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1 Innovative Strategies for Issues Complicating Brain Injury: 20th Annual Conference on Neurobehavioural Rehabilitation in Acquired Brain Injury May 9 10, 2013 Hamilton Convention Centre Hamilton, Ontario GLUCKSTEIN l P E R S O N A L I N J U R Y L A W Y E R S l

2 Innovative Strategies for Issues Complicating Brain Injury 20th Annual Conference on Neurobehavioural Rehabilitation in Acquired Brain Injury Target Audience This conference will be of interest to ABI Rehabilitation Professionals, Psychologists, Physicians, Program Planners, Insurance and Legal Representatives and Advocates. Attendance Certificates Conference attendance certificates will be placed in your delegate kit. Delegates are encouraged to review self-assessment guidelines issued by their professional college/association for continuing education credits or contact their professional college or association for further information. Evaluation Prizes Delegates who complete an evaluation form will be eligible for a draw. The draws will occur during lunch and evening Reception. Casual Friday Show your support for the Hamilton Health Sciences Rehabilitation Resource Centre and Camp Dawn by purchasing a $5.00 sticker and dressing casually on Friday May 10, Convention Centre Facilities The temperature varies from room to room. Please dress accordingly. Caregiver sponsorships A limited number of caregiver sponsorships are available. For information call Joyce Lambert at ext Liability Hamilton Health Sciences hereby assumes no liability for any claims, personal injury, or damage: To any individual attending this conference. That may result from the use of technologies, programs, products and/or services at this conference. That may arise out of, or during this conference. For further information, please contact Joyce Lambert ABI Conference Regional Rehabilitation Centre, HHS Level 1 North, Room B1-106F 237 Barton Street East Hamilton, ON L8L 2X2 Phone ext Conference Goals Enhance understanding of complex issues following brain injury related to forensics, addiction, behaviour, mental health, and pain Review practical approaches to these issues as they relate to impact on recovery, community reintegration, social relationships, health, and rehabilitation Provide an opportunity to network, share experiences and cultivate partnerships 2 Innovative Strategies for Issues Complicating Brain Injury

3 Plenary Sessions Gary Chaimowitz MD, FRCP(C) Head of Service, Forensic Psychiatry Service, St. Joseph s Healthcare Intro to the Forensic System This presentation will describe how assessment/ treatment approaches in forensic psychiatry which are typically geared toward a mental health population can be adapted to the needs of ABI clients. These include the application of the Mental Health Act, fitness/risk assessments, decisions related to criminal responsibility, court ordered treatment, & Community Treatment Orders, etc. The benefits, risks, gaps, and limitations with regard to rehabilitation and community integration will be highlighted. David Graham MD, MS Staff Psychiatrist for OEF/OIF/OND Veterans Michael E. DeBakey VA Medical Center An Overview of the Challenges for Successful Rehabilitation Following Brain Injury Brain injury imposes many untoward challenges complicating a person s ability to recover. This presentation will: 1) review the etiology and classification of brain injury 2) present a broad overview of the cognitive, behavioural, mental health, substance use, and physical challenges associated with brain injury and 3) highlight important differences between civilian and military causes of brain injury, notably blasts and explosions, and the significant overlap of military brain injury and Posttraumatic Stress Disorder. Harvey Jacobs PhD, LLC, Psychologist, Behaviour Analyst Removing Shame from Behaviour We frequently equate behaviour with misbehaviour, when in effect, behaviour involves most everything we do, not just that which annoys others. Proactive approaches validate others and often identify obvious but hidden capacity. Deficit based assessment strategies often end up judging the person, frequently in a negative light. This can provide fertile grounds for shame and its toxic effects on relationships. This session will describe the benefits of emphasizing success as compared to analyzing failure. Jonathan Silver MD, Clinical Professor, Department of Psychiatry NYU Langone Medical Centre Effort, Exaggeration, and Malingering after Concussion: What are we Missing? Most individuals who experience a mild TBI, or concussion, recover completely. However, a minority continue reporting symptoms well into the late period after concussion. The types and severities of these are inconsistent with the relatively mild severity of this type of TBI. These symptoms are not infrequently ascribed to malingering, exaggeration, or poor effort on cognitive testing. This presentation will examine previously unconsidered factors that challenge the view of symptom magnification or poor effort as result of conscious processes. 20th Annual Conference on Neurobehavioural Rehabilitation in Acquired Brain Injury May 9 10,

