Redesigning the scaffolding metaphor to suit pupils with
Acquired Brain Injury (ABI)
Siân A. Rees, David Skidmore
European Journal of Special Needs Education Vol 23 (4 )November 2008 pp 379-392
Abstract
This paper extends and develops the metaphor of scaffolding to take account
of the specific needs of pupils with an Acquired Brain Injury (ABI), drawing
on observational evidence gathered for an empirical enquiry into the learning
of pupils with ABI in mainstream classroom conditions. This is an area in
which there are few published studies to date. After considering the needs of
this particular group of pupils, the authors outline the development of the
scaffolding metaphor. The use of scaffolding for a group of pupils with ABI
is illustrated and the need for modifications discussed, before suggesting the
acronym PEDER (Point out, Explain, Demonstrate, Encourage, Repeat) to
focus on the particular needs of this group. However, in practice, this
acronym has been found to assist a wider group than just pupils with an ABI.
Introduction
It is not easy to ascertain exact numbers, but surveys indicate that in the UK about half a million
pupils a year return to the classroom after an Acquired Brain Injury (ABI) (Sharples et al. 1990,
Royal College of Surgeons 1999, Hawley et al. 2002, Petit-Zeman 2001, Hawley et al. 2003).
As the brain is still developing recovery becomes intertwined with the normal process of
development, can take many years, and may not be complete. The pupil’s way of thinking will
have changed with many underlying skills affected by the injury. With assistance, skills quickly
return to a level commensurate with previous learning and this is the point when pupils generally
return to school; however there are significant changes in personality (D’Amato & Rothlisberg
1996; Telzrow 1987; Hawley et al. 2004), underlying skills, such as memory and attention
(Begali 1992; Ewing-Cobbs et al. 1998a; Jones & Johnson 1994; Mateer et al. 1996; SemrudClikeman 2001; Telzrow 1987; Ylvisaker & Skezeres 1998) and subsequent ways of learning.
Pupils need assistance to learn in new ways. However impaired social communication (Blosser
& DePompei 2003; Dennis & Barnes 1990; Ewing-Cobbs et al. 1998a; Ylvisaker & Gioia 1998;
Ylvisaker et al. 1995) may be the most pronounced consequence of ABI and frequently leads to
behavioural and educational difficulties (Clark 1996; Ewing-Cobbs et al. 1986; Hawley et al.
2002; Ylvisaker et al. 1998a).
Most young people make a rapid physical recovery, which then creates expectations in parents
and schools for adequate cognitive and behavioural functioning, but a normal physical
appearance can mask underlying cognitive deficits (Lord-Maes & Obrzut 1996, Johnson 1992).
It is not just that older children with ABI act like the younger controls (Dennis et al. 1996,
1998), and Johnson (1992) states that there is no evidence that the further development of the
brain proceeds normally after injury. Teachers cannot assume that, by approaching a learner
with ABI as they would a younger pupil, learning will proceed without hindrance.
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As there is usually no outward sign of injury, changes in the pupil may be put down to other
factors, but there are specific difficulties arising from damage to the brain (Lord-Maes & Obrzut
1996). It is widely held that after ABI children can access all the learning which they had
acquired prior to the injury, but it is extremely difficult to add to this learning (Hebb 1949,
Adamovich et al. 1985, Kinsella et al. 1995, Semrud-Clikeman 2001). However the reasons for
this are couched in terms of brain function. This study examines how the consequences of injury
impact in the context of the classroom.
Impairments of ABI
Attention and concentration problems are frequently seen in children with ABI (Begali 1992,
Mateer et al. 1996, Semrud-Clikeman 2001, Ylvisaker & Szekeres 1998). Poor attention and
concentration may be mis-interpreted as attention-seeking behaviour (Middleton 2001). Group
seating in a classroom is therefore presumed inappropriate for many youngsters after a severe
brain injury, and a programme of gradual re-entry to school is usually advised to avoid
attentional overload (Telzrow 1987). Medics single out busy worksheets as problematic, as they
may distract from the main idea, but none of this has been examined in context.
