Integrated Neuropsychological Assessment

Size: px
Start display at page:

Download "Integrated Neuropsychological Assessment"

Transcription

1 Integrated Neuropsychological Assessment Dr. Diana Velikonja C.Psych Neuropsychology, Hamilton Health Sciences, ABI Program Assistant Professor, Psychiatry and Behavioural Neurosciences Faculty of Health Sciences, McMaster University Storrie, Velikonja and Associates Neuropsychological and Psychological Services Concussion Clinic

2 What is an Acquired Brain Injury Damage to the brain occurring after birth. Unrelated to degenerative diseases.

3 Types of Acquired Brain Injury Traumatic Penetrating Injuries Closed Head Injuries and Concussion Non Traumatic Aneurysm Swelling Disease Processes Anoxia Stroke A complex pathophysiological process affecting the brain, induced by traumatic biomechanic or other forces/changes resulting in the rapid onset of impairment of neurological function.

4 Predictive Indicators of Injury Severity MILD/ MODERATE/ SEVERE Duration of Coma/Loss of Consciousness Post-Traumatic Amnesia long term cognitive outcome Glasgow Coma Scale Initial level of function

5 Additional Mediating Variables Demographic variable age education and abilities (buffering) gender (male) pre-existing conditions

6 Model of Assessment Cognitive Processes

7 Acquired Skills and Knowledge Inherent verbally and visually mediated problem solving and reasoning skills; augmented by information we pick up through education, experience, interactions over the course of our lives. Formal and informal. The resources you have and acquire. Occupation, hobbies, leisure, interests Provides measure of extent of injury. Anchor for other cognitive skills. Role in recovery and long term outcomes.

8 Senses and Manual Abilities Sensory perception and manual motor skills

9 Attention and Information Processing Attention Verbal and Visual: focus divide/select sustain suppress distractions Processing Efficiency: how quickly and accurately can information be processed Working Memory mental manipulation of information

10 Memory Memory: Verbal and Visual: process and lateralization Acquired skills tell us how good should have been premorbidly Requires intact senses Dependent on attentional and processing integrity

11 Divergent thinking more than one answer to a question Creativity and Cognitive Flexibility generating ideas, thoughts; alternative ideas Strategy formation novel cognitive plans Metacognition Multi-tasking managing multiple tasks Behavioural Control: Executive Cognitive and Behavioural/Social Skills response inhibition risk taking and rule breaking perseverative thinking Temporal memory recency memory, frequency estimates, delayed response Impaired Social Behaviour

12 NEUROBEHAVIORAL SYNDROMES Disorders of Awareness: Anosognosia and anosodiaphoria. Frontal Syndromes: pseudo-depression, indifference, slowness, inertia, euphoria, disinhibition, hyperkinesia, lack of empathy and concern, poor insight. Temporolimbic: intense affect/, spontaneous rage, hyper- and hypo- sexuality Reactive Psychological Conditions: adjustment, PTSD, car phobia/anxiety, etc.

13 Effort and Consistency Ability to apply cognitive abilities Multiple factors emotional issues motivation sleep, medication, diet, etc. pain Understanding cognitive performance

14 Mechanisms of Recovery Acute Recovery Phase versus Chronic Recovery Phase neuroregeneration small scale addition of cells recovery compensation reorganization and stimulating plasticity key in rehabilitation lost functions not restored

15 Rehabilitation What Does the Evidence Tell Us

16 Rehabilitation What Does the Evidence Tell Us Herbs, vitamins and supplements Brain training and fitness cognitive reserve

17 Cognitive Reserve Aging and Demential Literature Brain reserve: number and density of neurons, structure; more pathology present before deficits become apparent. Cognitive reserve: pre-existing cognitive processes to employ in compensation (i.e., education, occupation, IQ, etc.). Richness and variety of experiences and activities. What improves reserve: aerobic exercise Shows promise: focused computerised training emphasis-change training extension of training to other tasks. Attention allocation. No clear evidence: cognitive training exercises.

18 Brain Training Limitations: Benefits short-lived once training discontinued. With longer periods of reported benefit there was questionable significance of training effects. Results open to many interpretations. Some limited cognitive benefits but can be task specific and not extend into practical tasks. Very limited evidence for generalized benefits.

19 Brain Injury and Cognitive Reserve Level of education, interest in occupation, IQ increased synaptic density, neurogenesis and synaptic plasticity slows ageing, and delays clinical manifestation of neurodegenerative diseases. Brain injury is associated not with the development of neurodegenerative diseases but with accelerated ageing. Even mild injuries and good recovery under conditions of stress show reduced cognitive abilities. Brain injury changes neural networks re-routing through plasticity and compensation. More of the brain in active during routine tasks. Not the same as degenerative diseases. Hypothesis is that brain injury lowers cognitive reserve resulting in different outcomes and prognoses.

20 Rehabilitation Managing Reserve Goal: To increase meaningful function based on reasonable and realistic expectations. Acute rehabilitation: Restoration or improvement of lost functions. Maximizing neurological recovery. Post-acute rehabilitation: Continuing to work with neuronal plasticity but changes may be slower and targeted. Integrate standardized test results, pre-injury characteristics, stage of development, contextual variables (i.e., meaning, goals, etc.)