4 Plenary Sessions Trisha Meili The Central Park Jogger: A Brain Injury Survivor s Perspective on Healing to Wholeness Shortly after 9:00 pm on April 19, 1989, a young woman out for a run in New York s Central Park was savagely beaten, raped and left for dead. Doctors despaired for her life and a horrified nation cried out in pain and outrage. Fourteen years later, Trisha Meili revealed her amazing story of survival and recovery in her best selling memoir, I am the Central Park Jogger: A Story of Hope and Possibility. Trisha will share how her journey of healing clearly linked the mind, body and spirit and taught her to look at healing in a new way. She will offer lessons that allowed her to move beyond being a victim, reclaim her life, and become whole. Sean Curran BSc, MD, FRCP(C) Chronic Pain Management Unit, Hamilton Health Sciences A Biopsychosocial Model for Pain Management in Patients with Cognitive Impairment Summary: Pain is a complex phenomena. Chronic pain is rarely relieved with a singular approach. Many individuals who have suffered a brain injury resulting in cognitive impairment present with significant challenges as it pertains to pain control. This presentation will focus on how a biopsychosocial model to pain management can be an effective approach to addressing this complex issue. Thank you to our Platinum and Gold Sponsors Platinum Sponsors GLUCKSTEIN l P E R S O N A L I N J U R Y L A W Y E R S l Gold Sponsors 4 Innovative Strategies for Issues Complicating Brain Injury

5 Concurrent Sessions A Thursday, May 9 2:30pm 3:30pm A1 Harvey Jacobs PhD, LLC, Psychologist, Behaviour Analyst 99 Questions About Life, Love and Behaviour There are only 99 important questions that you need to ask each time you begin working with someone and reconsider throughout the course of service delivery! The questions are important, but their context is even more essential. This session reviews these key questions and the role of context in how we relate to others and formulate successful relationships as well as service/ support/treatment outcomes. A2 Dennis Fast Behaviour Therapist, Brain Injury Services Amie Huisman Behaviour Therapist, Brain Injury Services Teaching Picture Exchange Communication (PEC) to Nonverbal Adults with Acquired Brain Injury as a Replacement Skill for Aggressive Behaviour Many adults with ABI and severe communication disorders develop aggressive behaviour as a means of communicating and negotiating for unmet wants and needs. Functional communication training (FCT) has been a proven method of reducing this aggressive behaviour in children and adults with autism or developmental disabilities. This presentation will discuss one type of FCT, Picture Exchange Communication System training (PECS) and its effectiveness with two adults with ABI and severe behavioural disorders. Trainingsession graphic and videotaped data will be presented demonstrating the effectiveness as well as the barriers when training individuals with ABI. A3 Bruce Linder PhD, CPsych, Brain Injury Services Chrystal Lynn Trainer and Consultant, Safe Management Group Inc. The Effectiveness of Crisis Intervention Skill Training of Staff who Service Adults with Acquired Brain Injury Staff working with adults with ABI require skills to manage conflicts with their clients as well as respond effectively to behavioural crisis situations involving verbal and physical aggression. Such skills are often learned in crisis intervention courses that are required by the provincial Ministries. This presentation will review the literature. It will present the results of pre-post knowledge and video-taped performance training evaluations conducted with staff at Brain Injury Services of Hamilton and undergraduate practicum students from McMaster University. They were all trained in Safe Management Group Inc. s Creating and Maintaining Safe Environments (www.safemanagement.org). A4 Shannon McGuire BHSc (PT) Becky Moran OT Reg. (Ont.) St. Joseph s Healthcare Parkwood Hospital Mild Traumatic Brain Injury and Headache: Using Creative Pacing Strategies and Vision Rehabilitation to Kickstart Recovery This presentation will outline the treatment framework used at Parkwood Hospital to treat mild TBI, highlighting multi-disciplinary, patient centered care approach. There will be a discussion about how to get patients out of rest using creative strategies for planning and pacing to address headaches and fatigue. Assessment and treatment of visual dysfunction, in particular, spatial visual dysfunction will also be presented. Treatment of visual dysfunction is initiated early by occupational and physiotherapy in consultation with optometry. Innovative treatment strategies used such as binasal occlusion and a weighted compression vest will also be discussed. 20th Annual Conference on Neurobehavioural Rehabilitation in Acquired Brain Injury May 9 10,