Clinical assessments of memory and new learning show that these difficulties are the most
frequently seen, persistent and problematic following ABI (Begali 1992, Telzrow 1987, Mateer
et al. 1996, Ewing-Cobbs et al. 1998b, Semrud-Clikeman 2001). Visual memory tasks do not
show as much deficit as verbal tasks. Ewing-Cobbs et al. (1998b) suggest this could be due to
developmental factors as visual memory develops much earlier and therefore may be retained
after injury. Donders (reported in Kinsella et al. 1995) found that pre-morbid overlearned and
automatized skills show little disruption after head injury, while Begali (1992) found difficulties
with categorisation and generalisation, essential for concept formation (Donaldson 1978, Green
et al. 1995). Learning, involving encoding, storage and retrieval of information, relies heavily
on memory. At the encoding stage a number of factors determine what and how much is
encoded, including attention, the depth to which the new knowledge is assimilated into existing
knowledge, the significance of the event in social, emotional or intellectual terms and the extent
of deliberate elaboration at the time of encoding. However the manner in which this operates
within the everyday context of the classroom has not yet been examined.
Executive functions are so-called as they control the planning, monitoring, goal-setting
processes, strategic problem-solving and inhibition of unwanted behaviours. Pennington et al.
1997, Temple 1997, Ylvisaker et al. 1998a). Metacognition, the knowledge of one’s own
cognitive abilities, is an exemplar of self-regulation (Dennis et al. 1996).
Disruption of executive skills, which are particularly vulnerable in TBI (Ozonoff 1995,
Ylvisaker et al. 1998a), could affect many aspects of classroom behaviour. It may involve
irrelevant distraction by extraneous stimuli and therefore inability to maintain attention on task.
It could also lead to perseveration, failure to initiate appropriate activity, inhibition of impulsive
responses, failure to maintain effort over time and failure to use feedback. Difficulties in
thinking divergently mean that the young person may have problems in thinking creatively.
Executive functions also intersect with other functions, such as memory. Memories organised
before storage are retrieved much more easily and memory strategies, such as asking a young
person to ‘remember’ something, may be counter-productive in those with frontal lobe injuries,
as effort involved in trying to remember interferes with involuntary memory and learning.
Cognitive flexibility, frequently absent after a severe brain injury (Ewing-Cobbs et al. 1998b),
has implications for classroom functioning, especially in the secondary school, where different
teachers have different requirements and there are frequent changes of setting throughout the
day.
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The emphasis on language as a tool for problem-solving within the classroom, has brought
executive functions into play as the most common language difficulties after ABI are those
associated with executive functions, (Ylvisaker & Gioia 1998). In clinical studies it has been
found that reduced initiation results in a paucity of communication, while socially inappropriate
comments, volatility and perseveration have been attributed to poor inhibition (Ewing-Cobbs et
al. 1998b, Ylvisaker et al. 1998a).
Whilst medical research has given insights into the various problems experienced by these young
people the ways in which these manifest themselves and interfere with classroom learning is an
area into which there has been little research. Within the classroom the differences due to the
aetiology are seen to be of less importance and the manifestations between the different groups
within ABI are comparable. Many more young people are returning to mainstream classrooms
and being referred for specialist advice after an ABI which makes this a burgeoning issue for
schools.
Scaffolding and the Zone of Proximal Development
When developing meaning, concepts and skills, Vygotsky (1979) puts forward the notion that
there are two levels, the actual level and the potential level, between which teaching should
occur. He claims that through imitation within this Zone of Proximal Development (ZPD),
children are capable of much more under the guidance of adults than alone. Through the ZPD
children grow into the intellectual life around them, into the culture created by the adults.
Higher mental functions evolve through social interactions with adults: they are gradually
internalised as the child becomes more and more proficient and needs less and less support from
the adult (Vygotsky, 1979). Any cognitive function appears twice, or on two planes (Vygotsky
1978), firstly at a social level as intermental and then on the psychological plane as intramental.
