CONFERENCE Program and Objectives
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Thursday, March 5 |
Managing Behavioral Challenges Following Brain Injury
Harvey E. Jacobs, Ph.D., Psychologist / Behavior Analyst
Partner, Lash and Associates Publishing/Training
The purpose of this workshop is to provide a broad overview regarding relationships between brain injury and the behavioral challenges that may follow. While changes in neurological, physical and cognitive changes that occur following an injury clearly affect behavior; social and environmental factors often have equal or greater influence. This is especially true in day, residential, community based and other program formats. Oftentimes the manner a person is regarded and treated, regardless of their brain injury can contribute more to problem behaviors than most other factors. The settings in which people live and interact, the roles and functions of all people in their lives and the supports they have to help them succeed are all critical.
The workshop will detail these factors and discuss how they apply in home, community and professional service settings. There will be a special emphasis on promoting positive supports to help all individuals succeed. This is not only relevant for people who experience disability following brain injury, but also for caretakers, providers and other members of a person’s circle of support.
As a result of this workshop, participants will be able to:
Provide clear and comprehensive definitions of behavior in diverse situations;
Identify the difference between behavior disorder and behavior dysfunction;
Clarify and prioritize salient factors contributing to presenting behavior challenges;
Understand the relationships between functional capacity, social reciprocity and environmental context relate to success;
Specify key factors of programming that rely on positive behavioral supports;
Learn how to involve the person who experiences disability, family members, staff and other involved parties into successful programming;
Create and sustain positive support plans for all involved parties;
Understand how to collect and analyze data;
Create personally relevant productive activity and living patterns for involved parties;
Understand the role of adjunctive therapies, such as medication, when addressing behavioral challenges;
Identify key times and situations when extra help is needed.
Ain't Misbehaving
Chapter 2: What is Behavior?
COMPL-Doc 1
Neurobehavioral Crisis Hospitalization
Stop Treating the Brain Injured |
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Friday,
March 6 |
Saturday, March 7 |
7:00 a.m. - 7:45 a.m.
Registration and Check-in - Continental Breakfast
8:00 am - 8:15 am |
7:00 a.m. - 7:45 a.m.
Registration and Check-in - Continental Breakfast
7:30 a.m. - 8:00 a.m.
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Welcome to
BIA Conference 2009:
8:15 a.m. - 9:15 a.m.
Keynote Speaker - Harvey Jacobs, PhD
Managing Challenging Behaviors
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Meeting of the Members
8:00 a.m. - 8:10 a.m.
Welcome to
BIA Conference 2009:
8:15 a.m. - 9:15 a.m.
Keynote Speakers: Cynthia Lefever and Rory Dunn—The Iraq Experience—A Survival Story
- Soldier’s mom becomes voice for wounded warriors
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9:30 a.m. - 10:30 a.m. |
9:30 a.m. - 10:30 a.m. |
Track 1: Pain Management Following a Brain Injury
Andy Ellis, PhD, Director, Brain Injury Rehabilitation Center, and Catriona Buist, PhD, Director of PRA Pain Center
Track 2:
Serving Behavioral Needs after Brain Injury- Debra Braunling-McMorrow, Ph.D., Vice President ABI Service Diversification, The MENTOR Network
Often following brain injury a person with brain injury may experience behavioral issues, which may significantly interfere with their lives. While an unfortunately common issue, many providers feel inadequate in addressing the often complex and dangerous behaviors that a person may demonstrate. This presentation is intended to provide an overview of contemporary behavioral interventions applicable to a variety of behavioral issues and settings. In addition, the attendee will learn practical strategies in providing least restrictive treatment alternatives. Sample Personal Intervention plans utilizing contemporary and least restrictive treatment alternatives will also be discussed. In addition, the importance of understanding behavioral sequences and the importance of windows of opportunities in determining when to provide support will be discussed.
Track 3:
Controversies in
Post-Concussion Syndrome -
Mark Tilson, PhD, Neuropsychologist, Rehabilitation
Institute of Oregon
Dr. Tilson will review issues of continuing
clinical and legal debate regarding
post-concussion syndrome. These
include the role of psychological factors;
symptom validity and malingering; vestibular
symptoms; and the distinction between
subjective symptoms and objective functional
impairment. |
Track 1: Ethics and TBI - David Clarke, MD, Kaiser Permanente
Track 2:
The Faces of the Returning Soldier
- Fred Flynn, DO, FAAN, Director, Traumatic Brain Injury
Program, Madigan Army Medical Center
An overview on the process used at Madigan for screening and evaluating returning Soldiers with a history of mild TBI; the structure and function of the Madigan TBI Program; a review of the common somatic, cognitive, and neurobehavioral symptoms of the returning Soldiers seen in our clinic; and co-morbidities and effects on recovery; and lessons learned and questions yet to be answered.
