As the brain is developing and maturing
throughout childhood, it is common for some
problems to become evident months or even
years after the original illness / injury.

Such ‘late onset’ difficulties may emerge long
after the pupil has been discharged from
rehabilitation follow up.
It is thus important that pupils with acquired
brain injury are identified within the education
system, and can be tracked throughout the
education process. This will ensure that any
emergent problems are associated with ABI
and that appropriate guidance can thus be
sought at any stage.
Critical points educationally include when the
pupil is changing school year, teachers and / or
schools.
Brain maturation continues throughout
childhood and into adulthood. Critical points
have however been linked with both entering
and leaving adolescence.
A pupil is coming into our school
following ABI – what do we need to
do?
Key elements that will promote successful entry
or re-integration to school include:

Liaison with rehabilitation professionals,
to gain a clear overview of the current
situation and prognosis.
 Provision of information to rehabilitation
professionals regarding:

If known, the pupil’s prior learning style
– both strengths and weaknesses.

The structure of the school day.

Resources available to support the
successful entry / return of the pupil
Setting up a review meeting with / seeking
guidance from both



rehabilitation and educational
professionals, and parents regarding:

Timing of reintegration e.g. a
phased return to school which takes
into account issues such as fatigue.

Any necessary modifications to the
school’s physical environment

Any recommended changes to
schedules / activities

Coping strategies to support altered
learning and / or psychosocial skills
Monitoring the pupil across the weeks
and months after entry / return to the
school.
Continued liaison with the rehabilitation
professionals and relevant educational
professions (e.g. educational
psychology)
Ensuring that information is passed on
to receiving teachers and schools as the
pupil moves through the education
system, to ensure that the information
regarding ABI is available throughout.
For further information, please contact:
Educational Psychology:
0114 2506800
Clinical Psychology:
0114 2717608
Speech and Language Therapy: 0114 2717617
Hospital and Home Education: 0114 2397711
This series of leaflets was developed through
the collaborative work of the above services.
PSL 13 29/09/08
Acquired Brain Injury
(ABI)
An Overview
.
While not every pupil will necessarily have
every problem outlined below, the following
summary illustrates areas of potential change.
School staff should be aware of such potential
changes when a pupil enters / returns to school
following an ABI.
What is Acquired Brain Injury?
This leaflet aims to provide:  An introduction to some of the
consequences of Acquired Brain Injury
(ABI).
 General advice regarding ways in
which receiving schools can support
pupils following ABI.
What skills can be affected by ABI?
The presentation of any of the problems
identified below will be affected by the pupil’s
age and level of development at the time of the
injury / illness.
Acquired Brain Injury (ABI) is the term applied
when an illness or injury affects the
development of a brain, which was previously
developing along broadly normal lines.
Cognitive and executive skills e.g.: Remembering (long and / or short term
memory problems)
 Paying Attention
 Planning and Goal Setting
 Self – initiation, control, monitoring and
evaluation
 Reasoning
 Thinking Flexibly and Problem Solving
 Information Processing
 Forming Judgments
ABI does not describe disabilities that are
present from birth (i.e. congenital or
developmental difficulties).
An ABI can result from: 

Trauma, including motor vehicle
accidents, falls, and sporting injury
Non-traumatic causes including
infections, tumours, strokes, and anoxic
damage i.e. lack of oxygen to the brain
(e.g. through choking, strangulation or
near drowning)
Sensory, and motor skills e.g.:  Vision
 Hearing
 Walking and other physical activities
Incidence in the region of 200 per 100,000
population. Thus a large number of schoolaged children in city the size of Sheffield will
sustain and live with the consequences of
acquired brain injury.
Perceptual skills e.g.:  Judging depth or distance
Psychosocial skills e.g.:  Forming and maintaining friendships
 Understanding other peoples views or
needs
 Behavioural skills e.g. distractibility,
irritability, impulsivity – leading to acting in
a way inconsistent with the setting.
 Mood changes e.g. anxiety, passivity,
depression
It is estimated that each year 3000 children in
the UK will acquire new neurological or
cognitive disability as a result of traumatic brain
injury alone.
While a proportion of pupils will have visible
physical difficulties following ABI, the majority
will have more subtle changes, related to
altered cognitive abilities and / or psychosocial
skills.
.
Language and speech skills e.g.: Understanding and using language
 Impaired ability to communicate in a
manner appropriate to the social
setting
 Retrieving known words

Talking clearly
Are there other signs of ABI
which could affect education?
Common problems include:  Fatigue
 Headaches
 Frustration
What does school need to
know?
When a pupil enters or returns to school
following an ABI, their educational and /
or emotional abilities and needs may be
very different from before.
Pupils with ABI differ from pupils with
developmental learning or behavioural
problems, as often they will retain a
sense of their previous skills. They can
be aware of, but unable to understand,
the changes in these skills.
The expectations of family and staff may
need to change, in order to provide
appropriate support, and introduce
suitable and effective strategies to
support the returning pupil.
Schools need to be aware of the types of
difficulty that can result from an ABI, and
the ways in which learning can be
affected. This will enable timely access to
support and advice, both in the short and
longer term.