But this is not a single once-and-for-all event. Inner processes develop only as a result of a
prolonged development.
But Vygotsky’s ideas lack the mechanism by which that support takes place. It was left to
Wood, Bruner and Ross (1976) to suggest such a mechanism. Using the metaphor of
scaffolding, Bruner (1978) suggested teachers assist learners by a form of vicarious
consciousness, seeking to reduce the possibility of failure by breaking tasks into chunks,
directing attention, reducing degrees of freedom, marking critical features and demonstrating
solutions.
Four elements of scaffolding emerged in the 1980s as cited by Stone (1998a):
1. recruitment of a child’s interest
2. contingence on the understanding of the pupil
3. wide range of assistance which is available, verbal and non-verbal
4. support is temporary and is gradually removed to transfer responsibility to the learner.
Other studies developing this idea include those of Rogoff (1991), Rogoff and Gardner (1984),
Mercer (eg 2000), Hoogsteder et al. (1996), Bruner (1981) and Tharp and Gallimore (1988).
Limitations
As with all metaphors, scaffolding has its limitations. Originally the concept of scaffolding
arose from observation of effective learning in middle-class homes which is focussed at the
micro-level (Stone, 1998a), ignoring elements such as the relationship between parent and child,
or other social and cultural factors. Criticisms were levelled at the dynamics of scaffolding as it
relied on adults to do the teaching, ignoring the possibility of peer scaffolding, though Rogoff
(1990) showed that peers are less sensitive and effective than adults in this. Concerns were also
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raised about the inherent power structures and assumptions of an ideal adult-child relationship,
based within a middle-class value system which ignored cultural differences in the meanings of
various actions and objects. For a young person learning in school after a severe brain injury the
conditions are very different from this.
Within the classroom, pupils may not be so easily engaged in an activity when there are so many
distractions, the language may not match that used at home, and a cultural shift has to take place
in order to understand the schooled language of the teacher. Verbal, pupil and task-specific
scaffolding is rarely seen. However teachers support learning by other means too. Tharp and
Gallimore (1988) suggested children learn through assisted performance which consists of
responsive, assisting interactions within activity settings and the co-accomplishment of
meaningful goals. To get away from the idea that scaffolding looks the same whatever building
is going up, they emphasise many different kinds of assistance, embedded in on-going
performance of a task. This however ignores the need for repetition to establish new behaviours.
It was left to Love and Mason (1995) to point out that the most important part of scaffolding is
its removal or ‘fading’, with the unstated assumption that scaffolded learning may be repeated.
Teachers act as models to young learners whether they like it or not, in behaviour, language and
cognitive strategies. Active coding of modelled behaviour into descriptions, or labels, or vivid
imagery increases learning and retention of complex skills (Tharp & Gallimore 1988).
Modelling has been shown to be a highly effective means of establishing
abstract or rule-governed behaviour. On the basis of observationally derived
rules, people learn, among other things, judgemental orientations, linguistic
styles, conceptual schemes, information-processing strategies, cognitive
operations and standards of conduct. Evidence that generalisable rules of
thought and conduct can be induced through abstract modelling reveals the
broad scope of observational learning (Bandura, 1977: 42)
The metaphor of ‘apprenticeship’, introduced by Lave (1977 cited in Brown et al. 1984),
encompasses the active roles of both learners and teachers within socioculturally organised
contexts which are motivating and meaningful to the learner, such as a school. The child
undergoes an apprenticeship in the skills of the culture, and by practising these skills and
reflecting on them internalises the cognitive tools that earlier members of the culture have
developed. The developing thinker does not have to create cognition out of an unpeopled
vacuum, but will first imitate and then internalize some of the cognitive content and processes
provided by others and may in turn develop and pass on these skills (Meadows, 1995). But for a
child who is socially confused this may be asking too much.