Track 3: Enhancing Quality of Life Through Employment -Vocational Rehabilitation: Specific Needs and Interventions Bruce McLean
The similarities and differences between traditional vocational rehabilitation and the vocational rehabilitation of the brain injured person will be presented with examples of some vocation needs and interventions and two case histories.
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10:45 am - 12:00
pm |
10:45 am - 12:00
pm |
Track 1: Understanding MRI's and their use in Evaluating Brain Injury in both Adults and Children- Sam Browd MD, WA
Track 2:
The Idaho Vet Model
- Mary Kelly and Russ Spearman
This presentation will focus on the work accomplished via Idaho's TBI Implementation
Grant and will include an overview of
Idaho's new partnership grant with a focus on returning service members and their families.
Track 3:
Medical Legal Issues for the Brain Injury Professional
The Effective Use of Demonstrative Evidence in BI Litigation
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Michelle Peterson: Medi-Visuals
Medical Illustrator/Animator Consultant
Demonstrative aids can make a significant difference in the amount of recovery obtained in a brain injury case. In cases where liability or coverage limits the types of demonstrative aids that can be developed. More simple and less expensive demonstrative aids can be developed. The lecture will demonstrate the most severe of brain injuries and as well as the most subtle. Because more subtle brain injuries are tht e most difficult to prove, those types of cases benefit the most from demonstrative aids-the presentation will explain the medical and technological reasons why this is.
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Track 1: The Overlooked Value of Neuro-Optometric Intervention after Traumatic Brain Injury Bruce Wojciechowski, O.D., F.C.O.V.D
Track 2: TBI and PTSD
- Adam Nelson, PhD,
and Mary Lu, M.D., Oregon VA
This presentation will discuss TBI/PTSD and blast
injury.
Explosions can produce unique patterns of
injury seldom seen outside combat. When they
do occur, they have the potential to inflict
multi-system life-threatening injuries on
many persons simultaneously. The injury
patterns following such events are a product
of the composition and amount of the
materials involved, the surrounding
environment, delivery method (if a bomb),
the distance between the victim and the
blast, and any intervening protective
barriers or environmental hazards. Because
explosions are relatively infrequent,
blast-related injuries can present unique
triage, diagnostic, and management
challenges to providers of emergency care.
Few U.S. health professionals have
experience with explosive-related injuries.
Vietnam era physicians are retiring, other
armed conflicts have been short-lived, and
until this past decade, the U.S. was largely
spared of the scourge of mega-terrorist
attacks.
Track 3: PDAS and Smartphones Used to Support Memory and Organization for Persons with Cognitive Challenges Laurie Ehlhardt, PhD
This presentation will focus on: 1) the importance of conducting a Needs Assessment before selecting an assistive
technology device; 20 trial use to insure a good match between the person, technology, and the
environment; and 3) systematic training and support from others to maximize
successful device use. |
12:00 - 1:00 pm Lunch
Video Presentation -
Right to Risk
Common perceptions of disability consistently and dramatically underestimate virtually every measure of competence, productivity and quality of life. These misperceptions and assumptions about what the 54 million people with disabilities in our society can and cannot do, result in reduced opportunities, lowered expectations, and barriers to full participation.
“Right to Risk” is a one-hour documentary that chronicles a 15-day, 225-mile whitewater rafting adventure through Grand Canyon by eight individuals with disabilities. The film is distributed by American Public Television to more than 350 member public television stations through 2009.
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12:00 - 1:00 pm Lunch
Video Presentation -
Right to Risk
Common perceptions of disability consistently and dramatically underestimate virtually every measure of competence, productivity and quality of life. These misperceptions and assumptions about what the 54 million people with disabilities in our society can and cannot do, result in reduced opportunities, lowered expectations, and barriers to full participation. “Right to Risk” is a one-hour documentary that chronicles a 15-day, 225-mile whitewater rafting adventure through Grand Canyon by eight individuals with disabilities. The film is distributed by American Public Television to more than 350 member public television stations through 2009.