21 Rehabilitation What Does the Evidence Tell Us Education as a Process: early education is associated with a significant reduction in symptom exacerbation and functional declines mechanisms of injury, how the injury caused certain deficits, retained strengths, realistic expectations rehabilitation process stages, developing meaningful and functional goals every session should involve review/education

22 Rehabilitation What Does the Evidence Tell Us Restorative Techniques: Attention/Processing, Memory and Executive Skills Neuro- / Bio- Feeback Computerized strategies Integrated into specific therapy sessions Identify the skills being taught Develop a strategy to transfer the skill to a real life task There must be practice of that skill in the context of a functional task

23 Rehabilitation What Does the Compensatory Strategies Evidence Tell Us Learning New Skills Developing strategies to manage disorganized behaviour

24 Scenarios Mona needed to clean up her apartment before some people were to arrive. On her dresser, she noticed a letter she had not opened. One hour later she was still re-reading the letter and trying to figure out how to deal with it and her visitors were about to arrive, but she had not done any cleaning. John was preparing to go to his medical appointment and placed his medications and a list of questions on the table. He got ready and then left to his appointment. When the got into the appointment room he realized he did not have his medications or list of questions.

25 Goals and Strategies Behavioural Goal client goal Goal attainment scaling framework to identify and quantify Current functioning and target functioning Strategies break down the function and identify how to fix it Metacognitive strategies Compensatory strategies

26 What Strategies Would You Suggest Compensatory Strategies White board Phone reminder Learning New Skills Review and checking strategy Developing strategies to manage disorganized behaviour Alerting, monitoring, reminding strategies Others???

27 Why is it not working?

28 Rehabilitation What Does the Evidence Tell Us Implementation and Teaching we do the metacognitive work passive approaches and strategies why we do not learn Individualized learning strategies

29 Rehabilitation What Does the Evidence Tell Us Metacognitive strategies: Precision teaching: acquisition, application and adaptation. Operant self-instruction: PQRST (preview, question, read, state, test). Goal management training Instruction: Task Analysis breaking down tasks and strategies and teaching individual steps Procedural learning: repetition of a procedure Error-free learning: especially important for severe memory impairments.

30 Task Analysis weighting scores using specific cueing breaking the task into component steps Incorporates the use of a composite functional score Has additional score system that uniquely accounts for cognitive as well as physical impairments unlike any of the other functional scales.

31 Task Analysis Composite Scores Composite Scores: 1 Total Physical Assistance (24 hour supervision): FIM (1) Total Assistance 2 Specific Verbal Cueing and Minimal Physical Assistance (75% assistance): FIM (2) Maximal Assistance 3 Specific Verbal Cueing and Gesture Modeling (assistance up to 50%): FIM (3) Moderate Assistance 4 Specific Verbal Cueing (monitoring for task up to 25%): FIM (4) Minimal Assistance 5 General Verbal Cue (monitoring for specific task under 25% of the time: FIM (5) Supervision 6 Independent (no supervision) : FIM (6-7) Independent, Complete and Modified

BINSA Information on Brain Injury

BINSA Information on Brain Injury Acquired Brain Injury (ABI) There are a number of ways an individual can suffer an acquired brain injury (ABI) Figure one - ABI causes Significant causes of ABI Traumatic Brain Injury (TBI) Traumatic Brain

More information

Brain Talk. Presented By Rachael Henry, ABI System Navigator

Brain Talk. Presented By Rachael Henry, ABI System Navigator Brain Talk Presented By Rachael Henry, ABI System Navigator If you are concerned about your health, see your doctor!! I am not a doctor and this talk is not intended to substitute individualized medical

More information

Memory, Behaviour, Emotional and Personality Changes after a Brain Injury

Memory, Behaviour, Emotional and Personality Changes after a Brain Injury Memory, Behaviour, Emotional and Personality Changes after a Brain Injury The consequences of a brain injury on any individual, family or relationship are far reaching. A brain injury not only impacts

More information

Coma. Post-Traumatic Amnesia (PTA)

Coma. Post-Traumatic Amnesia (PTA) Coma 1. When is a patient out of a Coma? A scale called the Glasgow Coma Scale is used to measure the level of consciousness, with the maximum score being 15, when a patient is fully alert and usually

More information

Concussion Recovery and Prevention: Neuroplasticity, Normal Concussion Course vs. Complicated Course. Roger Hartl, M.D. Kenneth Perrine, Ph.D.

Concussion Recovery and Prevention: Neuroplasticity, Normal Concussion Course vs. Complicated Course. Roger Hartl, M.D. Kenneth Perrine, Ph.D. Concussion Recovery and Prevention: Neuroplasticity, Normal Concussion Course vs. Complicated Course Roger Hartl, M.D. Kenneth Perrine, Ph.D. Weill Cornell Medical College Financial Disclosures Dr. Hartl

More information

CPEP Traumatic Brain Injury (TBI) Examination

CPEP Traumatic Brain Injury (TBI) Examination CPEP Traumatic Brain Injury (TBI) Examination Please read each question carefully and click on the circle next to the correct answer. When you have finished all the questions, click the Submit button at

More information

Measuring Outcomes in Brain Injury Rehabilitation. By: Kyle Haggerty, Ph.D.

