For many people who have a head injury, going back to school is one of the toughest things they are going to face. A number of head injury factors will make this difficult. First of all, short-term memory will make it very hard to learn new material. School is nothing but learning new things. Second, school has a fair amount of fatigue associated with it. With head injury, people have limited energy. They may be good in the morning, but fade early in the afternoon. Third, returning to school involves a social dimension--people very desperately want to fit it with their peers. For some people, having some friends that you can hang out with is their number one priority in college or high school. Often, they put more effort into being social than into studying.
RETURNING TO COLLEGE
Many universities will help you learn new material if you let them know that you have a disability. If you are blind, colleges will help you get books in braille or get a reader for you. A head injury is also a disability. Colleges are willing to help you, but you have to ask for help. In each college, there will be a "student services" or "special needs" department; the name of the department will vary with each college. You need to have your doctor or neuropsychologist write a letter to document that you have a valid disability.
The college is then going to ask you, "What do you want? What sort of accommodations or special help are you looking for?" One of the things you could ask for is extra time taking a test. Many people who have a head injury don't think as fast as they used to, and they need longer to think about some of the items. Ask to take exams without time limits. In other words, you would be allowed to just keep working on it until you are done. Ask to take the exam in a quiet room so you won't be distracted by other students. Many people who take a test are distracted by people rattling their chairs, moving papers, or people walking by in the hall. If you are taking a test and you can't filter out noise, you are not going to do well. Ask if you can take the exam in one of the counseling offices.
Ask if you can get help with notes. Sometimes you can get the teachers notes or you can get another students notes. Why should you ask for notes? Many people with a head injury have a hard time concentrating on what is being said and writing at the same time, particularly if the material is very hard. For some people, doing two things at once makes learning impossible. In addition, getting another student's notes will also help you separate what is important from what is not important. Basically, the question that you may need to ask in every class is, "What is going to be on the exam?" That is not always easy, but if you have another person to work with, you are more likely to figure that out. Try to get an "A" student's notes. Also try to get someone who has good handwriting. If you set this up ahead of time, most people won't mind doing this. In the college level environment, most people are happy to help.
RETURNING TO HIGH SCHOOL
If you are returning to high school, the procedure is a little different. In Michigan, you are going to need to schedule a meeting called an IEPC (the letters stand for Individual Educational Planning Committee). If you have a disability, you need to have this IEPC, or the school will not give you any special help. The committee will determine if you qualify for services. Before this meeting, the school may need to do some testing. If you already have a neuropsychologist, speech therapist, or other person who has done some type of testing, it would be helpful to submit the results to the school. But if you don't have that, you can request that the school provide testing for you. Under Michigan law, they are required to provide assessment for you.
To request an IEPC, you have to notify the school in writing. There is a certain time limit in which they can schedule this meeting. If you wait for this meeting in the middle of summer, you are out of luck. Why? Because there are no teachers in the school. The beginning of school is often a very busy time. You need to start planning this as early as possible (sometimes, you might start this process while the head-injured person is in the hospital).
At the IEPC meeting, the school has to "classify" you so that you can receive services. For example, many people have a classification called "Learning Disability" (often called "LD" for short). This classification requires that people are at least 2 to 3 years behind in their studies. There is also a classification called "EMI" which stands for "Emotionally Mentally Impaired." There is a third classification called "POHI" (standing for "Physically or Other Health Impaired"). In the past, most people who had a head injury fell into this category, but head injuries don't really belong in any of the above categories. There is a new category in the Michigan school system appropriately called "Traumatic Brain Injury." In order to receive this classification, you will need documentation from medical doctors or other specialists such as neuropsychologists. Does this mean you have to be in a "special" classroom with very impaired people? No. In fact, you can attend regular education classes even with this head injury diagnosis. The Traumatic Brain Injury classification allows you to receive available services. For example, you can ask for speech therapy if the school has a speech therapist available. You may also be able to get some counseling through the school system. But you have to justify why you need each of these services within the school system. That's why the IEPC meeting is so important. In general, if you know what you want, they are more likely to give it to you.
If you are returning to high school, what help do you need? Some of the things we have already talked about are no time limits on tests, and getting notes (maybe even teachers notes). I would also recommend someone to help you review your progress in your classes (someone from the special education department). You would meet once every week or every other week to review how you are doing in each of your classes. They might need to meet with your teachers if you start to develop a problem in one of your classes.
I would also highly recommend an academic journal. Make a folder that lists each class with the homework and upcoming tests for the next couple of weeks. If you have a test in a history class, you need to prepare in advance. Short-term memory is impaired in head injury and it takes many repetitions of the material to learn it. You need to plan ahead and not wait until the last minute.
