The “Invisible” Disability: Under-Identification of Students with Traumatic Brain Injury in Special Education

Traumatic Brain Injury (TBI) is often referred to as the "invisible injury" due to its complex and often subtle nature. Yet the impact it can have on a student's life is anything but invisible. Many students with TBI experience significant problems at school after TBI. They may struggle with cognition, memory, executive function, and behavioral issues. 

The statistics paint a stark picture: out of the estimated 145,000 children living with the effects of TBI, less than 1 in 5 are currently identified and receiving special education services under the TBI eligibility category (Nagel et al., 2019; Zaloshnja et al., 2008). That is almost 30,000 children not receiving the services they need! This means that a significant number of students grappling with the aftermath of TBI are slipping through the cracks, unnoticed and underserved by the education system. 

The discrepancy becomes even more concerning when considering that, on average, only 32% of students with moderate to severe TBI are identified nationally under the Special Education TBI category (Nagel et al., 2019). This begs the question: why are so many students with TBI not being identified and provided with the support they need to thrive academically and socially?

Several factors contributing to this troubling gap in identification and support include:

• many educators are unaware about TBI as a disability,
• communication breakdowns between hospitals and schools,
• under-reporting of injuries by parents, and 
• restrictive definitions of TBI that fail to encompass other forms of acquired brain injury (CDC Report to Congress, 2018).

Additionally, some students with TBI may be receiving services under alternative disability categories, further skewing the numbers, and perpetuating the under-identification of TBI.

Addressing this issue requires a multi-faceted approach that begins with raising awareness and providing education and training to school staff and parents alike.

Increasing awareness of TBI and its potential consequences is essential for early identification and intervention. Collaboration between healthcare providers and educators is also crucial to ensure that students receive the support they need both in medical settings and in the classroom. Implementing screening for TBI and evaluating school brain injury protocols can further streamline the identification process and ensure that no student falls through the cracks.

The under-identification of students with TBI in special education is not just a statistical discrepancy; it's a systemic failure to recognize and address the needs of some of our most vulnerable students. By shedding light on this issue and advocating for change, we can work towards a future where every student, regardless of their neurological condition, has access to the resources and support they need to thrive.