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1:00 pm -
2:00 pm |
1:00 pm - 2:00 pm |
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Track
1:Co-Occurring Disorders: Identification and
treatment—Issues in Psychopharmacology
Ron Heintz,
MD, Psychiatrist, Oregon
State Hospital
This presentation will review the complexity of identification of psychiatric syndromes in TBI patients and review common psychopharmacologic approaches to treatment of psychiatric syndromes,. Including risks and potential benefits.
Track 2: Outcomes: a ten year retrospective analysis Debra Braunling-McMorrow, Ph.D., Vice President ABI Service Diversification, The MENTOR Network
As inpatient, hospital-based rehabilitation stays for persons with brain injuries have decreased, people re leaving the hospital quicker and post-acute providers have been expected to serve people with greater rehabilitation needs. In a study by Kreutzer et al., 2001, acute care length of stays declined from 1990 – 1996 at an annual average rate of 2.25 days and post acute rehabilitation reducing on
average 3.65 or 8% annually. With shorter acute stays, persons entering post-acute programs typically have more significant medical, cognitive, physical and behavior issues than even a decade ago. At the same time, both insurance and public payers have become more discriminating in providing financial support for persons with brain injuries to enter post-acute rehabilitation programs.. These issues point to the importance of measuring both the effectiveness of post-acute rehabilitation and the “value” (or return on investment) for all consumers to help guide future decision making on access to care This presentation will focus on measuring what matters and share outcome information including the relevance of time post injury in accessing rehabilitation.
Track 3: Medical Legal
Issues for the Brain Injury Professional
The change in Medicare
and what it means to you and your case-
James Coon, JD
The training will provide you with medical,
assessment and treatment information helpful
in representing your clients with
mild-moderate brain injuries.
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Track 1, 2,
3: General Session – Sports Concussion
Pro Sports Players and brain injury -
The new guidelines for concussion management and discuss new assessment and treatment tools.
Jim
Chesnutt, M.D., Medical Director, OHSU
Sports Medicine Program
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2:00 pm -
3:00 pm |
2:00 pm -
3:00 pm |
Track 1:
Co-Occurring Disorders: Identification and treatment—Issues in Psychopharmacology Ron Heintz, MD, Psychiatrist, Oregon State Hospital
Track 2: The ABI Clubhouse Harvey Jacobs, PhD
The purpose of this presentation is to provide an overview of the ABI Clubhouse model including its origins, history of development and present status; including the recent development of the International Brain Injury Clubhouse Alliance (IBICA).
This presentation will provide an overview of the concepts of person directed services, productive daily activity patterns, and community basis, and their applications within the ABI Clubhouse model. Special attention will be devoted to the IBICA ABI Clubhouse standards, which have been recently adopted, as well as distinctions between ABI Clubhouses and more traditional day activity and day treatment approaches. Information will also be shared on how different groups have established such programs and the various steps required in this process, including assessing if such a model is the most appropriate resource for an existing community’s needs.
Track 3:Medical Legal Issues for the Brain Injury Professional
Cognitive Problems Associated with ABI
Jan Johnson, MS, CCC-SLP; Jeri Cohen, BS, JD, Job Coach.
Review of cognitive problems associated with
acquired brain injuries and treatment.
Co-presenter, Jeri Cohen, a brain injury
survivor an inactive attorney will provide
specific examples of how her ABI affected
her cognitively and her practice.
The training will provide you with medical, assessment and treatment information helpful in representing your clients with mild-moderate brain injuries.
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Track 1: Treatment for
Balance Disorders Dr. John Epley
An overview of The Epley maneuver (or Epley's exercises), a maneuver used to treat benign paroxysmal positional vertigo (BPPV) which is performed by a doctor. This maneuver was developed by Dr. John Epley and first described in 1980.