Measuring Outcomes in Brain Injury Rehabilitation. By: Kyle Haggerty, Ph.D. Measuring Outcomes in Brain Injury Rehabilitation By: Kyle Haggerty, Ph.D. Learning Objectives What is Traumatic Brain Injury (TBI) Goals of Rehabilitation Measuring Outcomes in Brain Injury Rehabilitation

More information

Cognitive rehabilitation in MS

Cognitive rehabilitation in MS 14th MS Nurse International Workshop Lyon, France, October 9th 2012 Cognitive and psychological issues in MS Cognitive rehabilitation in MS Psychological Unit Neurological Department San Raffaele Hospital

More information

Early Response Concussion Recovery

Early Response Concussion Recovery Early Response Concussion Recovery KRISTA MAILEY, BSW RSW, CONCUSSION RECOVERY CONSULTANT CAREY MINTZ, PH.D., C. PSYCH., PRACTICE IN CLINICAL NEUROPSYCHOLOGY FOR REFERRAL: Contact Krista Mailey at (204)

More information

RESTORATIVE TECHNIQUES IN COGNITIVE REHABILITATION: PROGRAM DESIGN AND CLINICAL BENEFITS

RESTORATIVE TECHNIQUES IN COGNITIVE REHABILITATION: PROGRAM DESIGN AND CLINICAL BENEFITS RESTORATIVE TECHNIQUES IN COGNITIVE REHABILITATION: PROGRAM DESIGN AND CLINICAL BENEFITS In the treatment of traumatic brain injury, cognitive rehabilitation is an intervention that seeks to improve cognitive

More information

EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY

EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury (TBI) is a common neurological condition that can have significant emotional and cognitive consequences.

More information

Occupational Therapy in Cognitive Rehabilitation

Occupational Therapy in Cognitive Rehabilitation Occupational Therapy in Cognitive Rehabilitation Connie MS Lee Occupational therapist Queen Mary Hospital Hong Kong Cognition Cognition refers to mental processes that include the abilities to concentrate,

More information

Memory Rehabilitation in Early Dementia. Diana Golvers Clinical Psychologist Central Dementia Service

Memory Rehabilitation in Early Dementia. Diana Golvers Clinical Psychologist Central Dementia Service Memory Rehabilitation in Early Dementia Diana Golvers Clinical Psychologist Central Dementia Service Loss of Memory in AD Memory impairment earliest manifestation of AD and other dementias Major impact

More information

Attention, memory and learning and acquired brain injury. Vicki Anderson. Jamie M. Attention & learning: an information processing model

Attention, memory and learning and acquired brain injury. Vicki Anderson. Jamie M. Attention & learning: an information processing model Attention, memory and learning and acquired brain injury Vicki Anderson Jamie M. Childhood acquired amnesia Attention & learning: an information processing model MANAGEMENT Organising, problem solving

More information

STROKE CARE NOW NETWORK CONFERENCE MAY 22, 2014

STROKE CARE NOW NETWORK CONFERENCE MAY 22, 2014 STROKE CARE NOW NETWORK CONFERENCE MAY 22, 2014 Rehabilitation Innovations in Post- Stroke Recovery Madhav Bhat, MD Fort Wayne Neurological Center DISCLOSURE Paid speaker for TEVA Neuroscience Program.

More information

TBI TRAUMATIC BRAIN INJURY WITHIN THE MILITARY/VETERAN POPULATION

TBI TRAUMATIC BRAIN INJURY WITHIN THE MILITARY/VETERAN POPULATION TBI TRAUMATIC BRAIN INJURY WITHIN THE MILITARY/VETERAN POPULATION What is TBI? An external force that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The

More information

The Thirteen Special Education Classifications. Part 200 Regulations of the Commissioner of Education, Section 4401(1)

The Thirteen Special Education Classifications. Part 200 Regulations of the Commissioner of Education, Section 4401(1) The Thirteen Special Education Classifications Part 200 Regulations of the Commissioner of Education, Section 4401(1) Student With a Disability: A student as defined in section 4401(1), who has not attained

More information

IMPROVING YOUR EXPERIENCE

IMPROVING YOUR EXPERIENCE Comments trom the Aberdeen City Joint Futures Brain Injury Group The Aberdeen City Joint Futures Brain Injury Group is made up of representatives from health (acute services, rehabilitation and community),

More information

Neuro-rehabilitation in Stroke. Amit Kumar Neuro-Occupational Therapist

Neuro-rehabilitation in Stroke. Amit Kumar Neuro-Occupational Therapist Neuro-rehabilitation in Stroke Amit Kumar Neuro-Occupational Therapist Neuro-rehabilitation A process whereby patients who suffer from impairment following neurologic diseases regain their former abilities

More information

Attention & Memory Deficits in TBI Patients. An Overview

Attention & Memory Deficits in TBI Patients. An Overview Attention & Memory Deficits in TBI Patients An Overview References Chan, R., et.al.. (2003). Are there sub-types of attentional deficits in patients with persisting post- concussive symptoms? A cluster

More information

Chapter 4: Eligibility Categories

Chapter 4: Eligibility Categories 23 Chapter 4: Eligibility Categories In this chapter you will: learn the different special education categories 24 IDEA lists different disability categories under which children may be eligible for services.

More information

Memory Development and Frontal Lobe Insult

Memory Development and Frontal Lobe Insult University Press Scholarship Online You are looking at 1-10 of 11 items for: keywords : traumatic brain injury Memory Development and Frontal Lobe Insult Gerri Hanten and Harvey S. Levin in Origins and

More information

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD What is Rehabilitation Medicine? Rehabilitation Medicine (RM) is the medical specialty with rehabilitation as its primary strategy. It provides services

More information

Traumatic Brain Injury and Incarceration. Objectives. Traumatic Brain Injury. Which came first, the injury or the behavior?