6 Thursday, May 9th Time Event Speaker 7:45 8:15 Registration & Continental Breakfast 8:30 8:45 Announcements John Zsofcsin Welcome 8:45 9:30 An Overview of the Challenges for Successful Rehabilitation David Graham Following Brain Injury 9:30 10:30 Removing Shame from Behaviour Harvey Jacobs 10:30 11:00 Refreshment Break & Poster Presentations 11:00 12:00 Effort, Exaggeration, and Malingering After Concussion: What are we Missing? Jonathan Silver 12:00 1:15 Lunch & Poster Presentations 1:15 2:15 Intro to the Forensic System Gary Chaimowitz 2:30 3:30 Concurrent Sessions A A1 99 Questions About Life, Love and Behaviour Harvey Jacobs A2 Teaching Picture Exchange Communication (PEC) to Nonverbal Adults with Acquired Brain Injury as a Replacement Skill for Aggressive Behaviour A3 The Effectiveness of Crisis Intervention Skill Training of Staff who Service Adults with Acquired Brain Injury A4 Mild Traumatic Brain Injury and Headache: Using Creative Pacing Strategies and Vision Rehabilitation to Kickstart Recovery 3:30 4:00 Refreshment Break & Poster Presentations 4:00 5:00 Concurrent Sessions B B1 Serotonin Transporter Genotype and Mild Traumatic Brain Injury Independently Influence Resilience and Perception of Limitations In Veterans B2 Return to School Following Concussion and Mild Brain Injury: A Model for Group Intervention Dennis Fast Amie Huisman Bruce Linder Chrystal Lynn Shannon McGuire Becky Moran David Graham Penny Welch-West Julie Hughes Elizabeth Skirving B3 Pathways to Recovery through the Forensic Lens Mini Mamak Heather Moulden B4 Real Life Activities: A Springboard for Therapy Ted Newbigging Christina Versteeg 5:00 Cocktail Reception & Band 6 Innovative Strategies for Issues Complicating Brain Injury

7 Friday, May 10th Time Event Speaker 7:45 8:45 Buffet Breakfast & Announcements 8:45 9:45 The Central Park Jogger: A Brain Injury Survivors Perspective on Healing to Wholeness 9:45 10:45 A Biopsychosocial Model for Pain Management in Patients with Cognitive Impairment 10:45 11:15 Refreshment Break & Poster Presentations 11:15 12:15 Concurrent Sessions C C1 Building a Recovery Attitude by Voicing our Experiences Every Day C2 Where to Start: The Complex Relationship Between Substance Use, Brain Injury and the Rehabilitation Process C3 Neurocognitive Correlates of Musculoskeletal Injury and Pain: Rehabilitation Issues 12:15 Farewell Lunch Trisha Meili Sean Curran Harvey Jacobs Carolyn Lemsky William Parkinson Dinesh Kumbhare Platinum De Rose Barrister & Solicitors Gluckstein and Associates Himelfarb Proszanski Oatley, Vigmond Law office Ross and McBride Thomson Rogers Gold Howie, Sacks, and Henry LLP Martin & Hillyer Associates Neinstein and Associates Paquette Travers and Deutschman Smitiuch Injury Law Allen J. Wynperle Sponsors Silver Alert Best Nursing Bartimaeus Inc. Mackesy Smye Michael Lamont Bronze ABI Community Services Dr. William Fulton McLeish Orlando NRIO Power OT 20th Annual Conference on Neurobehavioural Rehabilitation in Acquired Brain Injury May 9 10,

