Transcript Traumatic Brain Injury (TBI) Rehabilitation Programs

Traumatic Brain Injury (TBI)
Rehabilitation Programs for
Younger Children and Adolescents
Vanderbilt Bill Wilkerson Center:
Pi Beta Phi Rehabilitation Institute
Populations Served
• Since 1988, the mission of the Pi Beta Phi
Rehabilitation Institute at Vanderbilt Bill
Wilkerson Center has been service to children
and adults with acquired brain injuries.
Services Provided
• Our services focus on the most primary and persistent
concerns after post acute recovery from TBI: memory,
executive functions, academic learning skills, speechlanguage abilities, & social communication.
• Additionally, we provide therapies to improve functional selfcare, safety, mobility, strength, range of motion, balance and
coordination, and feeding and swallowing.
• Depending upon the age of the client, our therapy programs
are aimed at readiness for school, school reentry, classroom
placement, and selection of appropriate supports for
academic success.
Age 3 to 10
Therapy Services
• Speech-Language Pathology:
Evaluation and tx of cognitivecommunicative & academic
skills, and social communication.
• Occupational Therapy:
Evaluations and tx to address
physical, visual, perceptual,
and cognitive abilities limiting
functional independence,
safety, and school academic
success.
Pre-school/School-Age/Academic
• Develop language-literacy and
handwriting skills,
• Improve executive functions
and attention and class room
performance
• Assistance with IEP and
classroom/school placement.
Age 11 – 21
Therapy Services
• Speech-Language Pathology:
Evaluation and treatment targeting
cognitive-communicative deficits,
academic skill development, and
social communication.
• Occupational Therapy: Assessment
and treatment targeting physical,
visual, perceptual, and cognitive
deficits that influence independence
in activities of daily living, safety, and
academic success. Driver
Evaluation/Training
• Physical Therapy: Assessment and
treatment targeting physical
problems, such as decreased
mobility, balance, coordination,
dizziness, weakness, that influence
independence and safety in daily
activities.
Middle School, High School, & College
Academic Entry/Re-entry
• Conduct a comprehensive
evaluation of the student’s cognitive
deficits to identify barriers to
academic success.
• Comprehensive treatment plan is
developed with goals targeting
reading comprehension, listening
skills, speech, writing, attention,
and memory
Physical Therapy
• Evaluation of balance and vestibular function, including a
neurological screen
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Oculomotor function
Vestibular screening
BPPV assessment (video goggles)
Dynamic visual acuity/Gaze stability ( inVision computerized testing)
Dynamic gait assessment
• Examine use of sensory cues for balance (vestibular, visual,
somatosensory)
– Computerized dynamic platform posturography (Neurocom Smart
Equitest)
Physical Therapy
• Balance/vestibular rehabilitation
– Oculomotor training
– Vestibulo-ocular-reflex (VOR) training
– Functional balance retraining
– Dynamic gait training
• Dual-task activities to incorporate cognitive
skills
• Incorporate relevant functional tasks,
including sports specific activities
Balance Disorders Laboratory (BDL)
• The BDL is a diagnostic clinic
where specially-trained
audiologists conduct tests to
help physicians determine the
cause of dizziness,
disequilibrium and vertigo.
• The BDL specializes in unique
treatment options, and assess
conditions using the most
current testing techniques and
technologies (e.g. head
impulse, rotational, and
videonystagmography testing).
Driver Evaluation and Training
• Evaluate patients to
determine if they are able
to safely drive a vehicle in a
variety of environments.
• If patient is able to benefit
from intervention
– train patients to drive
without risk.
– train the use of adaptive
driving equipment.
How to refer…
Multidisciplinary TBI Clinic
• Collaboration between PBPRI, Acute Care SLP
Service, and Trauma Surgery
• Director – Oscar Guillamondegui, MD