Traumatic Brain Injury and Incarceration. Objectives. Traumatic Brain Injury. Which came first, the injury or the behavior? Traumatic Brain Injury and Incarceration Which came first, the injury or the behavior? Barbara Burchell Curtis RN, MSN Objectives Upon completion of discussion, participants should be able to Describe

More information

ABI APPLICATION FOR SERVICE

ABI APPLICATION FOR SERVICE ABI APPLICATION FOR SERVICE INSTRUCTIONS FOR COMPLETING APPLICATION FOR SERVICE To avoid a delay in processing your application, review the following checklist to ensure you have completed the necessary

More information

Revised 10-4-10 Bethel Park s Sports Concussion and Closed Head Injury Protocol and Procedures for Student-Athletes

Revised 10-4-10 Bethel Park s Sports Concussion and Closed Head Injury Protocol and Procedures for Student-Athletes Bethel Park s Sports Concussion and Closed Head Injury Protocol and Procedures for Student-Athletes If the Certified Athletic Trainer of Bethel Park School District has a concern that a student-athlete

More information

The Road to Rehabilitation

The Road to Rehabilitation The Road to Rehabilitation Part 3 Guideposts to Recognition: Cognition, Memory & Brain Injury Written by Joseph Bleiberg, PhD Content reviewed by Gregory O Shanick, MD Brain Injury Association of America

More information

www.projectlearnet.org WHAT IS COGNITIVE INTERVENTION/REHABILITATION?

www.projectlearnet.org WHAT IS COGNITIVE INTERVENTION/REHABILITATION? Tutorial: Cognitive Intervention/Rehabilitation (See Tutorials on Cognition; Transfer/Generalization; Instructional Routines; Attention; Memory and Memory Problems; Organization; Problem Solving; Concrete

More information

Learning and cognitive effects of acquired brain injury caused by meningitis or septicaemia

Learning and cognitive effects of acquired brain injury caused by meningitis or septicaemia Learning and cognitive effects of acquired brain injury caused by meningitis or septicaemia Meningitis and septicaemia can be a cause of acquired brain injury (ABI). This is an injury to the brain that

More information

Neurocognitive Disorders of the DSM-5

Neurocognitive Disorders of the DSM-5 Neurocognitive Disorders of the DSM-5 Allyson Rosen, PhD, ABPP-Cn Director of Dementia Education Mental Illness Research, Education, and Clinical Center (MIRECC) VA Palo Alto Health Care System Clinical

More information

Clinical Neuropsychology. Recovery & Rehabilitation. Alan Sunderland School of Psychology

Clinical Neuropsychology. Recovery & Rehabilitation. Alan Sunderland School of Psychology Clinical Neuropsychology. Recovery & Rehabilitation Alan Sunderland School of Psychology 1 The Changing Role of Clinical Neuropsychology HISTORY The Origins of Clinical Neuropsychology Emergence as a profession

More information

Cognitive Rehabilitation of Blast Traumatic Brain Injury

Cognitive Rehabilitation of Blast Traumatic Brain Injury Cognitive Rehabilitation of Blast Traumatic Brain Injury Yelena Bogdanova, PhD VA Boston Healthcare System Rehabilitation Research & Development Boston University School of Medicine IOM Committee on Cognitive

More information

What is a concussion? What are the symptoms of a concussion? What happens to the brain during a concussion?

What is a concussion? What are the symptoms of a concussion? What happens to the brain during a concussion? What is a concussion? The working definition used today for concussion is a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces (developed by the consensus

More information

1695 N.W. 9th Avenue, Suite 3302H Miami, FL. 33136. Days and Hours: Monday Friday 8:30a.m. 6:00p.m. (305) 355 9028 (JMH, Downtown)

1695 N.W. 9th Avenue, Suite 3302H Miami, FL. 33136. Days and Hours: Monday Friday 8:30a.m. 6:00p.m. (305) 355 9028 (JMH, Downtown) UNIVERSITY OF MIAMI, LEONARD M. MILLER SCHOOL OF MEDICINE CLINICAL NEUROPSYCHOLOGY UHEALTH PSYCHIATRY AT MENTAL HEALTH HOSPITAL CENTER 1695 N.W. 9th Avenue, Suite 3302H Miami, FL. 33136 Days and Hours:

More information

Victorian Acquired Brain Injury (ABI) Rehabilitation Referral Male Female

Victorian Acquired Brain Injury (ABI) Rehabilitation Referral Male Female UR: Family Name Victorian Acquired Brain Injury (ABI) Rehabilitation Referral Given Names Date of Birth Gender Male Female *XX146B* REFERRAL PROCESS The Victorian ABI Rehabilitation Services at Alfred

More information

Orientation Yes Yes. Memory - Learning/Delayed recall. Attention Yes Yes. Language Yes Yes. Visuospatial Yes Yes. Executive Function

Orientation Yes Yes. Memory - Learning/Delayed recall. Attention Yes Yes. Language Yes Yes. Visuospatial Yes Yes. Executive Function COGNITIVE TESTING AND LOCALIZATION MADE RIDICULOUSLY SIMPLE David F. Tang-Wai MDCM FRCPC Assistant Professor (Neurology & Geriatric Medicine), University of Toronto Geriatric Refresher Day, University

More information

Skate Australia Concussion Guidelines

Skate Australia Concussion Guidelines Skate Australia Concussion Guidelines Introduction Forces strong enough to cause concussion are common in all roller sports. Even though helmets are worn in most disciplines, the risk of concussion is

More information

Expert Witness Services for Personal Injury Lawyers

Expert Witness Services for Personal Injury Lawyers Advanced Assessments Ltd Expert witnesses and Psychologists A Member of the Strategic Enterprise Group 180 Piccadilly, London, W1J 9HP T: 0845 130 5717 Expert Witness Services for Personal Injury Lawyers

More information

Comprehensive Evaluation, Management and Treatment of Mild Traumatic Brain Injury