Track 2:
Right to Risk-
Kathleen Jo Ryan
Track 3: Advocacy - What we need to know to
be successful - Sen Bill Morrisette, Rep
Vic Gilliam, Bill Olson |
3:00 pm -
4:00 pm |
3:00 pm -
4:00 pm |
Track 1: Brain Injury and Mental Illness: A Dangerous Intersection
- Thomas Boyd, PhD, ABPP, Neuropsychologist
How Brain Injury and Mental Illness Overlap
Traumatic Brain injury (TBI) Disrupts Thought Processes;
TBI Can Lead to Personality and Affective Changes;
Characteristic Symptoms of Schizophrenia;
Psychosis and TBI: What’s the Brain ‘Connection’?;
Misidentification and Duplication Syndromes
Brain Injury and Mental Illness: A Vicious Cycle
TBI Increases Vulnerability to Psychiatric Illness;
Risk Factors for Post-TBI Psychosis;
Psychiatric Problems Increase Risk of Brain Injury;
Risk Factors for TBI and Genetic Risk for Schizophrenia Interact;
Violence, Abuse and Neglect after TBI;
Societal Impact
Treatment Models and Approaches:
Treatment Models,
Treatment Strategies;
Importance of Psychiatric Consultation,
What Is Needed?
Track 2:
A Multi-Modal Approach to School Re-entry for the Brain Injured Student and Under-identification of Students with TBI
- Pat Sublette, PhD, Oregon TBI
Education Coordinator and Vicki Bernard,
Supervisor of Special Programs, Southern
Oregon ESD
Reentry to school following a TBI can be a pivotal time for setting up supports, schedules and planning to create the flexible program often needed for students with TBI. This presentation will outline a set of strategies that are often useful for school reentry and discuss under identification of students with TBI and resources available in Oregon.
Track 3: Medical Legal Issues for the Brain Injury Professional
Functional & Cognitive Vision Problems Following Brain Injury
- Carol Marushich, OD, MS, FCOVD
Vision plays a vital role in rehabilitation. Specialized testing for ABI identifies those areas of ocular and cognitive visual function which can enhance overall recovery. Ocular disease must be stabilized, compensatory Optical treatment can address structural vision limitations and vision rehabilitation therapy can provide the opportunity to improve visual comfort and efficiency as well as relearn functional vision skills including visual information processing.
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Track 1:
Use of Neuro-Imaging and Functional Outcomes Paul van Donkelaar, PhD, University of Oregon
Track 2:
Addiction Solutions: Methamphetamine and TBI– Rob Bovett,
JD, OR Narcotics Enforcement Assoc
This presentation will explore drug addiction solutions, with an emphasis on methamphetamine. Brain chemistry, prevention and treatment will be discussed, as well as drug abuse trends.
Moderator: Dave Kracke
Track 3:
Traumatic Brain Injury and the Shared Mission Of Disease Management
David Harrington, MBA, OTR/L, CBIST
This session provides a review of commonly encountered report terminology, which should alert the file reviewer to the presence of traumatic brain injury (TBI), as well as viewing TBI through the perspective of disease management. Common persistent symptoms are reviewed together with frequently used diagnostic procedures. Complications of no treatment are presented. A case study is used to provide concrete examples of symptoms and complications. Suggestions for case managers and claims staff are presented.
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4:00 pm -
5:00 pm |
Track 1: The Impact of Exercise on Mood after TBI- Jeanne M. Hoffman, Ph.D., University of Washington,
Department of Rehabilitation Medicine
Exercise is encouraged for everyone to improve health and wellness. In a recent study we sought to identify potential positive impacts of exercise on mood and wellness after TBI. This presentation will include an overview of the results of that study and how exercise can have a positive impact for individuals with TBI.
Track 2:
The Northwest Brain Injury Alliance
- Gene van den Bosch, MPA
new ideas in growing your business and collaborating with others.
Track 3: Study of Undiagnosed Brain Injuries In Wyoming’s Prison Population - Dorothy Cronin, ED BIAW
Study of Undiagnosed Brain Injuries In Wyoming’s Prison Population - Dorothy Cronin, ED BIAW
Wyoming completed a Brain Injury Survey Questionnaire (BISQ) assessment of 200 inmates in Wyoming Department of Corrections facilities. The 17 page survey relied on self-reporting signs, symptoms, and causes for potential brain injuries. The results were scored according to likelihood of brain injury per individual. Presentation will describe the tool used, the process and completion of the project, as well as outcomes and recommendations for the Department of Corrections.
According to jail and prison studies, 25-87% of inmates report having experienced a head injury or TBI as compared to 8.5% in a general population reporting a history of TBI. See the attached CDC publication entitled Traumatic Brain Injury in Prisons and Jails: An Unrecognized Problem.
