School Reintegration for Children with Traumatic Brain InjuriesConflicts between Medical and Educational Systems

The complexities and challenges of school reentry and integration for children with traumatic brain injuries (TBI) have been examined largely from the clinical perspectives of specialists working in rehabilitation settings or programs. Less attention has been directed to the inherent differences and priorities of hospital, school, and family systems that can undermine effective educational planning and programming. This paper describes the development of a consumer-generated, school-based, model TBI program. It examines: (1) programmatic and fiscal conflicts between medical and educational systems, (2) different expectations for family involvement by hospital and school staff, and (3) the meaning of transition. The authors conclude that clinical competence of rehabilitation specialists is not sufficient for designing effective educational programs for student, with TBI. Schools and medical/rehabilitation facilities need to become much better informed about each other's resources, method, of service delivery, and payment systems in order to become effective partners with complementary expertise. Otherwise, false assumptions and unrealistic expectations among schools, medical providers, and families will continue to compound the difficulties that children have when they enter or return to school after TBI.