Comprehensive Evaluation, Management and Treatment of Mild Traumatic Brain Injury Comprehensive Evaluation, Management and Treatment of Mild Traumatic Brain Injury Steven M. Erickson, MD Medical Director, Sports Medicine and Concussion Specialists Definition of MTBI A complex pathophysiological

More information

COURSE APPROVAL GUIDELINES APS COLLEGE OF CLINICAL NEUROPSYCHOLOGISTS

COURSE APPROVAL GUIDELINES APS COLLEGE OF CLINICAL NEUROPSYCHOLOGISTS Page 1 COURSE APPROVAL GUIDELINES APS COLLEGE OF CLINICAL NEUROPSYCHOLOGISTS Updated October 2000 Page 2 1. General Introduction and Principles Clinical neuropsychology is a division of psychology concerned

More information

Presents. Brain Basics. A Seminar of Education and Understanding

Presents. Brain Basics. A Seminar of Education and Understanding Presents Brain Basics A Seminar of Education and Understanding Welcome to the Presentation. Brain Overview What Are The Stats? Brain Injury is the LEADING cause of death and disability in children, adolescents

More information

Occupational Therapy Treatment for People with Cognitive Limitations: Position paper

Occupational Therapy Treatment for People with Cognitive Limitations: Position paper Occupational Therapy Treatment for People with Cognitive Limitations: Position paper Background The purpose of a position paper is to present the professional stance regarding a given topic. The Senior

More information

Cognitive Remediation of Brain Injury

Cognitive Remediation of Brain Injury Cognitive Remediation of Brain Injury Amanda Sacks, PhD, ABPP-CN Weill Cornell Medical College Purpose 1. Outline possible cognitive deficits resulting from brain injury 2. Explain the role of cognitive

More information

Mild Traumatic Brain Injury and Malingered Cognitive Symptoms: Part I Elizabeth L. Leonard, PhD Neurocognitive Associates Scottsdale, AZ

Mild Traumatic Brain Injury and Malingered Cognitive Symptoms: Part I Elizabeth L. Leonard, PhD Neurocognitive Associates Scottsdale, AZ : Part I Elizabeth L. Leonard, PhD Neurocognitive Associates Scottsdale, AZ Dr. Leonard is a clinical and forensic neuropsychologist practicing in Scottsdale, AZ. She was formerly on the faculty at Harvard

More information

Psychological and Neuropsychological Testing

Psychological and Neuropsychological Testing 2015 Level of Care Guidelines Psych & Neuropsych Testing Psychological and Neuropsychological Testing Introduction: The Psychological and Neuropsychological Testing Guidelines provide objective and evidencebased

More information

Traumatic brain injury (TBI), caused either by blunt force or acceleration/

Traumatic brain injury (TBI), caused either by blunt force or acceleration/ Traumatic Brain Injury (TBI) Carol A. Waldmann, MD Traumatic brain injury (TBI), caused either by blunt force or acceleration/ deceleration forces, is common in the general population. Homeless persons

More information

Pragmatic Evidence Based Review Substance Abuse in moderate to severe TBI

Pragmatic Evidence Based Review Substance Abuse in moderate to severe TBI Pragmatic Evidence Based Review Substance Abuse in moderate to severe TBI Reviewer Emma Scheib Date Report Completed November 2011 Important Note: This report is not intended to replace clinical judgement,

More information

Concussion Management Return to Play Protocol

Concussion Management Return to Play Protocol Concussion Management Return to Play Protocol Returning to play following a concussion involves a stepwise progression once the individual is symptom free. There are many risks to premature return to play

More information

Alice A. Gervasini, PhD, RN Nurse Director, Trauma & Emergency Surgical Services Massachusetts General Hospital Instructor in Surgery Harvard Medical

Alice A. Gervasini, PhD, RN Nurse Director, Trauma & Emergency Surgical Services Massachusetts General Hospital Instructor in Surgery Harvard Medical Alice A. Gervasini, PhD, RN Nurse Director, Trauma & Emergency Surgical Services Massachusetts General Hospital Instructor in Surgery Harvard Medical School None of the planners or presenters of this session

More information

Recovering from a Mild Traumatic Brain Injury (MTBI)

Recovering from a Mild Traumatic Brain Injury (MTBI) Recovering from a Mild Traumatic Brain Injury (MTBI) What happened? You have a Mild Traumatic Brain Injury (MTBI), which is a very common injury. Some common ways people acquire this type of injury are

More information

Neuropsychiatry Disorders

Neuropsychiatry Disorders Neuropsychiatry Disorders Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems (Copyright UHS 2009; All rights reserved) For more information: Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems 12710

More information

Objectives 11/25/2014. Promoting safety, justice and healing by recognizing and responding to the Brain s Response to Trauma and Abuse

Objectives 11/25/2014. Promoting safety, justice and healing by recognizing and responding to the Brain s Response to Trauma and Abuse Promoting safety, justice and healing by recognizing and responding to the Brain s Response to Trauma and Abuse Kim Day, RN, SANE A, SANE P SAFta Project Director Jennifer Pierce Weeks, RN, SANE A, SANE

More information

acbis Chapter 1: Overview of Brain Injury

acbis Chapter 1: Overview of Brain Injury acbis Academy for the Certification of Brain Injury Specialists Certification Exam Preparation Course Chapter 1: Overview of Brain Injury Module Objectives Describe the incidence, prevalence and epidemiology