In Wyoming, prison populations had never before been screened for brain injuries. When the Department of Corrections (DOC) was approached about the project, they were very willing to consider that this population was likely to have brain injuries, but DOC had no screening tools to attempt to identify those inmates with such a history.
The Centers for Disease Control and Injury Prevention state by state comparison data from 1999 stated that Wyoming had the highest per capita incidence of brain injury in the nation at 3%, compared with the national average of 2%. It might figure then that Wyoming had a potentially larger prison population living with brain injury as well.
Although the sample population was screened using a self-reporting tool, the Brain Injury Screening Questionnaire (BISQ), that identifies potential brain injury based on history and reported symptoms, it is not a definitive test for brain injury and will result in a report only of the LIKELIHOOD of inmates to have a brain injury. Therefore, it is important for DOC to recognize that those whose results indicate a moderate to high likelihood will require additional testing, such as a neuropsychological evaluation, to confirm a diagnosis of brain injury.
The presentation will discuss the findings, recommendations for future screening, and follow up completed to date.
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Track 1: Adult Human Neural Stem Cell Therapy for Traumatic Brain Injury - Associate Professor and PI Larry Sherman, PhD, OHSU Primate Center
A number of recent studies have indicated
that neural stem cells can either directly
or indirectly impact on recovery following
insults the the central nervous system.
This talk will review several questions
related to these findings inlcuding:
- What are neural stem cells?
- Where do neural stem cells reside in the
brain?
- How do neural stem cells respond to brain
injury?
- How do transplanted or injected neural
stem cells influence injury repair?
- How does the injury microenvironment
impede repair by neural stem cells?
Track 2: Addiction Solutions: Methamphetamine and TBI– Rob Bovett, JD, OR Narcotics Enforcement Assoc
Continued
Moderator: Dave Kracke
Track 3: Getting back on the road to life -
Jay Herzog, Mentor Oregon
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Objectives
At the completion of the conference, participants will be able to:
1. Implement strategies designed to significantly reduce brain injury-related mortality and morbidity in all communities.
2. Summarize recent brain injury-related research with corresponding practical application.
3. Identify clinical management practices, specifically new prevention, diagnosis, and treatment guidelines.
4. Describe public health interventions to reduce the impact of brain injury among different types of racial and ethnic populations and settings (e.g., school, workplace, community).
5. Understand health care delivery trends and their impact on long-term brain injury management, acute care, and prevention.
6. Analyze past brain injury-related interventions and weigh their value in today’s world.
7. Implement health communication strategies and know how to more effectively reach target populations and raise awareness.
8. Summarize brain injury data, including mortality, morbidity, and risk factor prevalence.
9. Create networking opportunities and build partnerships with key brain injury researchers, clinicians, and prevention professionals.
CEUs Offered: CME, CLE, SLP, OT, CCRC, CPDM, CDMS, CCMC Hours:
March 5: 6 hours ; March 6-7: 6.5 hours each day
This activity and the pre-conference workshop have been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Northwest Permanente Department of Clinical and Leadership Education, Kaiser Permanente Northwest Region, accredited by the Oregon Medical Association, and the Brain Injury Association of Oregon. This activity has been approved for AMA PRA Category I CreditTM.
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Payment: Please register online or by
printing the registration brochure and mail
or fax to the office
Mail registration forms and payments to:
2009 Conference
Brain Injury Association of Oregon
PO Box 549
Molalla OR 97038
Or Fax to: (503)
961-8730
Confirmation and Cancellation Policies
To register,
please register online, contact us via
e-mail at
biaor@biaorgon.orgg or by telephone at
1-800-544-5243 or 503-740-3155, M-F, 9-5.
Cancellations must be received in writing by
February 15, 2009 to qualify for a refund. A
$25.00 administrative fee will be deducted.
Substitutions are always welcomed and
no-shows will be billed.
Registration,
Payment, and Refund Policy
Please submit payment with completed
registration form.
Fees are payable by check, credit card, or
state government purchase orders which
obligate payment. All payments must be
received by Feb 20, 2009, to be eligible for
discount. All cancellations are subject to
a $25 processing fee. No refunds will be
issued for cancellations received after Feb
15, 2009;
however, registrations are transferable.
  Continuing
Education Units: 13 hours for Friday and
Saturday, 19 hours for all three days
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