Western Oregon University

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TBI Transition System:
Improving the Hospital-School Transition of Children with TBI

Project Description

Due, in part, to inconsistent procedures for transitioning students from hospital to school, many students with TBI who need specialized services are not identified for special education. This lack of identification can lead to inappropriate services, and perpetuates the lack of awareness of TBI among school professionals. This five-year project, funded by the National Institute on Disability and Rehabilitation Research (NIDRR), presents a systematic approach to developing, testing and disseminating a comprehensive hospital-school transition intervention, called The School Transition and re-Entry Project (STEP). The STEP intervention includes hospital, school, and family components.

Hospital: The STEP intervention provides hospitals with a simple, consistent process for linking TBI patients and their parents with school personnel. After obtaining parent consent, the hospital contacts the State Department of Education (DOE) to provide general information about the child and his or her injury. By designating a single point of contact at the State DOE, hospitals are relieved of the burden of asking the parent for information about what school the child attends and locating the appropriate school representative. This arrangement also relieves parents of the responsibility of making contact with the school at a time when they may be struggling to return to family routines while overwhelmed by concerns about their injured child.

School: The contact person at the DOE informs a trained school transition facilitator in the region where the student attends school that the student is returning to school. This local educator (e.g., school nurse, school psychologist) contacts the student’s parents and discusses the student’s condition and parent’s concerns, then contacts the school to provide information on TBI in general and on the student’s condition specifically (if available). The transition facilitator also assesses the school’s need for support and resources, and provides these as needed. The transition facilitator sets up a process for tracking the student’s progress, to identify problems that emerge later and suggest to parents and school personnel that the child be assessed to determine whether these problems may be related to TBI.

Family: The family component of the STEP intervention includes the provision of family-friendly information about TBI, consistent communication with school representatives, and training in being an effective advocate within the school system. Prior to discharge, parents will receive a parent information notebook with (a) text and video materials about childhood TBI and sequelae that potentially could have a negative impact on school functioning, and (b) the Brain Injury Partners parent advocacy training program. This interactive multimedia program includes: (a) skill modules, which teach specific behaviors and procedures for effective advocacy (i.e., identifying problems, setting/prioritizing goals, communicating effectively, and evaluating progress), and (b) information modules, which present information and resources important for parents’ effective planning and advocacy (e.g.., Individual Education Program (IEP)/504 plans, post school transition, and accessing social support).