Wednesday, November 20, 2013

Supports on Long Island

     After someone suffers from a traumatic brain injury (TBI), they may need services and supports in one, or many areas. On Long Island, a well know agency that provides support and services to brain injury survivors is Long Island Head Injury Association (LIHIA). Their slogan, "A Bridge to Hope and Healing," says a lot about them. Their mission is to provide information and assistance to victims of a TBI as well as their families. The LIHIA offers family & community services, service coordination, residential programs, supported employment and community habilitation. Recovery or adjustment to a brain injury could be extremely difficult for most. This agency assists families by educating them and directing them in the appropriate direction. Their mission is to maximize TBI survivors' potential by providing the necessary residential and support programs to help them achieve four valued outcomes. These outcomes are individualization, independence, integration and productivity.
     The first step to receiving services is to be assigned a Medicaid Service Coordinator (MSC). The MSC will assist individuals and families with applying for services and receiving care. These services include Medicaid, clinical services, rehabilitation, and group home and job placement assistance. The Head Injury Association has multiple housing opportunities across Long Island. These housing options include community residences, supportive apartments and condos. The type of housing offered to a TBI victim is dependent on the severity of their brain damage and their level of independence. Like all residential settings, the goal is to assist and teach the individual to be as independent as possible. 
     A victim of a brain injury may not be able to return to work for months, years or ever. The supported employment services train the individuals to be able to work a job to the best of their abilities. Some skills could be learned again and mastered while some may never come back. At the Head Injury Association, a plan is set up to cover knowledge, skill-sets training, on-the-job accommodations, safety requirements and transportation. If needed, an individual will be provided a one-to-one staff member to give full support.
     
     The Long Island Head Injury Association's goal is the same as most other agencies that work with Developmentally Disabled Adults. The only difference is that the "focus" or disability here is traumatic brain injury. The goal is to teach and promote independence of the individuals involved to the furthest possible extent. Although some people may recover for the most part from a brain injury, there are many who have very serious, permanent disabilities. Places like the LIHIA hope to make the process a little bit easier for the victims of a traumatic brain injury, as well as their family.

    For more information about the Long Island Head Injury Association, please visit their website.

Thursday, November 7, 2013

The Stories of 2 Different Children

     Please watch this touching video about two different children that suffered a traumatic brain injury. These children are suffering from very different deficits after their injury. As stated in the video, the Centers for Disease Control states that brain injury is the most frequent cause of disability and death amongst children and adolescents in the United States. The main effects of a TBI on children is the tendency to become impulsive, have outbursts and difficulty sustaining focus.


Brandon
     Brandon was four years old and playing at the park with his father and older brother. He was struck on the top of his skull with a baseball. He spent a week in the hospital with a depressed skull fracture. When he was released, the doctors were unsure if there would be any long term effects.
     Brandon is now eleven years old. He is in a Special Education classroom and suffers cognitive and behavioral issues. His parents, Mary and Randy, noticed a change in Brandon pretty soon after returning home from the hospital. He was not the Brandon they knew. They noticed behavior problems such as violence and verbal threats. Mary and Randy took their son for a neuropsychological evaluation and it found that there were cognitive and behavioral changes that will be long term.
     Brandon currently takes medication that helps control his negative behaviors. He receives Medicaid and Home & Community based services from the Office for People With Developmental Disabilities (OPWDD). These services include; service coordination, respite/residential habilitation and behavior intervention. These services help, but Brandon's long term disabilities effect himself, his parents and older brother on a regular basis. In the video, Brandon says he is trying to do better to not get so mad. Due to the TBI, Brandon cannot help it.

Allie
     Allie is a seventeen year old student. Prior to her injury, she was very socially active and had a busy life. She enjoyed school, dancing and track. At the age of fifteen, Allie was thrown on her head on a wood floor during dance class. She was seen by a doctor and sent home with a concussion.
     Soon after her accident, Allie and her family noticed some problems that were not present before. She was suffering from short term memory loss and would forget things after about twenty seconds. She could not handle too much information or stimulation at once and it would cause her to get confused. Allie suffered from such terrible headaches that she spent most of her time in her bedroom with the lights out from June through September.
     Allie's parents began researching the internet for help and came across the New York State Brain Injury Association. There, they got information about a program called FACTS. FACTS is The Family Advocacy Counseling and Training Services Program. This program helped Allie and her family tremendously. They offered family support, referrals, information and training. A FACTS coordinator was assigned to Allie. This person met with Allie's school and teachers to train them on how to better assist Allie after her injury. A 504 Plan was put together for Allie. This plan is used to ensure and identify accommodations that a student needs in order to be successful in school.
     Allie was the type of student that never had to study in order to do well. Now she must. She must work extremely hard to retain information and do well in school. She refers to herself in the video as an extremely motivated person. She has learned to advocate for herself and ensure she receives the assistance she needs. Allie now has very little time for a broad social life because she has to work so hard in school. Allie continues to have dreams for her future that she works towards.

