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GED 653!

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Fall!2012!

Case Study #2 Methods for Teaching Students with Brain Injury: Matt Point Loma Nazarene University

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Matt: A Kindergarten Student !Matt!was!a!healthy,!pleasant!little!

boy!before!his! accident.!When!Matt!was! four!years!old,!he! fell! from! the!top! of! a! poolside! onto! the! concrete!patio!below.!!!

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He! was! hospitalized! and!diagnosed! with! a! brain! injury,!fractured! skull,! and! fractured! right!shoulder.! He! required! surgery! to!remove!a!subdural!Hematoma!from!his! frontal! lobe.! Scans! showed! a!diffuse!brain!injury!with!focal!injury!to! his! right! frontal! lobe.! Matt! was!unconscious! for! nine! days! and!was!in! the! acute! care! hospital! for! six!weeks.! He! was! transferred! for!rehabilitation! to! Sunny! Hill! Health!Centre! for! Children,! where! he! was!an!inpatient!for!two!months.!!

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After!discharge! from!rehabilitation,!a! speech! language! pathologist! and! a!psychologist! specializing! in! behavior!worked! closely! with! Matt's! daycare!and!future!school!to!develop!a!support!plan.!!

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Matt! returned! to! his! daycare! for!May! and! June! 1999.! His!Kindergarten! teacher,! Ms.! Lee,! and!his! Resource! Room! teacher,! Ms.!MaxwellKSmith,! were! able! to! visit!his! daycare! and! observe! Matt's!participation! and! his! interactions!with! the! other! children.! In! June!1999,! before! his! entry! into!Kindergarten,! Ms.! Lee! and! Ms.!MaxwellKSmith! met! with! Matt's!daycare! staff,! rehabilitation! team,!and! parents! to! discuss! his! learning!challenges! and! behavior! and!appropriate! intervention! strategies,!Matt's! parents! continue! to! be! very!involved! in!his! school!program!and!are! keen! to! carry! out! the! same!strategies!and!practices!at!home.!!

Matt! is! currently! integrated! fullKtime! into! a! halfKday! Kindergarten!program.! Matt! has! made! an! excellent!physical! recovery;! however,! he! has!residual! cognitive! and! fine! motor!difficulties.! Ongoing! cognitive! issues!include! difficulties! with! attention! and!concentration,! distractibility,! auditory!memory,! receptive! and! expressive!language,!and!aggressive!behavior.!

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!!Matt! has! a! difficult! time! paying!

attention! when! the! teacher! is!addressing! the! class.! He! is! easily!distracted! and! frequently!overwhelmed! when! the! classroom!gets! busy! and! noisy.! He! has! a! hard!time!participating!in!a!group!setting!and! displays! his! frustration! by!hitting! other! students.! Matt! is! on!medication! for! a! seizure! disorder.!He! requires! constant! supervision!because! of! his! impulsiveness! and!resulting! physical! aggression!towards! his! peers.! Matt! is!considered!to!be!a!safety!risk!on!the!playground.!

Analysis and Program Plan !

GED$653$

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School History: Matt!attended!the!G.F.!Strong!Daycare!Centre!for!two!years!before!his!injury.!He!returned!to!the!daycare!setting!for!May!and!June!1999.!He!participated!well!in!structured!supervised!environments.!He!required!close!supervision!due!to!his!seizure!disorder!and!his!aggression!towards!other!students.!! !

Analysis and Program Plan !

GED$653$

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Current Levels of Performance: Language:!Matt!currently!performs!in!the!low!average!range!for!receptive!language!(see!Sunny!Hill!SLP!report)!and!in!the!mildly!impaired!range!of!expressive!language.!His!vocabulary!is!limited,!and!he!will!frequently!point!and!say!"that"!rather!than!use!the!correct!word.!!

Math:!Matt!has!emerging!number!concepts.!He!can!identify!when!he!has!one,!two,!and!three!objects!in!his!hands!but!cannot!count!higher.!He!is!able!to!sort!simple!objects!and!classify!with!color!but!can!!become!confused!when!asked!to!sort!sizes.!He!does!not!enjoy!playing!with!building!toys!and!needs!help!to!engage!in!constructional!activities.!

Analysis and Program Plan !

GED$653$

Student Strengths/Interests: [What areas can be built upon and used to support other areas of difficulty?]

• Enthusiastic!about!school!outgoing.!• Enjoys!physical!activity.!• Listens!attentively!to!orally!read!stories,!contributes!to!class!discussion,!likes!to!communicate!verbally.!!

• Uses!good!spontaneous!greeting!language.!

• Attends!well!in!onePtoPone!situations!with!few!distractions!engages!actively!in!large!motor!play.

Analysis and Program Plan !

GED$653$

Student Weaknesses: • Poor$listening$skills.$• Often$interrupts$others.$$• Low$level$of$participation$in$group$activities.$$

• Minimal$effort$using$expressive$language$skills.$$

• High$levels$of$time$off$task.$$• Expresses$his$frustration$or$excitement$by$hitting$or$pushing.$$

• Poor$independence$with$self@care$activities.$(e.g.,$shoe$tying,$putting$on$coat)$$

• Poor$fine$motor$control.$$• Not$able$to$currently$follow$one@$and$two@step$directions.!

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