Research into the cognitive and behavioural sequelae of traumatic brain injury in children has frequently noted difficulties encountered by these children when they begin school or re-enter the education system following injury. However, these difficulties have seldom been linked to underlying specific cognitive deficits as traditional educational assessment is not sufficient to determine the pattern of cognitive strengths and weaknesses exhibited by these children. The return of the brain injured child into the classroom requires planning and monitoring as well as liaison between parents, teachers, hospital personnel, therapists, and psychologists. This paper briefly reviews the literature regarding academic performance in children following traumatic brain injury and outlines elements of an effective reintegration program. Possible reintegration problems are discussed.

While there is the likelihood that student, teacher, and psychologist will benefit from neuropsychological work carried out in classrooms, experience suggests that there is often a problem of communication of information between neuropsychologist and teacher. The nature of this problem is discussed here and a means of resolution is suggested. An infomation-processing model of cognition is presented which has been used with parents and teachers in order to provide a means of translation between the brain/processing schema of the neuropsychologist and the teaching schema of the teacher. A checklist of questions that focuses the attention of both teacher and psychologist on potential problem areas in each of the phases of the model is also presented.

Learning difficulties affect up to 20 percent of school-aged children. While many children “grow out” of their disability, a significant proportion experience ongoing problems which can hinder academic, social, and emotional development.

Neuropsychological models suggest that these children may suffer from subtle deficits in memory and organizational abilities, which make them vulnerable within a classroom environment. Understanding the specific neuropsychological strengths and weaknesses of children with learning difficulties may provide information regarding the most appropriate form of intervention and the likelihood of its success.

In recent study at the Royal Children's Hospital, Melbourne, 160 learning disabled children were evaluated. Findings from the group suggested a high frequency of general health problems as well as mild episodes of central nervous system dysfunction. Neuropsychological data showed that the sample, as a whole, performed within the average range on standardized intellectual measures, but achieved poor results on measures of new learning and executive function. Furthermore, data supported the presence of a number of patterns of learning disability, including linguistic deficit, non-verbal deficit, and information processing deficit. These subtypes are discussed with reference to educational characteristics, and models of intervention are suggested.

Children who suffer traumatic brain injury frequently experience difficulties in those behaviours represented as “executive” or prefrontal lobe functioning. In an educational setting these may involve disorganisation, difficulty moving from one activity to another, following rules, and staying on task to complete activities. Return to school involves a three-phase process: (1) an assessment period where school is viewed as a vehicle for stability; (2) modification of the school environment; and (3) student strategies. For the assessment phase, checklists are based on neurobehavioural sequelae of brain injuries in children and classified according to functional categories of Personal/Social, Work Habits, and Cognitive/Communicative behaviours. These are used to generate teaching and learning strategies for the second and third phases. One approach presently under trial is the development of executive skill training involving student plans. Student plans provide a framework for training students to generalise from one activity to another. Recent research provides some promise for the efficacy of this approach. The challenge to those working in rehabilitation of students with brain injuries, particularly where the frontal lobes are implicated, is to develop a process where students can recognise there is a problem, apply strategies across settings, unprompted, and monitor their performance. These are the very dysexecutive behaviours typical of students with brain injuries.

Interpretation of a child's comprehension score on the Neale-R is usually done independently from the reading accuracy score. Such a procedure can result in erroneous conclusions about the comprehension skill level of a child. When the child has both accuracy and comprehension reading ages below his/her chronological age, the comprehension data needs to be analysed only for those passages successfully read, rather than being compared directly with the recommended normative data.