Elementary students raise their hands while a teacher stands ready to call on one of them

Helping children return to school after traumatic brain injury focus of new $2.2M CDC research grant

With a four-year, $2.2 million grant from the Centers for Disease Control and Prevention (CDC), researchers at Case Western Reserve University will seek answers on how children with traumatic brain injury (TBI) can return to school.

Nearly 2,000 children visit emergency rooms every day with TBI, which include concussions, contusions and symptoms such as difficulty concentrating and blurred vision.

While some educational services are available that help students with TBI return to school, many states do not offer them, and little data exists on outcomes and effectiveness of these programs—despite documented negative long-term academic, social and behavioral challenges experienced by these children.

Angela Ciccia
Angela Ciccia

“We’ve seen children who participate in TBI-related programs show better academic, social and health outcomes than students who do not receive these services—but we need to better understand this relationship to improve educational support resources in the future,” said Angela Ciccia, the grant’s principal investigator and an associate professor in the Department of Psychological Sciences in the College of Arts and Sciences at Case Western Reserve.

The study

Researchers will collect measurements related to the cognitive, physical, social-emotional and behavioral impairments associated with TBI—which negatively affect classroom performance and learning—that can be improved by educational support and resources. They will also look for data on quality of life and the resolution of physical injury symptoms.

The study will focus on a model return-to-school program for K-12 students who have experienced TBI, called BrainSTEPS, in Pennsylvania. Started in 2007, the program aims to “build a bridge connecting the medical, rehabilitation, education sectors and families” following a brain injury and has been acknowledged by the CDC for its approach.

“Children in this program receive an extra level of support from trained consulting teams, who meet with a student’s teachers and parents to develop education plans and referrals—and follow-up to respond to ongoing needs,” said Ciccia.

Data from 450 students who participate in BrainSTEPS will be compared to that from 308 students with TBI in Ohio, who do not participate in a formal program. For study participants, much of the data collection can take place by phone or online through videoconferencing and email.

“With brain injuries, it’s not just the problems you notice at the time of injury,” Ciccia said. “Because a child is developing, problems may not show up immediately but may become more apparent long-term highlighting lags in development. How educational resources can be responsive to such a dynamic and personalized needs is key.”


The CDC aims to use findings from the research to provide national guidance for states without formal programs for helping students with TBI.

A similar CDC-funded project will be administered by the University of Oregon.

Coordinating and collecting data on the control group in Ohio, which lacks a formal program for students with TBI, is Jennifer Lundine, an assistant professor in the Department of Speech and Hearing Science at Ohio State University and director of its Childhood Cognition, Communication, and Brain Injury Lab.

For more information, contact Daniel Robison (daniel.robison@case.edu)