More information

Service Overview. and Pricing Guide

Service Overview. and Pricing Guide Service Overview and Pricing Guide Millard Health s Service Overview and Pricing Guide Millard Health provides rehabilitation services for both work-related and non-work-related injuries. The rehabilitation

More information

Alzheimer Dementia. Incidence: % of all dementias Women twice as likely to develop AD as men. Onset: years. Duration: 8 10 years

Alzheimer Dementia. Incidence: % of all dementias Women twice as likely to develop AD as men. Onset: years. Duration: 8 10 years Alzheimer Dementia Alzheimer Disease (AD) is the most widespread of the dementias, the main features being a progressive deterioration of cognition and memory. Incidence: 50 60 % of all dementias Women

More information

A model of rehabilitation service delivery for moderate to severe traumatic brain injury in New Zealand: its development and implementation

A model of rehabilitation service delivery for moderate to severe traumatic brain injury in New Zealand: its development and implementation A model of rehabilitation service delivery for moderate to severe traumatic brain injury in New Zealand: its development and implementation Allison Foster, PhD Max Cavit ABI Rehabilitation New Zealand,

More information

Neuropsychological Assessment in Sports-Related Concussion: Part of a Complex Puzzle

Neuropsychological Assessment in Sports-Related Concussion: Part of a Complex Puzzle Neuropsychological Assessment in Sports-Related Concussion: Part of a Complex Puzzle Jillian Schuh, PhD 1, 2, John Oestreicher, PhD 1, & Linda Steffen, PsyD 1 1 Catalpa Health 2 Department of Neurology,

More information

Neuropsychological Rehabilitation. Neuropsych Assessment. Neuropsych Assessment 2/23/11

Neuropsychological Rehabilitation. Neuropsych Assessment. Neuropsych Assessment 2/23/11 Neuropsychological Rehabilitation Neuropsych Assessment Rehabilitation requires a team approach Design evaluations to aid treatment team Identify breadth and depth of deficits Identify remaining strengths

More information

SAMPLE QUESTIONS The following 15 questions serve as samples of the question type and content found on the CRRN examination.

SAMPLE QUESTIONS The following 15 questions serve as samples of the question type and content found on the CRRN examination. SAMPLE QUESTIONS The following 15 questions serve as samples of the question type and content found on the CRRN examination. 1. Mr. Smith is a 54-year-old male who had a left middle cerebral artery stroke

More information

Traumatic Brain Injury for VR Counselors Margaret A. Struchen, Ph.D. and Laura M. Ritter, Ph.D., M.P.H.

Traumatic Brain Injury for VR Counselors Margaret A. Struchen, Ph.D. and Laura M. Ritter, Ph.D., M.P.H. Training Session 1c: Understanding Recovery Courses and Outcomes after TBI What is the typical recovery course after a mild or moderate/severe TBI? What are the effects of personal and environmental factors,

More information

Dedicated Stroke Interprofessional Rehab Team. Mixed Rehab Unit. Dedicated Rehab Unit

Dedicated Stroke Interprofessional Rehab Team. Mixed Rehab Unit. Dedicated Rehab Unit Outpatient & Community I n p a t I e n t Stroke Rehab Definition Framework Institutional Setting Inpatient Rehab in Acute Care or Rehab Hospitals* Acute Care Integrated Specialized Units Transitional Care

More information

ACUTE INPATIENT REHABILITATION GUIDELINE

ACUTE INPATIENT REHABILITATION GUIDELINE ACUTE INPATIENT REHABILITATION GUIDELINE Inpatient rehabilitation facilities promote rehabilitative health care services rather than general medical and surgical services. Rehabilitation is defined as

More information

Concussion Management Program for Red Bank Catholic High School Athletic Department

Concussion Management Program for Red Bank Catholic High School Athletic Department Concussion Management Program for Red Bank Catholic High School Athletic Department *This document should be used as a framework for a successful concussion management program but is not intended to replace

More information

What is Narrative Exposure Therapy (NET)?

What is Narrative Exposure Therapy (NET)? What is Narrative Exposure Therapy (NET)? Overview NET is a culturally universal short-term intervention used for the reduction of traumatic stress symptoms in survivors of organised violence, torture,

More information

Comprehensive Special Education Plan. Programs and Services for Students with Disabilities

Comprehensive Special Education Plan. Programs and Services for Students with Disabilities Comprehensive Special Education Plan Programs and Services for Students with Disabilities The Pupil Personnel Services of the Corning-Painted Post Area School District is dedicated to work collaboratively

More information

Epilepsy and Neuropsychology Dr. Sare Akdag, RPsych

Epilepsy and Neuropsychology Dr. Sare Akdag, RPsych Epilepsy and Neuropsychology Dr. Sare Akdag, RPsych Most people living with epilepsy do not experience serious problems with their thinking. However, there are aspects of thinking that can be affected

More information

MENTAL IMPAIRMENT RATING

MENTAL IMPAIRMENT RATING MENTAL IMPAIRMENT RATING Lev.II Curriculum Rev. 6/09 155 OBJECTIVES MENTAL AND BEHAVIORAL DISORDERS 1. Identify the axes used in the diagnostic and statistical manual of mental disorders - DSM. 2. Understand

More information

Management of Concussion/Mild Traumatic Brain Injury - Evidence Based Practice

Management of Concussion/Mild Traumatic Brain Injury - Evidence Based Practice Management of Concussion/Mild Traumatic Brain Injury - Evidence Based Practice Introduction 1) The Centers for Disease Control and Prevention has estimated that each year, approximately Americans survive

