Hi. This is my first time using the forum. I'm a new ESL teacher and have been asked by the agency where I work if I'd be willing to be an instructor for a French woman that was a former English scholar. She was in a terrible car accident and lost her short term memory. After 6 years of living in a special facility for handicapped people, she has arranged to be transported to the language school once a week for a lesson.
I'm not quite sure how to approach this and would certainly appreciate input from other teachers that have perhaps had students with different disabilities - specifically memory loss.
Students with disabilities
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treemonster
- Posts: 4
- Joined: Sun Feb 11, 2007 6:20 pm
- Location: France
You may want to check out the website of the Traumatic Brain Injury (TBI) association, and do a web seach to learn more about TBI. The American Speech-Language Hearing Association (www.ASHA.org) may also have some good info about communication issues with TBI.
My brother also has TBI from a car accident (now 5 years status post). Here are some basics you might want to know about common TBI symptoms.
1) fatigue sets in easily. Be prepared to make lessons easier or less intense on days when the student is already totally wiped out by the other events of the day.
2) the most spontaneous improvement from TBI happens within 6 months of the injury. And more continues to happen within the first two years. After that improvement is much slower.
3) memory loss is a huge issue. Repeat, repeat, repeat your lessons. Make use of memory notebooks/notetaking/handouts. Don't get frustrated. It just is what it is. It may improve with time and practice, or it may not ever improve, depending on the injury.
4) decrease distractions. Most people can hold a bunch of things in their short term memory at the same time. People with TBI can't hold as many. If they are thinking about family stresses, plus the noise outside the window, plus the headache the bright lights are giving them, then they won't be able to concentrate on your lesson and they won't be able to remember it either. Try to keep the environment quiet and comfortable. Keep your language simple and to the point.
5) reading comprehension (and even the visual tracking skills needed to decode words ) may also be decreased by TBI. Don't assume the student understands the simple things she is reading.
6) above all, realize that TBI really screws up a person's life. They can't do what they used to do before, and that is incredibly frustrating. Try to quietly understand the magnitude of what your student is going through, and be supportive what necessary.
Good luck. Feel free to PM me with any specific issues that arise.
-EH
My brother also has TBI from a car accident (now 5 years status post). Here are some basics you might want to know about common TBI symptoms.
1) fatigue sets in easily. Be prepared to make lessons easier or less intense on days when the student is already totally wiped out by the other events of the day.
2) the most spontaneous improvement from TBI happens within 6 months of the injury. And more continues to happen within the first two years. After that improvement is much slower.
3) memory loss is a huge issue. Repeat, repeat, repeat your lessons. Make use of memory notebooks/notetaking/handouts. Don't get frustrated. It just is what it is. It may improve with time and practice, or it may not ever improve, depending on the injury.
4) decrease distractions. Most people can hold a bunch of things in their short term memory at the same time. People with TBI can't hold as many. If they are thinking about family stresses, plus the noise outside the window, plus the headache the bright lights are giving them, then they won't be able to concentrate on your lesson and they won't be able to remember it either. Try to keep the environment quiet and comfortable. Keep your language simple and to the point.
5) reading comprehension (and even the visual tracking skills needed to decode words ) may also be decreased by TBI. Don't assume the student understands the simple things she is reading.
6) above all, realize that TBI really screws up a person's life. They can't do what they used to do before, and that is incredibly frustrating. Try to quietly understand the magnitude of what your student is going through, and be supportive what necessary.
Good luck. Feel free to PM me with any specific issues that arise.
-EH
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treemonster
- Posts: 4
- Joined: Sun Feb 11, 2007 6:20 pm
- Location: France
THANK YOU
Dear EH,
Your suggestions were so helpful. Thank you so much for sharing your insight.
I really appreciate it! Wednesday will be my first session and I feel as if I might be a little more prepared now. I'll let you know how it goes
Kind Regards,
Denise
(Treemonster)
Your suggestions were so helpful. Thank you so much for sharing your insight.