8 Concurrent Sessions B Thursday, May 9 4:00pm 5:00pm B1 David Graham MD, MS Serotonin Transporter Genotype and Mild Traumatic Brain Injury Independently Influence Resilience and Perception of Limitations in Veterans In the past seven years, new genetic research has suggested that the serotonin transporter may function as a plasticity gene rather than as an at-risk gene. The purposes of this presentation are: 1) to briefly review the train of investigation suggesting the serotonin transporter was an at-risk gene to its current conception as a plasticity gene; and 2) to review recent work by the presenter that supports the plasticitygene viewpoint. Afterwards we will offer some thoughts as to how knowing a person s genotype may assist in treatment planning. B2 Penny Welch-West MClSc, Reg CASLPO, SLP Julie Hughes SLP, MS, Reg CASLPO Elizabeth Skirving MS, MEd, Reg CASLPO, SLP, St. Joseph s Parkwood Hospital Return to School Following Concussion and Mild Brain Injury: A Model for Group Intervention High school, College and University students participated in a 6-week group treatment program addressing cognitive and communication difficulties that are prevalent following concussions and mild TBI. Issues such as fatigue, pain, headaches, hypersensitivity to light and sound, changes in vision and mood were identified as barriers to academic and social performance. Academic accommodations were introduced. Strategies for selfadvocacy and social interactions were discussed. The goals of the program were to provide evidencebased intervention, in a timely and student-centered group format in order to facilitate successful return to academics, and to reduce the incidence of mental health concerns for students with post-concussion syndrome and acquired brain injury. B3 Mini Mamak EdD, CPsych. Heather Moulden PhD, CPsych Forensic Service, Centre for Mountain Health Services St. Joseph s Healthcare, Hamilton Pathways to Recovery Through the Forensic Lens While many understand that the criminal justice system dictates entry into the Forensic System, the pathway to an absolute discharge is often less clear. This is particularly true to those outside of the system who are asked to assess, work with, and possibly supervise forensic patients. The focus of this talk will be to provide information about the Forensic System, the need for risk assessment and management, as well as treatment and rehabilitation strategies. B4 Ted Newbigging BSc, Executive Director Christina Versteeg Clinical Coordinator Paradigm Rehabilitation and Nursing Services Real Life Activities; A Springboard for Therapy One of the biggest challenges in ABI rehabilitation is rebuilding lives that have been destroyed. Providing out of context therapy through meaningful activity is an innovative and practical strategy for addressing complicating issues such as addictions, mental health, pain and behaviour. Achieving success (attainable goals) through participating in desired real life activities is an indirect approach to developing a multifunctional tool box of practical strategies. Strategies learned are then applied to client s everyday ABI issues and to a client s additional complicating challenges. Attendees will gain knowledge of how to address complicating issues in an uncomplicated way using out of context Therapy. 8 Innovative Strategies for Issues Complicating Brain Injury

