Several disorders affect a child’s ability to learn, but are less common, misunderstood, or not acknowledged by academic or medical professionals. Unfortunately, when such issues go unidentified and thus, untreated, the child suffers severe frustration, anxiety, and often ridicule or mistreatment in school. Hopefully, the following information awakens awareness and curiosity to further research and understand of the difficulties your child may be facing.
Traumatic Brain Injury
A traumatic brain injury (TBI) is caused by a forceful bump, blow, or jolt to the head or body, or from an object that pierces the skull and enters the brain. However, not all blows or jolts to the head result in a TBI.
Some types of TBI can cause short-term problems with how a person thinks, understands, moves, communicates, and acts, which may also look like ADHD symptoms. Some injuries are considered primary, meaning the damage is immediate; others are secondary and may occur gradually over the course of hours, days, or weeks later. Although there are two main types of head injuries, non-penetrating & penetrating, our focus is on non-penetrating since these are the ones that may go undetected in children and cause learning difficulties. These injuries are also known as closed head injury or blunt TBI and are caused by an external force strong enough to move the brain within the skull. With early diagnosis and ongoing therapeutic intervention, the severity of symptoms may decrease.
“Symptoms can vary greatly depending on the extent and location of the brain injury. Impairments in one or more areas (such as cognitive functioning, physical abilities, communication, or social/behavioral disruption) are common”, Brain Injury Association of America
In children, the signs to look for are:
- changes in interest
- inability to give attention to tasks
- changes in sleep patterns, moods, and eating
- dizziness, balance, vomiting
- inappropriate behaviors, especially if not seen before
- brief loss of consciousness
- fatigue or restlessness
These symptoms may look similar to ADHD or a behavior problem, but call for a much different response. If your child has experienced a blow to the head (fell off trampoline or bicycle, had a four-wheeler wreck, received a hard baseball hit in the head or other hard hits to the head) a medical examination is required to diagnose TBI.
Causes in Children
- Falls (50.2%)
- Struck by/against events (24.8%)
- Motor vehicle accidents (6.8%)
- Assault (2.9%)
- Unknown/other (15.3%)
- Center for Disease Control, Causes of TBI in Children
- National Institute of Neurological Disorders & Stroke, www.ninds.nih.gov , TBI
- America Speech Language Hearing Association (ASHA), Signs and Symptoms
Tourette Syndrome is one of several types of Tic Disorders. Tics are defined as involuntary, repetitive movements and vocalizations.
In Individuals with Disabilities Education Act (2004), Tourette Syndrome was included under the category of Other Health Impairment which is defined as ‘having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment’. If a child is identified and diagnosed as having Tourette Syndrome, the school paperwork will have him listed as Other Health Impairment.
These three types of Tic Disorders, neurological conditions, begin in childhood:
- Tourette Syndrome (TS);
- Persistent (Chronic) Motor or Vocal Tic Disorder; and
- Provisional Tic Disorder.
The types of tics present (motor, vocal/phonic, or both) and the length of time that the tics have been active, determines which tic is diagnosed. Diagnosis must be determined by a medical professional.
- eye blinking
- facial grimacing
- head bobbing, jerking
- neck movements, stretching
- arm jerking
- shoulder shrugging
- combination of the above
- throat clearing
- blurting out a phrase out of context
- swearing, ethnic slurs or socially unacceptable words (this only occurs in 10-15% of the cases)
I have noticed that many children exhibit some of these behaviors at some point in their early development, but don’t have a true case of Tourette Syndrome. It is not uncommon to have a child that clears her throat excessively or blinks her eyes continuously, but after a few weeks or months discontinues this behavior. The key is how long it last. Anxiety can produce tics in children that may be situational and will cease when the situation changes, but if it persists for over a year, then it is uncontrollable. Observe and take notes to determine if your child needs a medical examination.
- Tourette Association of America, An Overview of Tourette
- Center for Disease Control, Treatments for Tourette