I really appreciate it! Wednesday will be my first session and I feel as if I might be a little more prepared now. I'll let you know how it goes
Kind Regards,
Denise
(Treemonster)
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treemonster
- Posts: 4
- Joined: Sun Feb 11, 2007 6:20 pm
- Location: France
Dear EH,
It was pretty interesting. The woman is obviously very intelligent and I could see she was getting very frustrated, so I tried to keep it very relaxed and convivial. I tried to keep some of the things you said in mind and it really helped - thanks again!
One thing that was very interesting, she would suddenly lapse back into French and start speaking at an incredibly fast pace - not even a breath in-between. I just let her go for a bit and decided that it would improve my French and responded in English. After a while she slowed down to a normal pace, but then later on she when back into high speed mode. I guess this must be something to do with the accident.
She's quite direct, rude in fact - kept mentioning how Americans all talk through their noses, but I didn't take it to heart. She said that her parents accuse her of saying exactly what she thinks - I just have to be careful not to show too mych pity, or to seem too patronizing. I think I'll forgo my second cup of coffee until after the lesson - what I really wanted was a stiff drink!
I went on the sites you suggested and they're quite informative although I have to admit that I started to get pretty depressed. I know they'll be a handy resource in the future.
Thanks again!
Denise-
It was pretty interesting. The woman is obviously very intelligent and I could see she was getting very frustrated, so I tried to keep it very relaxed and convivial. I tried to keep some of the things you said in mind and it really helped - thanks again!
One thing that was very interesting, she would suddenly lapse back into French and start speaking at an incredibly fast pace - not even a breath in-between. I just let her go for a bit and decided that it would improve my French and responded in English. After a while she slowed down to a normal pace, but then later on she when back into high speed mode. I guess this must be something to do with the accident.
She's quite direct, rude in fact - kept mentioning how Americans all talk through their noses, but I didn't take it to heart. She said that her parents accuse her of saying exactly what she thinks - I just have to be careful not to show too mych pity, or to seem too patronizing. I think I'll forgo my second cup of coffee until after the lesson - what I really wanted was a stiff drink!
I went on the sites you suggested and they're quite informative although I have to admit that I started to get pretty depressed. I know they'll be a handy resource in the future.
Thanks again!
Denise-
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Sally Olsen
- Posts: 1322
- Joined: Thu Apr 08, 2004 2:24 pm
- Location: Canada,France, Brazil, Japan, Mongolia, Greenland, Canada, Mongolia, Ethiopia next
I wonder if she would be interested in trying to figure out what areas of expertise are still there and what is missing - I suppose she has been tested extensively though - will she allow you to see the tests? Was she "rude" before the accident or is the part of your brain that senses 'rudeness" missing? In some ways studying people who have had accidents has led to understanding more about the brain and how it works so this might be a good opportunity for you to note down things you think are missing and then try to figure out some kind of test for them.
I can understand that you would be depressed to see that people don't usually regain what they had but can't they learn new ways to cope and wouldn't that be inspiring? You could gradually point out the new ways she is learning to her as you see them and encourage her to brainstorm about ways to overcome or bypass things that are frustrating for her.
I wonder if it wouldn't be good to read up on grief as well because she might be greiving for her former life and you could help her get through that to the other side.
I can understand that you would be depressed to see that people don't usually regain what they had but can't they learn new ways to cope and wouldn't that be inspiring? You could gradually point out the new ways she is learning to her as you see them and encourage her to brainstorm about ways to overcome or bypass things that are frustrating for her.
I wonder if it wouldn't be good to read up on grief as well because she might be greiving for her former life and you could help her get through that to the other side.
I'm glad you posted again. I was so curious about how your session went.
It is pretty depressing, eh? Sometimes best not to think about the enormity of the problem...
You mentioned unnaturally rapid speech, inappropriate code switching, rudeness, and an apparent lack of awareness of the impact of these communication behaviors. This could be her premorbid state. But it was probably influenced by her head injury. All of these things are "pragmatic" (i.e., social use of language) skills. Pragmatic skills tend to be controlled by the frontal lobe of the brain, which is what is usually most impaired after car accidents because the brain sloshes foreward against the forehead area when the car suddenly impacts. As time goes on, if she continues like this you may want to explicitly call her attention to her communication behavior. At the beginning of a session you could mention that you've noticed X, Y, and Z behaviors, and that they make it hard for listeners to follow her. Then, if she's receptive to it, gently call her attention to each behavior as it occurs during the session--not nagging or anything, just making her aware of what she's doing.