More information

BINSA Information on Mild Traumatic Brain Injury

BINSA Information on Mild Traumatic Brain Injury Mild traumatic brain injuries (MTBI) occur through sporting, car and workplace accidents. Mild brain injury is not easily diagnosed. This fact sheet explains how it may be recognised and assessed, and

More information

Effects of hypoglycemia on brain. Ji Hyun Kim Department of Neurology Korea University College of Medicine

Effects of hypoglycemia on brain. Ji Hyun Kim Department of Neurology Korea University College of Medicine Effects of hypoglycemia on brain Ji Hyun Kim Department of Neurology Korea University College of Medicine Glucose and brain The brain is dependent on glucose as its principal fuel Interruption of glucose

More information

Introduction to Neuropsychological Assessment

Introduction to Neuropsychological Assessment Definitions and Learning Objectives Introduction to Neuropsychological Assessment Alan Sunderland Reader in Clinical Neuropsychology Neuropsychological assessment seeks to define cognitive disability in

More information

Neuropsychological Exams. Larry Fisher, Ph.D., ABPN UHS Neurobehavioral Systems

Neuropsychological Exams. Larry Fisher, Ph.D., ABPN UHS Neurobehavioral Systems Neuropsychological Exams Larry Fisher, Ph.D., ABPN UHS Neurobehavioral Systems For More Info: Larry Fisher, Ph.D., ABPN Director of Neuropsychological Services Comprehensive Neurobehavioral Systems 12710

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does a neurocognitive habilitation therapy service improve executive functioning and emotional and social problem-solving skills in children with fetal

More information

The Role of Neuropsychological Testing in Guiding Decision- Making Related to Dementia

The Role of Neuropsychological Testing in Guiding Decision- Making Related to Dementia The Role of Neuropsychological Testing in Guiding Decision- Making Related to Dementia By Scott Knight, Director, SLR Diagnostics & Assessments, a division of Sibley & Associates Inc., and Konstantine

More information

Survivors need to be reminded to use affected limbs and impaired functions.

Survivors need to be reminded to use affected limbs and impaired functions. Progress in Recovery Stroke is overwhelming. At one moment, we are fully functional, and in the next, abilities are taken away and we feel shock, loss, fear, grief, and helpless to forces beyond our control.

More information

Neuropsychological Assessment in Sports- Related Concussion: Part of a Complex Puzzle

Neuropsychological Assessment in Sports- Related Concussion: Part of a Complex Puzzle Neuropsychological Assessment in Sports- Related Concussion: Part of a Complex Puzzle Jillian Schuh, PhD 1, 2, John Oestreicher, PhD 1, & Linda Steffen, PsyD 1 1 Catalpa Health 2 Department of Neurology,

More information

Behavioral Health Psychological/Neuropsychological Testing Guidelines

Behavioral Health Psychological/Neuropsychological Testing Guidelines Behavioral Health Psychological/Neuropsychological Testing Guidelines Psychological testing (procedural code 96101) and Neuropsychological Testing (procedural code 96118) involve the culturally and linguistically

More information

Review Evaluation of Residuals of Traumatic Brain Injury (R-TBI) Disability Benefits Questionnaire *Internal VA or DoD Use Only*

Review Evaluation of Residuals of Traumatic Brain Injury (R-TBI) Disability Benefits Questionnaire *Internal VA or DoD Use Only* Review Evaluation of Residuals of Traumatic Brain Injury (R-TBI) Disability Benefits Questionnaire *Internal VA or DoD Use Only* Name of patienweteran: SSN: ----------- Your patient is applying to the

More information

Post-Acute Rehab: Community Re-Entry After Stroke? Sheldon Herring, Ph.D. Roger C. Peace Rehab Hospital Greenville Hospital System

Post-Acute Rehab: Community Re-Entry After Stroke? Sheldon Herring, Ph.D. Roger C. Peace Rehab Hospital Greenville Hospital System Post-Acute Rehab: Community Re-Entry After Stroke? Sheldon Herring, Ph.D. Roger C. Peace Rehab Hospital Greenville Hospital System 2014 Neurocognitive Deficits After Stroke: The Hidden Disability Sheldon

More information

Health Professionals who Support People Living with Dementia

Health Professionals who Support People Living with Dementia Clinical Access and Redesign Unit Health Professionals who Support People Living with Dementia (in alphabetical order) Health Professional Description Role in care of people with dementia Dieticians and

More information

Alcohol and Brain Damage

Alcohol and Brain Damage Alcohol and Brain Damage By: James L. Holly, MD O God, that men should put an enemy in their mouths to steal away their brains! That we should, with joy, pleasance, revel, and applause, transform ourselves

More information

Suicide Attempts Following Traumatic Brain Injury

Suicide Attempts Following Traumatic Brain Injury Suicide Attempts Following Traumatic Brain Injury From Risk Identification to Prevention Rolf B. Gainer, Ph.D. Neurologic Rehabilitation Institute at Brookhaven Hospital Identify psychiatric and psychological

More information

The Concept of Cognitive Reserve: A Catalyst for Research

The Concept of Cognitive Reserve: A Catalyst for Research Journal of Clinical and Experimental Neuropsychology 1380-3395/03/2505-589$16.00 2003, Vol. 25, No. 5, pp. 589 593 # Swets & Zeitlinger The Concept of Cognitive Reserve: A Catalyst for Research Yaakov

More information

WHERE CAN PSYCHOLOGY TAKE ME?