As an anthropologist Rogoff wanted to emphasise the contextual embeddedness of children’s
learning and the temptation in using this metaphor is to ignore the individual in favour of the
social. Rogoff (1990) attempts to focus on both as inseparable in cognitive development,
declaring:
active novices advance their skills and understanding through participation with
more skilled partners in culturally organised activities. (Rogoff, 1990: 39)
Brown et al. (1989) suggest how apprenticeship may operate within mathematics teaching,
seeing the world through mathematicians’ eyes and learning to use mathematicians’ tools. In
this framework the goal is understanding the problem and its inherent mathematical structure
rather than reaching a solution. This mode of learning is utilised in GCSE maths coursework
tasks and is therefore met at least at this level by pupils who have sustained an ABI. They argue
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that authentic activity, a central tenet of Vygotskian psychology (Wertsch et al., 1984), is the
only way to gain access to the standpoint that enables practitioners to act meaningfully and
purposefully, shaping the tools of the culture and giving them meaning through experience.
The term apprenticeship helps to emphasise the centrality of activity in learning and knowledge
and highlights the inherently context-dependent, situated and enculturating nature of learning.
And apprenticeship also suggests the paradigm of situated modelling, coaching and fading
whereby teachers or coaches promote learning, first by making explicit their tacit knowledge or
by modelling their strategies for students in authentic activity. Then teachers and colleagues
support students attempts at doing the task. Finally they empower the students to continue
independently (Brown et al. 1989).
Rogoff refines the notion of apprenticeship with her model of guided participation (termed Adult
Guidance in Rogoff and Gardner 1984) revising the idea of the ZPD to include the
developmental goals of all cultures and not just academic and literate ones (Rogoff et al. 1991),
which had dominated Vygotsky’s notion of culture, stemming as it did from a concern with sign
systems (Wertsch and Tulviste 1996). Rogoff and Gardner (1984) show that guidance varies
between cultures, mirroring their value systems, and taking account of various adult roles, or
‘end-states’ (Gardner 1996) across societies. After ABI for some families important goals are
not necessarily academic ones, but school goals tend to remain ‘academic’. Ylvisaker and his
colleagues(1998) pick up the metaphor of apprenticeship as a framework for realistic cognitive
rehabilitation after ABI. They emphasise the role of communication partners in scaffolding the
re-learning which has to take place after ABI, but also understand scaffolding to be a set of
environmental compensations that enable the child to complete a task effectively.
Method
A qualitative study was undertaken to ascertain how far the concept of scaffolded learning is
appropriate to the reintegration of pupils into school after an ABI. An opportunistic sample of all
pupils in mainstream secondary schools referred to Supporting Head Injured Pupils in Schools
(SHIPS Project www.shipsproject.org.uk ) within the 5 year period, were observed in their
normal classes.. Within the scope of a single paper it is possible to present evidence form only a
subsample of the pupils observed and here we draw particularly on 4 pupils: Owen, Vicky, Ruth
and Louise. However Table 1 gives details of the 17 pupils all aged 11-16; pseudonyms have
been used to preserve confidentiality.