     The two children interviewed and discussed in the video are suffering from different deficits caused by the traumatic brain injury. Brandon's injury has negatively effected his personality and behavior. Allie's injury has changed her style of learning and has made it difficult for her to retain information the way that she used to. As stated in previous blogs, the severity of the effects and impact on one's life is dependent upon the severity and location of the injury.

If the video cannot be viewed here, please click on the link below:
http://www.youtube.com/watch?v=l5YBR1zQpQg

Friday, October 25, 2013

Prenatal vs. Postnatal


In children, traumatic brain injury (TBI) is not a result of genetic issues. There are no prenatal factors or issues that will cause a child to be at higher risk for developing a TBI. Brain damage can occur in the event of a complicated birth, such as a breach birth or lack of oxygen to the infant. Usually a TBI occurs due to the environment the child is raised in and subjected to. TBI is often found in children and young adults that are victims of abuse, gun shot wounds and physical altercations/accidents. The main issues that a child with a TBI might experience are issues with attention, memory and learning. Children suffering from a brain injury that results in a comatose state for twenty-four hours or more are more susceptible to intellectual disabilities (ID). 
A traumatic brain injury to a child or young adult can result in deficits in one or more of the following areas; intelligence, executive functions, academic, perceptual, psychosocial, memory and family relationships. Damage to the left hemisphere of the brain will cause problems with speech and language. Psychosocial issues include changes in personality and increased psychiatric disorders. Deficits in executive functions include impulsivity, attention deficits, excessive verbalizations, insensitivity and socially inappropriate behaviors. Perceptual deficits are dependent upon the severity of the injury.

Saturday, October 5, 2013

Behavioral Side Effects

       A person who suffers a traumatic brain injury (TBI) that results in mental retardation (MR), will usually exhibit negative behaviors that were not present prior to the injury. The type of negative behaviors that one may display that are directly caused by the injury depend on the portion of the brain that suffered the injury. Injuries to the frontal lobe, limbic system and cerebral cortex can cause issues with emotional responses and control as well as initiation and motivation. Damage to the frontal lobe and/or temporal lobe can cause frustration and uncontrolled aggression. The aggression will vary in intensity and form (physical or verbal). Many other physical and health issues can add to the person's frustration and aggression. With frontal lobe damage, sexual inappropriateness may also occur. An individual may not be able to control his/her self and may not be able to filter inappropriate language or behavior. The lack of motivation and activity is a common behavioral side effect of a TBI. Individuals suffering with these problems just don't feel up to participating in activities and are difficult to motivate. This may also be due to the fact that they are not able to complete certain tasks without tremendous assistance from another person.
     All of the psychological impairments will also cause negative behaviors. If someone is unable to walk, pick up items with their fingers, or hold items, due to damage to the cerebellum, it can be extremely frustrating. This frustration tends to be displayed in a negative fashion, especially if the individual has suffered damage to other areas of the brain that aid in the control of feelings or actions. The brain is extremely delicate. If one sustains an injury to a part of the brain that caused mental retardation, it is likely that the damage was to more than one part of the brain.
    The link below describes more of the areas of the brain that may be injured and the effects it would have on the person. Remember, if more than one area is injured, the deficits would be combined and the intensity may be increased.

http://www.bcftbi.org/about-tbi/behavior.asp

Friday, September 27, 2013

Traumatic Brain Injury- Intro


Traumatic Brain Injury
Intro

            A traumatic brain injury (TBI) is caused by a bump, blow or jolt to the head. Such occurrences can result in mild to severe damage to the brain. When a traumatic brain injury is sustained prior to the age of 22, an individual may then also be diagnosed with mental retardation, (MR). The mental retardation caused can range from mild to profound, depending on the trauma the brain had gone through. For a diagnosis of mental retardation as a result of a TBI, the damage must be permanent and severe enough to affect the individual’s IQ as well as areas of daily living. A TBI can affect thinking, emotion, sensation and language. Aside from mental retardation, a TBI could also cause other neurological disorders with age, such as epilepsy, Parkinson’s disease, Alzheimer’s disease and other brain disorders. At least 1.7 million TBI’s occur each year. Children ages 0-4, teens ages 15-19 and adults over the age of 65 are most likely to sustain a TBI.
            I have worked with developmentally disabled adults for the last ten years in both residential and community programs. Every case and every disability is sad and difficult to accept and understand. In my opinion, the saddest is a case of MR in an individual that occurred in the late teen years of life. People who have suffered a TBI at this stage of life may have an understanding of what life was like before the injury. By this stage in life, the person has experienced things, built relationships and started a life as a person without a disability. Although in some cases, the person may have no memory of their life prior to the injury, many times the person does remember. They may lose their short-term memory, daily living skills they learned as a child and even the capability of performing simple tasks such as dressing or showering independently, but still remember what it was like when they were able to do these things.
            The link below has more information on the causes of a traumatic brain injury, the potential effects and the statistics of such.