Transcript Hiring Individuals with Traumatic Brain Injuries (TBI)

Hiring Individuals with
Traumatic Brain Injuries
(TBI)
Education Employees About TBI
Michelle Maultsby, PhD, CRC
Associate Professor of Rehabilitation
Counseling - South Carolina State University
May 14, 2012
Throughout this webinar, attendees will be allowed to ask questions.
Note that presenters will provide a response based on limited and
unverified information. These responses should not be construed as
direct advice regarding the issue raised, nor should they be construed
as a formal opinion issued by CRCC or South Carolina State University.
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GOAL FOR TODAY
To obtain a general understanding of traumatic brain injury,
its signs, symptoms and affects in employment settings.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
3
LEARNING OBJECTIVES
• Have an understanding of traumatic brain injury (TBI)
• Be able to identify characteristics and symptoms
• Gain knowledge about other disabilities commonly
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associated with TBI
Gain factual information related to hiring individuals with
TBI
Understand some predictors of employment for
individuals with TBI
Be able to identify resources available to employees with
TBI
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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TRAUMATIC BRAIN INJURY
(TBI)
• An injury to the brain from external forces, such as
vehicular accidents, falls, violence, or sports or
recreational injury, or penetration of the skull by a foreign
object.
• Not degenerative
• Not a result of a disease
• Not congenital in origin
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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TRAUMATIC BRAIN INJURY
Cont.
• Can result in various forms of impairment
• Cognitive
• Emotional/Behavioral changes
• Physical manifestations
• Social
• Vocational
• Other areas of person’s life
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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TBI STATS
• 1.4 million persons in the US with TBI (yearly)
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 50,000 die
 235,000 are hospitalized
 1.1 million treated and released
Highest Risk group
 Infants -4
 Adolescents 15-19
Approximately 80,000-90,000 experience the onset of a
long term disability due to a TBI
Langlois, J. A., Rutland-Brown, W., & Thomas, K. E
(2006). Traumatic Brain Injury in the United States:
Emergency Department Visits, Hospitalizations, and
Deaths.Atlanta, Ga: Centers for Disease Control and
Prevention.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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Yearly Economics statuses for
TBI
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37.8 Billion total
4.5 billion in direct expenditures for medical purposes
20.6 billion in work related losses & disability
12.7 billion in lost income from premature death
Pangilinan, P.H., & Campagnolo, D. (2011). Classification
and Complications of Traumatic Brain Injury. J Head
Trauma.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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TYPES OF TBI
• Open Head Injury (Penetrating)
• Injuries as a result of the skull being fractured
• Impairments are related to specific areas of brain
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affected
Closed Head Injury
Skull is not fractured
Results from blow to the head or violent shaking of the
head
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
9
LEVELS OF TBI
Mild
• Approximately 70% of TBI
• Experience more subtle but disruptive symptoms
 headaches, dizziness
 ringing in the ears, sleep disturbances
 depression, irritability
 reduced attention span
 memory impairment
• May have credibility questioned
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
10
LEVELS OF TBI
Moderate
• Loss of consciousness for few minutes or several hours
 Confusion, disorientation
 Physical Impairments
 Cognitive Impairments
 Psychosocial Impairments
• Symptoms may be permanent
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
11
LEVELS OF TBI
Severe
•Remain in a coma for extended periods of time
•Permanent and more severe deficits
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
12
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Loss of response to sounds, light or touch
• Response to stimuli is affected
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 Responding to loud noises
 Eyes have difficulty focusing
 Movement is not consistent
Confusion and agitation
Falvo, D. (2009) Medical and Psychosocial Aspects of
Chronic Illiness and Disability. 4th ed. Sudbury, Ma:
Jones and Bartlett Publishers.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
13
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Impaired Communication
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Difficulty with speech (slurred)
Difficulty using and understanding words
Misarticulation
Laborious speech
Hesitancy
Reduced vocabulary and grammar
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
14
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Impaired motor skills (movement, coordination and
balance)
 walking
 unsteady balance, walk with a gait, lurch from side to
side
 Muscle coordination
 abnormal movements, abnormal muscle tone which
decreases ability to move, too much muscle tone
which heightens reflexes or exacerbates abnormal
movement
• Impaired motor skills will affect areas such as dressing,
eating, driving, typing etc.
Falvo, D. (2009) Medical and Psychosocial Aspects of Chronic Illness
and Disability. 4th ed. Sudbury, Ma: Jones and Bartlett Publishers.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
15
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Impaired Vision
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Visual-Spatial deficits affects judgment of distance,
size, position, rate of movement, form and the relation
of parts to wholes.
 May experience difficulty navigating movement
through environment and judgment of space
 May appear clumsy, knocking items off tables,
dropping things when attempting to put them on
tables because of perception, unable to read some
signs
Falvo, D. (2009) Medical and Psychosocial Aspects of Chronic Illiness
and Disability. 4th ed. Sudbury, Ma: Jones and Bartlett Publishers.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
16
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Hearing Impairments
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Difficulty interpreting sound
Acquired hearing loss
Ringing in the ear
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
17
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Memory
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Affects individuals ability to recognize and recall
Difficulty problem solving
Difficulty organizing and planning
Falvo, D. (2009) Medical and Psychosocial Aspects of Chronic Illiness
and Disability. 4th ed. Sudbury, Ma: Jones and Bartlett Publishers.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
18
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Touch, taste or smell
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 May experience numbness in various body parts
 Inability to feel pain
 Inability to sense movement of body parts
 Decrease sense of smell which affects taste
Eating/ swallowing
 Difficulty swallowing, chewing
 Increased chances of choking
 Saliva build up (causing drooling)
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
19
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Endurance
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Physical fatigue
Mental fatigue
Altered sleep patterns
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
20
CHARACTERISTICS AND
SYMPTOMS OF TBI
• Bladder and Bowel function
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Incontinence
Embarrassment
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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TBI - ASSOCIATED DISABILITIES
• Epilepsy
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Post traumatic epilepsy
Experience seizures which results in a loss of
control over body functions
 Prevoked seizures- caused by extrinsic factors such
as alcohol ,drugs or withdrawals
 Unprovoked seizure- a symptom of an underlying
neurological condition
Mayfield, J. & Homack, S. (2005). Behavioral considerations associated
with traumatic brain injury. Preventing Social Failure, 49(4), 17-22.