Name
Age(KS) at injury
Ruth
Nasser
Carl
Adam
Simon
Ian
Vicky
Owen
Ben
Louise
George
Darren
Evan
Jade
Harry
Mike
William
5mths(Pre)
2 (Pre)
7(KS2)
10(KS2)
9 (KS2)
11(KS2)
10(KS2)
9(KS2)
9(KS2)
13(KS3)
12(KS3)
13 (KS3)
13(KS3)
14(KS3)
14(KS3)
14(KS3)
15(KS4)
Age(KS) at
observation
11(KS3)
11-12(KS3)
11(KS3)
11(KS3)
11-12(KS3)
11(KS3)
11 (KS3)
14(KS3)
16 (KS4)
15-16(KS4)
15(KS4)
14 (KS3)
14(KS3)
15/16(KS4)
15 (KS4)
15-16(KS4)
15-16(KS4)
Type of
injury
TBI
TBI
TBI
TBI
TBI
non-TBI
TBI
TBI
TBI
TBI
TBI
TBI
Non-TBI
TBI
TBI
Non-TBI
Non-TBI
Cause
Non-accidental
Falling masonry
Fall
RTA
RTA
tumour
Quad-bike
RTA
Bike
RTA
RTA
Fall
Tumour
RTA
Fall
Hanging
Viral infection
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Key:
TBI – Traumatic Brain Injury
KS – Key Stage (within the UK system KS1 pupils are age 5-7years, KS2 age 7-11, KS3 age 11-14 and KS4 aged
14-16
RTA – Road Traffic Accident
Table 1: Pupils in the study
All the pupils sustained severe traumatic injuries, or were in intensive care for a significant
amount of time where the injury was non-traumatic. The pupils were recruited to the study as
they were all part of the observer’s regular job as a teacher assisting with the reintegration of
pupils into mainstream schools after ABI. Full consent was obtained from pupils, parents and
teachers. One author (reference identifying author omitted) acted as a participant observer within
the pupils’ normal classrooms in the south west of England over a period of 29 months in total.
A naturalistic approach was adopted and fieldnotes recording observations in a range of subjects
were taken in situ and written up within 24 hours, adding recollected points of contextual detail.
The observer sat close enough to hear the pupil’s comments, but far enough away so that (s)he
did not feel they had to include me in their reasoning, especially if I knew the pupil well from
having taught them at home. However, if a pupil became stuck and could not find a way out of
their dilemma, the lead author intervened in the form of dynamic assessment. The interpretivist
analysis was undertaken within NVivo (www.qsrinternational.com) using iterative coding to
develop inductively-derived themes until each category was ‘theoretically saturated’ (Strauss &
Corbin 1990). It was seen that after ABI the response to scaffolded instruction is subtly different
as the effects of the injury interfere with the behaviour expected by the teacher.
Scaffolding and ABI
Classroom teachers attempt to scaffold the learning of their pupils in a number of ways. In order
to link new concepts to previous knowledge teachers often ask their classes to recall earlier work
at the beginning of a lesson. This can be very beneficial to other pupils, but can be rather
difficult after ABI unless there is a visual stimulus for the memory.
Ruth was in a History lesson about medieval England
T: Can anyone remind me of what you were doing last lesson? Have a look in your
books.
Ruth did nothing. She was playing with a pen. Her Teaching Assistant (TA) came
and sat by her.
TA: Do you remember last time? Get out your book
Ruth got out her book. Her planner and pen were taken away
T: What is the feudal system? You might have to look at your book
Ruth ignored it. TA finds relevant place and pointed to it. Ruth talked animatedly to
her TA about the feudal system and added to her diagram. She did not appear to be
listening to the teacher.
(Key for extracts: T is teacher, TA teaching assistant, pupils are identified by their initial, P1, 2, 3 are other pupils, SR
is the researcher)
Ruth appeared here not to know what had been studied in the previous lesson. She may have
been distracted by the pen, or her memory may have let her down. Even though the teacher
suggested the class should look in their books, she did not have her book out and was not able to
use this suggestion. At this point her TA came and sat with her and gave her a direct instruction
to get out her book. She was then able to tell the TA about everything she had learned
previously about the feudal system. Ruth had understood the previous lesson, but could not
demonstrate her knowledge possibly because of the demands on her poor verbal memory,
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difficulties with planning (the need to get out the book was not realised), difficulties
understanding the auxiliary, ‘might’, or understanding that the TA’s suggestion that she ‘might’
look at the book, was a command. Only the demonstration of what was required, and the visual
rescued her. Using visual representations as well as verbal descriptions, is preferable.
Maths class; Owen’s teacher was introducing the next topic the class would
study
T: How many flat, 2D, shapes could you find the area of? Discuss this on your
tables.
The rest of the table discuss. Owen shouts across others ‘triangle’.
The group then have an off topic discussion. Owen looks away.
