Individual Educational Plans
The Individuals with Disabilities Education Act (IDEA) was enacted in 1990 as Public Law 101-476 and allowed for the inclusion of TBI as a condition of eligibility for special education and educational assistance within the public school system.
With this law in place, emphasis was placed on the child's global functioning rather than on academic performance alone. This resulted in increased emphasis on executive function deficits, memory and attention deficits, and slowed perceptual motor functions that tend to be characteristic of children with TBI (224). A team approach to the management of the IEP for the child with a TBI is important. The child's team should include a rehabilitation specialist, the child's school, and the child's family, at a minimum. Preparation of the initial IEP should begin while the child is still an inpatient on the rehabilitation ward. This allows for smooth transition from the inpatient rehabilitation program back to the school system (225). The involvement of the family is essential to facilitate a sense of continuity of care, and demonstrates to the parents that return to school does not represent return to the child's previous level of functioning. Ongoing difficulties will likely persist and need to be addressed accordingly. It is imperative that the team understand the dynamic and changing needs of the child with a brain injury, such that regular review and updating of the IEP occurs. The role of family involvement and family support for these children cannot be minimized, as it has been shown that there is an increased risk for maladaptive behavior in children with TBI who came from poorly functioning families. Therefore, individual and family counseling, parent training, and child behavior management is recommended to improve these children's outcomes (226).In recent years, a push toward identifying the best approach to assisting children with TBI within the school system has been investigated.
Some states have responded with programs that provide consulting services to the school systems and their educators with a TBI team model. The school system then presents on a case-by-case basis their concerns for a given pupil, and the consulting team assists in developing an IEP. The state brain injury team will then reassess the child and the IEP. It has been demonstrated that educators who receive training in childhood TBI have increased confidence in working with these pupils (227).Too often, children with TBI remain underserved and, in some cases, forgotten. Sometimes educators are unaware the child had a previous TBI, or if their academic performance on achievement tests was within the average or acceptable range, they are deemed to be unaffected by the brain injury. Their diagnosis is forgotten until they have failed academically. This is highlighted in the research estimating that there are approximately 130,000 students in the United States with special education needs after TBI; however, the U.S. Department of Education reported only about 15,000 students receiving services under the TBI label (208).