A couple of other things I wanted to mention before but forgot:
1) moodiness is really common with brain injury. Depression is nearly universal (...chemical changes in the brain, plus a really lousy life situation...), and bi-polar symptoms (depression then mania then back again) are pretty common, too. This usually gets better with time. But at about 6 months status post, you're very likely to run into this. Look out for suicidal/self-injurious comments and report them to caregivers. And don't let yourself get swept up in any manic schemes.
2) preseveration is also really common with brain injury. They get on a topic and just can't stop talking about it, rehashing it, restating it, etc. You don't have to put up with that. Respectfully point out that you've already discussed the topic extensively, and then change the subject.
Good luck!
-EH
It is pretty depressing, eh? Sometimes best not to think about the enormity of the problem...
You mentioned unnaturally rapid speech, inappropriate code switching, rudeness, and an apparent lack of awareness of the impact of these communication behaviors. This could be her premorbid state. But it was probably influenced by her head injury. All of these things are "pragmatic" (i.e., social use of language) skills. Pragmatic skills tend to be controlled by the frontal lobe of the brain, which is what is usually most impaired after car accidents because the brain sloshes foreward against the forehead area when the car suddenly impacts. As time goes on, if she continues like this you may want to explicitly call her attention to her communication behavior. At the beginning of a session you could mention that you've noticed X, Y, and Z behaviors, and that they make it hard for listeners to follow her. Then, if she's receptive to it, gently call her attention to each behavior as it occurs during the session--not nagging or anything, just making her aware of what she's doing.
A couple of other things I wanted to mention before but forgot:
1) moodiness is really common with brain injury. Depression is nearly universal (...chemical changes in the brain, plus a really lousy life situation...), and bi-polar symptoms (depression then mania then back again) are pretty common, too. This usually gets better with time. But at about 6 months status post, you're very likely to run into this. Look out for suicidal/self-injurious comments and report them to caregivers. And don't let yourself get swept up in any manic schemes.
2) preseveration is also really common with brain injury. They get on a topic and just can't stop talking about it, rehashing it, restating it, etc. You don't have to put up with that. Respectfully point out that you've already discussed the topic extensively, and then change the subject.
Good luck!
-EH
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Sally Olsen
- Posts: 1322
- Joined: Thu Apr 08, 2004 2:24 pm
- Location: Canada,France, Brazil, Japan, Mongolia, Greenland, Canada, Mongolia, Ethiopia next
Fascinating topic and replies. I was wondering if she has been living in a facility for 6 years, what they do for her and what they expect to accomplish now after all that time? I would imagine that just getting out would be good for her and attending a "class" would be good for her self-esteem. What else would she be able to accomplish?
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treemonster
- Posts: 4
- Joined: Sun Feb 11, 2007 6:20 pm
- Location: France
Dear EH and Sally,
Thank you again for your input. I had my second lesson last week and I brought in some short little articles from Mental Floss magazine. She has such a short attention span and retains so little that I wanted to find something that was interesting and not too daunting to read.
She seemed to enjoy the articles. I also downloaded a recorded interview from BBC Learning English site - it was an interview with Drew Barrymore. The hostess speaks very slowly and recaps everything. My student really seemed to enjoy that as well.
Her manic speak from the week before was not displayed. She seemed quite depressed and she said that she hadn't slept much she said she hasn't slept very well since the accident.
I appreciate your suggestions and I'll have to see how things unfold. I wasn't even sure if she'd remember me from the previous week - she did and I tried to get her to laugh at something silly that I'd said - such a lovely smile. It's so hard not to slip into sadness looking at this young person who had her whole life in front of her. She is obviously a very intelligent person and I suspect she was very demanding of herself - I have to be careful not to get too patronizing - she gets so frustrated and I know I have to be patient. She told me that she'd played the harp and had gotten some sort of scholarship for it. She said she hadn't even tried to touch the harp since the accident - she's too afraid.