TA: What can you think of? What else can you find?
T: OK P1 give me 2 shapes you could find......
P1: Square, rectangle
The teacher went around the tables asking. Owen put his hand up, with 2 others
T: Owen
O: Decagon
All the offers were listed on the board. Teacher wrote 3 arrows next to decagon,
octagon and hexagon
T: The 3 arrows are by ones that you may or may not be able to do, you may not have
enough information. The others you have enough maths to be able to do.
He went through them including find the area of a triangle by halving the
surrounding rectangle.
T: What’s the difference between a rhombus and a parallelogram?
P3: A rhombus has all sides the same length
T: A kite is a kind of triangle. If I cut the kite up and rearrange it, what would I
make?
The teacher drew a kite on the board. Owen’s was the first hand up
T: Owen
O: A rectangle
The teacher encourages the class to discuss what they already know with their groups. Owen
appears to struggle a little with this; he does not seem to be able to take turns in group
discussion, although he can when the teacher controls the discussion and is able to contribute.
He needed the TA to focus his attention back on the critical features of the task. His contribution
of a decagon did not really fulfil the teacher’s purpose as it is unlikely that at this stage the class
could have found the area of a decagon, but later Owen was very quick to rearrange the kite into
a rectangle of the same area. The teacher had prefaced his question by pointing out that a kite is a
kind of triangle and it may be that Owen was able to link together the technique for finding the
area of a triangle with the shape of the kite. However the teacher also provided a visual
representation of the shape. Altogether the combination of class and group discussion, teacher
statements, iconic representation and class question and answer allowed Owen to take a full part
in this construction of knowledge.
In scaffolded teaching skills and ideas are demonstrated, giving the pupil an iconic
representation of the task or concept.
French lesson; there are sentences in French and English written on the board
in different orders
T: You are going to jot down the English (pointing to the board) and find the
matching French one
An example was done
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T: You can write the French and copy the English underneath or you can do it in this
order (pointing)
L: I’ll do it in that order
Louise’s French teacher left reminders on the board about the task she was to complete. This
worked extremely well. Louise was helped to start by being given a choice of how to set it out,
even though as usual she chose the last mentioned. The fact that a choice was given meant that
the teacher modelled how she wanted it laid out. Later in the lesson the teacher modelled what
she wanted again.
T: What I would like you to do now is give your opinion. You use..
She pointed to the French phrases she had written on the board and the class read
them out. She demonstrated some examples.
T: For each of these (pointing to the French phrases about adolescents) write....
(pointed) I need you to write it in full to learn it
Louise read the English translations but answered in French.
Interestingly this teacher left many of her phrases unfinished, using what was written on the
board to complete them. This was probably to avoid too much speaking in French, which this
class clearly felt was more difficult than reading French, from their discomfort when she did
introduce the spoken language. Yet this moving from one mode of language to another did not
disturb Louise in the way that moving from diagrams to text does in other subjects.
During the lesson the teacher had loudly answered questions from all pupils
giving reasons for her responses. Frequently her reason was that the word was
a cognate.
The title was Où travaille-t-on?
T: Do you know what this means?
P1: Go
T: It’s not a cognate
L: To go, to work
T: Good work, where do they work?
Later
SR: What are you looking for?
L: Moody
SR: Which phrase do you think it might be?
Louise pointed to the correct one
SR: Yes, humeur is mood, changer is change, they change mood. It’s a cognate. Do
you know what a cognate is?
L: I know but I can’t explain
SR: OK If I say that this work (authorité) is a cognate what would you do with it?
She thought for a bit
L: authority?
SR: Yes, it is a similar meaning in English
Louise (pointing at individualité): Individuality?
SR: Yes
At the end of the lesson I asked
SR: How did you find that?
L: Easy
SR: Why?