9 Concurrent Sessions C Friday, May 10 11:15am 12:15pm C1 Harvey Jacobs PhD, LLC, Psychologist, Behaviour Analyst Building a Recovery Attitude by Voicing our Experiences Every Day This new video provides an overview of causes and outcomes following brain injury and a functional understanding of basic brain physiology. Narrated by experts and supplemented by interviews with people who experience disability, the video has been recognized for its outreach and accessibility to a broad audience of consumers, caretakers, professionals and lay people. It helps people understand the impairments and changes in abilities that occur following brain injury, as well as refines new capacities. C2 Carolyn Lemsky PhD, CPsych ABPP Community Head Injury Resource Services (CHIRS) Where to Start: The Complex Relationship Between Substance Use, Brain Injury and the Rehabilitation Process This presentation will provide a context for considering whether or not a client is among the 30 percent of people living with brain injury who would benefit from some intervention related to their substance use. Information about screening for substance misuse and supporting clients interest in intervention will be emphasized. An overview of current best-practices in intervention and issues related to referral and case management will also be reviewed. C3 William Parkinson PhD, CPsych Dinesh Kumbhare MD, MSc, FRCP(C), Associate Clinical Professor, Physical Medicine & Rehabilitation, McMaster University Neurocognitive Correlates of Musculoskeletal Injury and Pain: Rehabilitation Issues An interdisciplinary presentation will highlight issues affecting rehabilitation in pain patients who have neurocognitive impairments. Case studies will illustrate issues coming out of clinical practice. The growing literature on the topic will be described including neurocognitive influences on pain, as well as pain and injury influences on cognition. The hypothesis that systemic inflammation triggered by musculoskeletal injury could account for some neurocognitive changes associated with pain will be discussed. Evidence testing aspects of the hypothesis will also be presented. Research, aimed at filling a gap in understanding basic measurement properties of circulating interleukin-6 concentrations will be presented. 20th Annual Conference on Neurobehavioural Rehabilitation in Acquired Brain Injury May 9 10,

10 VINE ST YORK BOULEVARD WILSON ST CANNON ST W 407 TORONTO TORONTO CAROLINE ST S CAROLINE ST N MARKET ST KING ST W GEORGE ST MAIN ST W QUEEN ST S QUEEN ST N JACKSON ST W HUNTER ST W BAY ST S BAY ST N YORK BOULEVARD HESS ST S HESS ST N SUMMERS LN LLOYD D. JACKSON SQUARE CAROLINE ST S CAROLINE ST N YORK BOULEVARD MARKET ST CANNON ST W MACNAB ST S KING ST W GEORGE ST MAIN ST W VINE ST KING ST W MAIN ST W BAY ST S BAY ST N JACKSON ST W JAMES ST S JAMES ST N KING ST E KING ST E MAIN ST E HUGHSON ST S HUGHSON ST N SUMMERS LN REBECCA ST VINE ST KING WILLIAM ST JOHN ST S JOHN ST N 1 Hamilton Convention Centre 2 Hamilton Place 3 City Hall 4 Sheraton Hotel 5 Copps Coliseum KING ST W 6 Central Library WILSON ST JAMES ST S JAMES ST N 7 Hamilton City Centre MACNAB ST S QEW 6 BURLINGTON BRANTFORD 403 GUELPH YORK BLVD JAMES ST CATHARINE ST N WELLINGTON ST CATHARINE ST S Parking Lots BURLINGTON ST BARTON ST HAMILTON One-way MAIN ST W Streets MAIN ST KING ST KING ST E KING ST E MAIN ST E Lake Ontario HUGHSON ST S HUGHSON ST N WILSON ST QEW REBECCA ST KING WILLIAM ST NIAGARA FALLS REBECCA ST HESS ST S HESS ST N Driving Instructions CAROLINE ST S CAROLINE ST N MARKET ST From London and Beyond HUNTER ST W Follow the 401 East to Toronto. Take Exit 235 and merge onto Hwy 403 East to Brantford/Hamilton. Exit at Hwy 8 East/Main Street in Hamilton. Follow Main Street to Summers Lane. Turn left on Summers Lane. The Hamilton Convention Centre will be on your right hand side. Underground parking is on the left hand side. KING ST W GEORGE ST MAIN ST W From Toronto and Beyond Take the QEW West JACKSON to ST WHWY 403 Hamilton. Exit at Hwy 8 East/Main Street exit in Hamilton. Follow Main Street to Summers Lane. Turn Left on Summers Lane. The Hamilton Convention Centre will be on your right hand side. Underground HUNTER parking ST W is on the left hand side. From Niagara Falls and Beyond Take the QEW West to Hamilton. Take Exit 89 Burlington Street. Turn left at Wellington Street. Turn right at King Street. Turn left at Caroline Street. Turn left on to Main St. Follow Main Street to Summers Lane. Turn Left on Summers Lane. The Hamilton Convention Centre will be on your right hand side. Underground parking is on the left hand side. BAY ST S BAY ST N JACKSON ST W SUMMERS LN Accommodations MACNAB ST S KING ST W JAMES ST S JAMES ST N KING ST E HUGHSON ST S HUGHSON ST N JACKSON ST W KING WILLIAM ST There are several hotels within walking distance or a short drive of the conference site. Please call the hotels directly for conference rates: Sheraton Hotel KING ST E 116 King Street West or Staybridge Suites 20 MAIN Caroline ST W Street MAIN South ST E A limited number of rooms have been block booked at the conference rate and are available on a first JACKSON ST W come first served basis until April 8, JOHN ST S JOHN ST N CATHARINE ST N CATHARINE ST S 10 Innovative Strategies for Issues Complicating Brain Injury