One thing I misunderstood - she is back living with her parents now and she's not in a facility. I don't know if this is a good or bad thing. I really liked your suggestions about mentioning some of her slightly anti-social behavior (being quite direct or rude, speaking really fast, repeating the same story over and over again) and how it might be hard for people to understand her or want to interact with her. I think I'll see how our relationship develops - she has quite a problem with being corrected directly so I generally side step that by "reformulating." I'll keep you abreast of how things progress.
Denise-
Thank you again for your input. I had my second lesson last week and I brought in some short little articles from Mental Floss magazine. She has such a short attention span and retains so little that I wanted to find something that was interesting and not too daunting to read.
She seemed to enjoy the articles. I also downloaded a recorded interview from BBC Learning English site - it was an interview with Drew Barrymore. The hostess speaks very slowly and recaps everything. My student really seemed to enjoy that as well.
Her manic speak from the week before was not displayed. She seemed quite depressed and she said that she hadn't slept much she said she hasn't slept very well since the accident.
I appreciate your suggestions and I'll have to see how things unfold. I wasn't even sure if she'd remember me from the previous week - she did and I tried to get her to laugh at something silly that I'd said - such a lovely smile. It's so hard not to slip into sadness looking at this young person who had her whole life in front of her. She is obviously a very intelligent person and I suspect she was very demanding of herself - I have to be careful not to get too patronizing - she gets so frustrated and I know I have to be patient. She told me that she'd played the harp and had gotten some sort of scholarship for it. She said she hadn't even tried to touch the harp since the accident - she's too afraid.
One thing I misunderstood - she is back living with her parents now and she's not in a facility. I don't know if this is a good or bad thing. I really liked your suggestions about mentioning some of her slightly anti-social behavior (being quite direct or rude, speaking really fast, repeating the same story over and over again) and how it might be hard for people to understand her or want to interact with her. I think I'll see how our relationship develops - she has quite a problem with being corrected directly so I generally side step that by "reformulating." I'll keep you abreast of how things progress.
Denise-
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Sally Olsen
- Posts: 1322
- Joined: Thu Apr 08, 2004 2:24 pm
- Location: Canada,France, Brazil, Japan, Mongolia, Greenland, Canada, Mongolia, Ethiopia next
She is very lucky to have someone so understanding and willing to learn. I am sure the times together will benefit both of you.
Music might be a great way to develop her short term memory if she was so invested in it. I have always found that music seems to be stored deeper in the brain than other things. Older people who have lost a lot of abilities in thinking can often sing along with the old songs with no mistakes. I have to sing the alphabet song if I am stuck on knowing where one of those middle letters is in the dictionary. So there might be hope that she can retain more of the music than she did of other things.
If she is retelling stories, does that mean she tells them again with exactly the same words? I am really interested in this phenomena in older people too. It seems that one word sends them off on the story that you have heard so many times before - it is often a name and then you get the story of the distinguishing story of this person or a place and the distinguishing thing that happened at that place.
It might be interesting to tape one of the repeating stories, type it out and see what the structure is - can she follow through from beginning to end with a point? Is she missing any vital points of structure, particular grammar words?
Has she lost the abililty to react to people who have heard the story before and see their boredom or is she not aware of reactions?
Music might be a great way to develop her short term memory if she was so invested in it. I have always found that music seems to be stored deeper in the brain than other things. Older people who have lost a lot of abilities in thinking can often sing along with the old songs with no mistakes. I have to sing the alphabet song if I am stuck on knowing where one of those middle letters is in the dictionary. So there might be hope that she can retain more of the music than she did of other things.
If she is retelling stories, does that mean she tells them again with exactly the same words? I am really interested in this phenomena in older people too. It seems that one word sends them off on the story that you have heard so many times before - it is often a name and then you get the story of the distinguishing story of this person or a place and the distinguishing thing that happened at that place.
It might be interesting to tape one of the repeating stories, type it out and see what the structure is - can she follow through from beginning to end with a point? Is she missing any vital points of structure, particular grammar words?
Has she lost the abililty to react to people who have heard the story before and see their boredom or is she not aware of reactions?