Traumatic Brain Injury Evaluation Checklist
Track medical, neurocognitive and functional data after an acquired brain injury. A free, fillable checklist for school psychologists and evaluation teams.
What’s inside
- The federal eligibility requirements, each with space to note where the evidence is documented
- 17 commonly used measures to check off, with date tested, examiner and results
- Records, interviews, observations and screenings
- Return-to-school planning
- Evaluation timeline and a team summary box
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What IDEA requires for Traumatic Brain Injury
The checklist walks your team through each part of the federal definition so nothing is missed at the eligibility meeting:
- An acquired injury to the brain caused by an external physical force (open or closed head injury)
- Results in total or partial functional disability, psychosocial impairment, or both
- Impairments in one or more areas such as cognition, language, memory, attention, reasoning, judgment, problem-solving, sensory or motor abilities, behavior, physical functions, information processing or speech
- Not congenital, degenerative or caused by birth trauma
- Adversely affects educational performance
- Student needs specially designed instruction
Summary of federal IDEA regulations (34 CFR §300.8(c)(12)). Your state may add criteria or use different terms. Follow state and district procedures.
Measures included in the checklist
No single test determines eligibility. The checklist lists measures school psychologists commonly use so you can document what was given, when and by whom:
- Medical and history: Hospital / neurology records (with consent), Outside neuropsychological evaluation, Pre-injury school records and grades (baseline), Date of injury and current medical restrictions
- Neurocognitive: WISC-V (or WAIS-5), NEPSY-II (selected subtests), WRAML3 (memory and learning), D-KEFS (executive functions), Beery VMI, Processing speed and fatigue across the day
- Achievement and behavior: WIAT-4 or KTEA-3, BRIEF2 (parent / teacher), BASC-3 (parent / teacher / self), Adaptive measure (Vineland-3 or ABAS-3)
- Related services: Speech-language evaluation, Occupational therapy evaluation, Physical therapy evaluation
Blank rows let you add any other measures your team uses.
Return-to-school planning
- Return-to-learn plan with reduced schedule if needed
- Rest breaks and cognitive load adjustments
- Plan to re-assess as recovery changes
- Safety and physical activity restrictions
- Emotional adjustment and peer support
- Communication plan with medical providers
Frequently asked questions
Is the checklist fillable?
Yes. You can type into it on a computer or print it. Check boxes are printed, and every date, examiner and notes field can be filled in digitally.
Does this replace my state or district forms?
No. It is a working checklist to organize data. Your state may add criteria or use different terms, so always follow state and district procedures and use their required forms.
Can I share it with my evaluation team?
Yes. Share it with colleagues on your team. If others want their own copy, send them to this page.