. The results from the BCS can be offered as a major element of evidence of a past TBI to schools, hopefully opening the door to students’ placement in the most suitable special-education program for their needs.

Sample and Greene are exploring whether schools are using the newer educational identification as opposed to the traditional medical identification when determining who is placed in special education. The research team collaborates with a slew of different professionals, including school psychologists, nurses, special education teachers, occupational therapists, speech therapists and sports trainers in various Colorado school districts.

Future work

Sample and Greene look forward to studying the reliability of the BCS on a grander scale and are considering developing an online version of the tool, making the screening tool even more widely available. The BCS, along with scoring instructions and a form, are available to educators at no cost at the COkids website, as well as through the research team’s “Life Outcomes after Brain Injury.”

For more information about their current research project, contact Sample at
or (970) 491-1996, or Greene at or (970) 491-3810.