You should avoid studying in the evening. I have many people who do better studying in the morning, because they are alert and the brain works better then. Getting up in the morning to study is much better. If you can't do that, my suggestion is to plan it for early in the evening. The other thing that I would suggest is to study at the same time every evening. You are going to commit yourself to studying from 5:00--7:00 every night, only breaking for dinner. My suggestion is to set a time, whether you need to study or not, just to keep reviewing your materials. Get in the habit of making yourself study for 2 hours per night. Some people may have to increase that amount. In general, 2 hours is about the maximum that most people can handle. During that 2 hours, you will need to take occasional breaks, so you don't burn yourself out.
You can ask the school system to give you copies of your books. Most high schools only lend out the books. Normally, you cannot make any marks in the books, and you have to return them at the end of the class. I suggest that you ask the school to give you the books outright so that you can use a highlighter in the book. Highlighting is necessary to help you figure out what is the important material (in other words, what's going to be on the test). After you have highlighted, you may want to go back and reread it. Some school materials have questions at the back of the chapter. Most people avoid them. My suggestion is to answer everyone of them. Go back and go through the material and keep trying to do the questions as best as you can.
I strongly recommend getting a study group or a "study buddy." Get with a partner or group and try to figure out what is the most important material to learn. If you study the wrong material for an exam, you're going to get a bad grade even though you worked hard. This is particularly true with tests that have essays. A study partner will give you a new perspective by saying, "No, I think this is really important and this is why I think the teacher is going to ask this." So you cover what you think is important and cover what they think is important. Nine times out of ten, you are going to get it.
Let's talk about some test strategies. Most tests these days use multiple choice formats. Go through the test the first time and answer the questions you are sure you know. For any question you are not absolutely confident with, try to narrow down answers to two possibilities. If you think the answer is A or C, put little dashes by them and go on--don't answer those. Now go through the test a second time and start trying to answer the items with 2 or 3 possibilities. In general, don't go back a third time to change your answers. Your first guess is usually your best one; stick with it.
Many people make a common mistake of not turning over the page or not fully looking at the page to see if there are more items. They got a "C" or "D" because they didn't answer a third of the test. Always double-check every page and make sure every mark is filled in. If you can get it down to 2 or 3 items and haven't a clue, guess anyway. Don't leave it blank. Most tests don't penalize you for guessing. If it's a multiple choice and there are four items, you at least have a 1 in 4 chance. If you put nothing down, its automatically wrong.
Watch the wording of the items. There may be "trick" questions. Words like "always" and "never" are trick items. An item that says "which is the best answer" is a trick item, because they may give you 4 correct answers but only 1 of them is the very best answer. Watch for key words. Sometimes teachers don't realize that they are giving away the test item by the words they use. Most teachers are pretty good about this, but occasionally they will slip up. Watch if words are singular or plural (i.e., group or groups). Watch the wording of the test.
Essay exams are the world's toughest tests. When I was a teaching assistant, I was basically looking for key words when grading papers. If an essay needed three separate elements to get full credit, I would look for the key word or phrase as I was reading the essay. Before you even start answering the essay, try to outline the main points by scribbling them on the side of the paper. Once you are organized, start writing. Always start the first line of the paragraph with the main point you are going to cover.
One of the difficulties for most people is that they learn their material in the order that it was presented in class. The mid-term or final exam will not ask questions in that order. The problem is that you have memorized the material in order and you are going to have a hard time retrieving that information. Invest $2.00 or $3.00 and buy yourself a deck of blank file cards. Put a test question on one side of the card, then flip it over and put the answer on the back. First, learn the cards in order. Once you have gotten all the answers and questions correct, shuffle the cards and try to answer them again. In this way, the order of information will not be a factor. The other thing you can do is review every card one or two days before the exam. Sort every card you got right in one pile and every card that you got wrong in another pile. Keep working on the wrong pile until there are no more cards left in the wrong pile. If you are serious about getting good grades, this technique will work.
The social part of school is very important, and it probably is one of the things that people like the most. The problem is that socializing can get out of control if you dont spend the time on your classes. You have to set your own limits and apply discipline. Don't get behind. This is a fatal mistake for most head-injured people in school. If you need help with discipline, ask family members or friends to push you to study. Turn off the radio and the television when you are studying. Avoid distractions or get out of the house to study. When I was in college and lived in the dorm, there was something happening every minute. I made myself go to the library. I was in an environment where people were studying, and that gave me motivation to keep going. When at the library, I couldn't just go turn on the television or go to the refrigerator for a snack. But if the television or refrigerator is there, I'm going to be tempted to do it. Self-discipline is tough to come by. But it is something that can be learned. Using these techniques, you can be a better student.
By Dr. Glen Johnson, Clinical Neuropsychologist
5123 North Royal Drive || Traverse City, MI 49684
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