11 Send your completed registration to: Joyce Lambert ABI Conference Regional Rehabilitation Centre Level 1 North, Room B1-106F 237 Barton Street East Hamilton, ON L8L 2X2 Phone ext Cancellation policy Hamilton Health Sciences reserves the right to cancel this event due to insufficient registration or circumstances beyond our control. Cancellations received before April 22, 2013 will be refunded. No refunds will be issued for cancellations received after this date. Exhibitor Registration Name Organization Address City Bus. phone Exhibit space Exhibitor space is available to agencies who wish to share information about their programs at the conference. Display area includes: an 8 x10 space; draped table; one chair. The exhibitor s room has limited provision for electrical outlets. The Exhibitor Registration includes a display area and one registration for the exhibitor. To reserve exhibit space, please complete the Exhibit Space form. Your space is confirmed upon receipt of the completed form. Exhibit setup time for the conference is from 06:00 07:45 a.m. on May 9, Removal time is from 2:00 2:30 p.m. on May 10, For further information: Joyce Lambert ext ext. Prov./State Postal/Zip Fax Exhibitor Registration Fee Early Registration $750 Postmarked on or before April 12, 2013 Registration $850 After April 12, 2013 Exhibitor Requirements I will require a table I will require an electrical outlet Exhibitor Registration includes a display area and registration for one exhibitor.

12 Delegate Registration Name Profession Agency or Organization (please specify) Address City Prov./State Postal/Zip Bus. phone ext. Fax I CONSENT to having my name appear on a published registrant list YES NO Payment Please make cheque payable (in Canadian funds) to Hamilton Health Sciences ABI Conference and return your completed form(s) with your cheque to: Joyce Lambert ABI Conference Regional Rehabilitation Centre Level 1 North, Room B1-106F 237 Barton Street East Hamilton, ON L8L 2X2 For further information contact Joyce Lambert ext Concurrent Session Selection I will attend (please circle): Session A1 A2 A3 A4 Session B1 B2 B3 B4 Session C1 C2 C3 Please indicate any dietary limitations: Delegate Registration Fee Early Registration on or before April 12, 2013 Single $325 3 or more $300 ea Caregivers or Full-time student $150 Group Rate: A minimum of three registrations received together from the same organization is required. Subtract $25 from each registration. Registration after April 12, 2013 Single $400 3 or more $375 ea Caregivers or Full-time student $150 Confirmation of registration A written acknowledgement of your registration will not be sent to registrants prior to the event. Receipts will be provided in your registrant package. Registration includes breakfasts, lunches, refreshment breaks, reception (excluding beverages) and delegate kits.

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