Falvo, D. (2009) Medical and Psychosocial Aspects of Chronic Illiness
and Disability. 4th ed. Sudbury, Ma: Jones and Bartlett Publishers.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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TBI - ASSOCIATED DISABILITIES
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Major Depression
Anxiety Disorder
Substance Abuse
Other associated conditions (usually for more severe
TBI)
 Pneumonia
 Septicemia
 Digestive conditions
Mayfield, J. & Homack, S. (2005). Behavioral considerations associated
with traumatic brain injury. Preventing Social Failure,49(4), 17-22.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
23
MYTHS RELATED TO HIRING
INDIVIDUALS WITH TBI
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Persons with TBI don’t want to work
Persons with TBI are not able to return to work
TBI is immediate and recognizable
Hiring an individual with a TBI will be expensive
Organizations have to hire individuals with TBI
regardless of experience in order to prevent
issues of discrimination
Shames, J. Treger, I. Ring, H. & Giaquinto, S. (2007).
Return to work following traumatic brain injury: Trends
and challenges. Disability and Rehabilitation, 29(17),
1387-1395.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
24
MYTHS RELATED TO HIRING
INDIVIDUALS WITH TBI
• Individuals with TBI won’t be able to work long
• Individuals with TBI don’t have an earning
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capacity
Earning capacity is an individuals ability or
power to earn money
Gamboa, A. M., Holland, G. H., Tierney, J. P., & Gibson, D.
S. (2006). American community survey: Earnings and
employment for persons with traumatic brain injury,
NeuroRehabilitation, 21, 327-333.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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PREDICTORS OF EMPLOYMENT
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Assessment
Counseling/guidance
Job Placement
Job Search
Diagnosis and treatment
Schonbrun, St. L. & Kampfe, C. M. (2007). RSA services
and employment outcome in consumers with traumatic
brain injury. Journal of Rehabilitation , 73(2), 26-31.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
26
PREDICTORS OF EMPLOYMENT
• Level of Severity
• Level of functioning/Improvement
• Receiving vocational rehabilitation services early
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Knowing what services are available
Knowing what to say to employers
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
27
PREDICTORS OF EMPLOYMENT
Knowing what accommodations are necessary
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Shorten hours
Modified equipment
Modification of duties
Job restructuring
Rest breaks
Reassignment to different person
Modification of workplace
Training materials
Provision of readers
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
28
PREDICTORS OF EMPLOYMENT
Employer accommodation and discrimination can
powerfully affect successful job acquisition and
maintenance. Research shows that employers
who exhibit tolerance of difficulties and
disruption provided a supportive work
environment and assisted in the outcome of
successful employment.
Barton, B., Brouwers, L., Ruoff, J., Trudel, T., Valnes, B.,
Elias, E., & Pines, H. (2010). Child, adolescent, and
young adult community integration after a traumatic brain
injury. EP Magazine.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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PREDICTORS OF EMPLOYMENT
• Interest in Job
• On the job training
• Counseling and guidance
• Supportive work environment
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
30
PREDICTORS OF EMPLOYMENT
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Age
Personality
Family Functioning
Injury Characteristics
Simpson, A. & Schmitter-Edgecombe, M. (2002). Prediction
of employment status following traumatic brain injury
using a behavioural measure of frontal lobe functioning.
Brain Injury, 16(12), 1075-1091.
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
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RESOURCES FOR EMPLOYEES
• State/federal Vocational Rehabilitation Agencies
• American with Disabilities Act Technical Assistance
Program
• Job Accommodations Networks 800-562-7234
• Brain Injury Association of America
http://www.biausa.org/
• The Center on Outcome Measurement in Brain Injury
http://www.tbims.org/combi/
• Injury Prevention and Control: Traumatic Brain Injury
(CDC)
http://www.cdc.gov/TraumaticBrainInjury/index.html
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
32
Comments & Questions
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
33
Thank You
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
34
Contact Information
Michelle Maultsby
Associate Professor of Rehabilitation
Counseling - South Carolina State University
Email: [email protected]
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
35
Education Credits
CRCC Credit - (1.5)
Approved by Commission on Rehabilitation Counselor
Certification (CRCC)
• By May 24, 2012, participants must score 80% or
better on a online Post Test and submit an online
CRCC Request Form via the MyTACE Portal.
My TACE Portal: TACEsoutheast.org/myportal
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
36
Southeast TACE Region IV
Toll-free: (866) 518-7750 [voice/tty]
Fax: (404) 541-9002
Web: TACEsoutheast.org
My TACE Portal: TACEsoutheast.org/myportal
Email: [email protected]
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012
37
Disclaimer
This presentation was developed by the
TACE Center: Region IV ©2012 with funds
from the U.S. Department of Education,
Rehabilitation Services Administration (RSA)
under the priority of Technical Assistance and
Continuing Education Projects (TACE) – Grant
#H264A080021. However, the contents of this
presentation do not necessarily represent the
policy of the RSA and you should not assume
endorsement by the Federal Government [34
CFR 75.620 (b)].
TACE Center: Region IV, a project of the Burton Blatt Institute.
Funded by RSA Grant # H264A080021. © 2012