L: I know some of the words are like the English
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The use of cognates had been modelled over and again by the teacher. When one of the authors
(author name omitted) pointed out to her at the end of the lesson how helpful this had been to
Louise, she responded ‘I suppose there were a few’. This appeared to be part of her style of
teaching rather than a deliberate attempt to scaffold learning. However she modelled and
explained the use of cognates many times in the lesson. I had also asked Louise to verbalise her
understanding of the concept of cognate, retelling rather than reciting (Skidmore et al. 2003) so
that she had to engage with the ideas as opposed to memorising. When she was unable to do so I
guided her into finding an understanding by using the skill of finding cognates, which she had
been doing for most of the lesson. This reduced her degrees of freedom and asked her to do
something practical to focus her thinking. It may be that just as it is necessary to assist the ABI
pupil to focus their attention in class in order to concentrate, it may be also be necessary to help
them on the finer scale of focusing thoughts by reducing degrees of freedom. Louise’s response
at the end of the class showed that she had appropriated the understanding and was now able to
put it into words. Labelling the idea has now given Louise a new tool with which to think. This
teacher said that she did nothing special for Louise, but that Louise was getting on very well and
was near the top, if not the top of the class. Her lessons clearly suited Louise’s learning style;
Louise commented:
I like those lessons. Miss explains it all properly so it is understandable.
The style of teaching was successful from the teacher’s point of view and suited more than just
Louise. Owen’s support teacher realised how much he gained from modelled examples in maths
Emailed comments from support teacher about Maths classes
Year 9 has been fab because after much explanation/discussion with the teacher he
models everything on the board to the whole class. He breaks it down into small
steps on the board. He gives worked-through examples on the board.
While the teacher writes out the small steps he also talks about it illustrating both how and why it
is done, marking the critical features of the task, showing and telling at the same time. Owen’s
support teacher and TA take this further, using mind maps in almost every lesson to show him
how ideas fit together. This seems to be successful in that he is able to remember new terms and
ideas from one lesson to another.
Attention difficulties are common after an ABI. Pupils who have sustained an ABI seem to be
easily distracted, by people, things and their own thoughts, and are more easily distracted in
lessons which they find difficult, possibly because of informational overload. It seems more
important for this group that tasks are kept within their Zone of Proximal Development, and
because of the nature of their injury this may be different from others in the class. While other
pupils may be assumed to have a certain level of metacognitive ability and control, this may be
very different for the pupil with ABI and it may be this, rather than the academic learning, which
interferes with their ability to complete a task.
Pupils still try to use strategies which have worked previously, particularly in social situations.
But now they lack finesse and their attempts seem clumsy, attracting such comments as:
Comments made in the staffroom by one teacher
Vicky is manipulative, devious and light fingered, very streetwise. She gets stroppy
and flies off the handle quickly. She will get stuck on small annoyances, she is
almost obsessive, and very attention seeking. She has some very tolerant and
supportive friendships.
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There is generally a lack of appreciation of the strategies, metacognitive or otherwise, which will
now work for these pupils. Simon’s neuropsychologist comments:
Simon nonetheless has a number of specific problems which need to be brought to the
attention of his teachers, his family and Simon himself. The latter will require
sensitivity and courage as he is not really well adjusted to the new Simon but, in
order to move forward, he needs some realistic insight to his problems.
It is tempting to feel that it is kind and understanding to make allowances for pupils who have
been so ill, but this only delays the recovery as it leaves the pupil uncertain as to what is
expected. Frequently it is suggested that peers should act as ‘buddies’, showing the injured pupil
what to do, but pupils are not always able to explain ideas which are new to them in a way which
is understood by a pupil with ABI. Quickly these buddies become disillusioned with their job
and break off the friendship. As the neuropsychologist points out, in order to move forward, this
issue needs to be addressed with sensitivity. The intervention of a skilful teacher is what is
required.
Development of the concept of scaffolding for this group
The notion of scaffolding introduced by Wood, Bruner & Ross (1976) has been much elaborated
and refined (Stone 1998a, 1998b, Butler 1998). In many ways it supports the learning of pupils
with ABI but benefits from a further refinement in repetition and deliberateness (Norwich &
Lewis 2005). The acronym PEDER (as shown in Table 2) focuses on the particular needs of
pupils with ABI has been found to be helpful to teachers in busy classrooms.
