Under-Identification of Students with Long Term Disability from Moderate to Severe TBI: Analysis of Causes and Potential Remedies

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Drew A Nagele, PsyD
Stephen R. Hooper, PhD
Kristin Hildebrant, Esquire
Melissa McCart, DEd
Judy Dettmer
Ann Glang, PhD


Traumatic Brain Injury (TBI) is a special education eligibility category under the Individuals with Disabilities Education Act (IDEA). Unlike other special education categories (e.g., autism, specific learning disabilities), relatively few students with TBI are identified for special education nationwide compared to the known prevalence of TBI. Discrepanies between TBI hospitalization data, estimates of long-term disability due to TBI, and the number of students identified under the TBI category were analyzed. Only 33% of students projected to have moderate to severe TBI were represented in state child counts using the IDEA TBI category. Possible explanations for these discrepancies were explored, including that students with TBI are not referred for special education services, students are served under other special education categories, communications between medical systems-school systems are limited, and that students may not manifest difficulty until years after injury. Potential solutions to improve TBI identification for special education services are presented.


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Nagele, D. A., Hooper, S. R., Hildebrant, K., McCart, M., Dettmer, J., & Glang, A. (2019). Under-Identification of Students with Long Term Disability from Moderate to Severe TBI:: Analysis of Causes and Potential Remedies. Research, Advocacy, and Practice for Complex and Chronic Conditions, 38(1), 10–25. https://doi.org/10.14434/pders.v38i1.26850
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