WHERE CAN PSYCHOLOGY TAKE ME? WHERE CAN PSYCHOLOGY TAKE ME? There are many careers in Psychology and many types of psychologist. If you are thinking of a career in Psychology, you need to go to university to study Psychology at undergraduate

More information

A PEEK INSIDE A CLOSED HEAD INJURY CLAIM... 1

A PEEK INSIDE A CLOSED HEAD INJURY CLAIM... 1 A PEEK INSIDE A CLOSED HEAD INJURY CLAIM By: Douglas Fletcher Fernando Fred Arias Dr. Jim Hom April 11, 2014 CONTENTS A PEEK INSIDE A CLOSED HEAD INJURY CLAIM... 1 SYMPTOMATOLOGY... 2 CRITICAL INFORMATION...

More information

Psychological Society of Ireland Division of Neuropsychology

Psychological Society of Ireland Division of Neuropsychology Psychological Society of Ireland Division of Neuropsychology Dr. Brian Waldron Senior Clinical Neuropsychologist Chair- PSI Division of Neuropsychology 27th February 2016 Neurological / Neuropsychological

More information

2014 Neurologic Physical Therapy Professional Education Consortium Webinar Course Descriptions and Objectives

2014 Neurologic Physical Therapy Professional Education Consortium Webinar Course Descriptions and Objectives Descriptions and Neuroplasticity Health care providers are facing greater time restrictions to render services to the individual with neurological dysfunction. However, the scientific community has recognized

More information

Ronald G. Riechers, II, M.D. Medical Director, Polytrauma Team Cleveland VAMC Assistant Professor Department of Neurology Case Western Reserve

Ronald G. Riechers, II, M.D. Medical Director, Polytrauma Team Cleveland VAMC Assistant Professor Department of Neurology Case Western Reserve Ronald G. Riechers, II, M.D. Medical Director, Polytrauma Team Cleveland VAMC Assistant Professor Department of Neurology Case Western Reserve University The opinions or assertions contained herein are

More information

Rehabilitation Therapies

Rehabilitation Therapies Bluebonnet Medical Rehabilitation Hospital Rehabilitation Therapies 512-444-4835 or 800-252-5151 www.texasneurorehab.com Austin, Texas What Sets Us Apart Rehabilitation Therapies Physical Therapy - Neuromuscular

More information

Montreal Cognitive Assessment (MoCA) as Screening tool for cognitive impairment in mtbi.

Montreal Cognitive Assessment (MoCA) as Screening tool for cognitive impairment in mtbi. Montreal Cognitive Assessment (MoCA) as Screening tool for cognitive impairment in mtbi. Suresh Kumar, M.D. AUTHOR Director of: Neurology & Headaches Center Inc. Neurocognitve &TBI Rehabilitation Center

More information

Effective Services for People Living with Brain Injury

Effective Services for People Living with Brain Injury Effective Services for People Living with Brain Injury Jean Capler, MSW, LCSW Local Support Network Leader The Rehabilitation Hospital of Indiana Resource Facilitation Plan for Today Brain Injury 101 Challenges

More information

Symptoms Of Brain Injury

Symptoms Of Brain Injury BRAIN INJURY Laleh Jamshidi-Azad, CRRN Nurse Manager What is a Traumatic Brain Injury Blow or jolt to the head or a penetrating injury that disrupts the function of the brain. The severity may range from

More information

SAM KARAS ACUTE REHABILITATION CENTER

SAM KARAS ACUTE REHABILITATION CENTER SAM KARAS ACUTE REHABILITATION CENTER 1 MEDICAL CARE Sam Karas Acute Rehabilitation The Sam Karas Acute Rehabilitation Center is a comprehensive and interdisciplinary inpatient unit. Medical care is directed

More information

brain injury take care of yourself. we ll take care of the rest.

brain injury take care of yourself. we ll take care of the rest. take care of yourself. we ll take care of the rest. common injuries While injuries to the head do not always result in damage to the brain, it s important to note the most common forms of head trauma that

More information

DRIVER REHABILITATION OVERVIEW

DRIVER REHABILITATION OVERVIEW DRIVER REHABILITATION OVERVIEW What is included in a Driving Evaluation? The purpose of the evaluation is to determine if the individual s medical condition, medications, functional limitations and/ or

More information

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease.

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Memory loss and changes in mood and behavior are some signs that you or a family member may have Alzheimer s disease. If you have

More information

Concussion Guidance for the General Public

Concussion Guidance for the General Public CONCUSSION FACTS A concussion is a brain injury. All concussions are serious. Concussions can occur without loss of consciousness. All athletes with any symptoms following a head injury must be removed

More information

Annotations for Determining Non-Secondary Psychiatric Impairment

Annotations for Determining Non-Secondary Psychiatric Impairment Annotations for Determining Non-Secondary Psychiatric Impairment Dr Michael Epstein and Dr Nigel Strauss December 2005 Annotations for Determining Non-Secondary Psychiatric Impairment Page 1 of 12 Annotations

More information

Cognitive Rehabilitation Evidence- Based Practices. Cynthia Griggins, PhD Neuropsychologist, Neurological Institute UHCMC

Cognitive Rehabilitation Evidence- Based Practices. Cynthia Griggins, PhD Neuropsychologist, Neurological Institute UHCMC 1 Cognitive Rehabilitation Evidence- Based Practices Cynthia Griggins, PhD Neuropsychologist, Neurological Institute UHCMC 2 What is Cognitive Rehab? Goal: ameliorate injury-related cognitive deficits

More information

Maine East High School Athletic Concussion Protocol

Maine East High School Athletic Concussion Protocol Maine East High School Athletic Concussion Protocol As new medical information is disseminated, we at Maine East High School are ever evolving our safety procedures to create a safer environment for all

More information