Point out
Explain
Similarity with scaffolding
metaphor
Recruitment / reduction in
degrees of freedom
Marking critical features
Demonstrate Demonstration
Encourage
Frustration control
Repeat
ABI specific
Helps with attention to appropriate features and
reduces choice
Emphasis on labelling the processes and
constituent parts, providing links to previous
knowledge
Provision of iconic representation
Avoiding the downward spiral to depression
Establishing routines and memories
Table 2: PEDER acronym
Such support provides a rock1 or secure foundation for learning. The balance of the elements of
the scaffolding metaphor is important for the learning of pupils with an ABI. Such pupils do not
necessarily notice for themselves, they do not learn by ‘osmosis’ (O’Loughlin 2006) and
significant features need to be marked or pointed out. Attention control is different post ABI
(author name omitted, in preparation) and reduction of the elements of choice can be helpful to
focus ideas and learning in the classroom. It is then important to explain in order to label
features, make connections between ideas and give the pupil the tools to be able to manipulate
ideas for themselves. This assists with word finding difficulties and provides explicit links with
previous knowledge. Demonstration or modelling provides a visual, or iconic, representation of
the idea, but the study has shown that ‘show and tell’ is more helpful than pure demonstration.
Encouragement is extremely important for young people who have experienced such a
significant injury. Coming to terms with the new personality and learning style is not easy and
1
Peder is the Danish/Norwegian equivalent of Peter/Pierre which means ‘rock’
10
causes many pupils to become anxious. It is known that highly stressed pupils do not concentrate
or learn as well and think less flexibly (Turner & Curran 2006). However, once is never enough,
and instructions will need to be repeated in order for the routines and memories to be
established; in neuroscience the saying goes ‘neurons which fire together, wire together’ (Hebb
1949).
Advances in acute medical treatment technology have led to an increase in survival rates of
children with an ABI and many more are returning to mainstream schools than in the past. But,
as yet, educationalists have only briefly considered the teaching/learning implications.
All these children return to school, yet there is little or no information available
to help their teachers, their parents or other professionals, who are often illprepared to deal with the difficulties that are frequently faced. (HIRE
Newsletter Spring 2002)
Acquired Brain Injury is the most common cause of death and disability in children (Hawley et
al. 2003). It is an ‘invisible’ disability; it is easy for teachers and other professionals to forget
that these pupils have specific needs and cannot be assumed to have understood just because
they appear to get on with their work
Contingent teaching, guided by the PEDER model, may also benefit other pupils who do not
have ABI, but may struggle with transmission styles of teaching. It is evident from teachers’
comments in training sessions that other young people show the same or similar difficulties, for
different physiological reasons, but ABI is unique in the combination of these and it was seen in
this study that pedagogies which assist ABI, will assist others too. Having changed teaching
style to accommodate Owen’s needs his Maths teacher found that the rest of the class had made
more progress than was usually expected. It seemed that, at least in this case, by considering the
needs of the pupil with ABI the unspoken needs of others were also met. Comments gathered
from teachers, as feedback to the research, include ‘some of the ideas have been used to support
other children’ and ‘having D in school means I teach the others better’. Greater use of iconic
representation, for example, would probably help a much wider group of pupils, likewise the
emphasis on explanation and pointing out reflects the ‘deliberateness’ called for by Norwich &
Lewis (2005), while the repetition element could reflect their call for intensity. The PEDER
model promises benefits for young people who find choice, attention, word finding and verbal
instruction difficult, but may disadvantage those who need to explore ideas independently and
increased repetition, for example, runs the risk of demotivation for some pupils who are able to
take further steps in learning. Further research is needed to define the conditions under which
this model would be beneficial. The value of the PEDER model is in its conciseness and
memorability to the teacher.
11
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