Traumatic Brain Injury and Occupational Therapy

In March 2015 we were lucky enough to meet a private occupational therapist from our hometown that has significant history working with traumatic brain injuries and Jason worked with her for about a month. Then he was admitted to Toronto Rehab and was able to work with another occupational therapist there. They are both stunningly intelligent women with so much compassion for the people they work with. We count ourselves  very lucky to have met each of them. Here is our summary of Jason’s experiences with occupational therapy post TBI:

Treatment type: Occupational Therapy

How to find: http://www.caot.ca/index.asp : http://www.coto.org/default.asp

Price: in a hospital setting covered by OHIP, private often $120-160.00 an hour

Credentials: Look for someone that is registered with the College of Occupational Therapists

What is it? From the College of Occupational Therapists of Ontario “Occupational therapists (OTs) are health care professionals who help people learn or re-learn to manage the every day activities that are important to them, including caring for themselves or others, caring for their home, participating in paid and unpaid work and leisure activities. The people occupational therapists work with may be having difficulties because of an accident, disability, disease, emotional or developmental problem or change related to the normal aging process.”

Notes from our assessment:

In the private setting Tracy Milner assessed Jason using the BrainFX 360 tool which was the first real assessment Jason had in his recovery. She spent time explaining her results to us and our families and started working with Jason on sleep hygiene, a lot of the ideas we discussed last month came from her advice and materials she suggested. She worked with both of us on how to set up our home and schedule to make communication easier and later this year I’ll be writing about some of the designs we’ve used to create a command center in our house.

She put together a modified work program for Jason’s employer and met with them to explain what Jason’s limitations were and how they were affecting his work as well as she offered solutions that were workable for his management team. This alone was worth millions because recruiting Jason’s manager to be on our team and fighting for Jaosn was so important and there is a glaring lack of information out there for employers of those with traumatic brain injuries.

Tracy had plans to start working on cognitive skills such as planning Jason’s work days and project management but at that time he was admitted to Toronto Rehab and it was a program we couldn’t refuse.

In the hospital setting I think Jason was at an advantage because he already had an understanding of his limitations and lifestyle changes thanks to his time with Tracy. His OT at the rehab program was able to jump right in to tasks tailored to his goal of returning to work full time. Where we were only able to afford to meet with Tracy every 1-2 weeks rehab was offering OT sessions two times a week. The activities included things like: a treasure hunt of sending emails, making phone calls, checking in at locations around the hospital that let me work on goal setting and prioritization, building a motor and discussing energy conservation.

Brain FX: The wife’s perspective

Jason spoke the other day about his assessment from BrainFX and we hope to feature some information from the creators in the near future (she’s pretty busy since she also works as an OT!).

Obviously I did not have the chance to work with the software or the assessment. I did have a chance to chat with  Tracy Milner, one of the creators (also Jason’s private OT) and sat in on one of their webinars for health professionals. Approximately a third of my massage therapy clientele are suffering from traumatic brain injuries and post concussion syndrome so having a deeper understanding of resources out there is always a good thing. This was another case, similar to our eperiences with behavioural optometry, where we are so very lucky to have the connections we have and that Tracy Milner is a friend of our doctor.

So here is my review:

Treatment type: Actually an assessment, BrainFX

How to find: www.brainfx.com

Price: $300-500.00 (estimated)

Credentials: Use the Find An Administrator tab on their website

What is it? From their website “BrainFx 360 was created to measure cognitive (thinking skills), mood, social, behavioural, fine motor and balance effects through self-report, collateral report, and standardized performance testing, through real-life skills and game-like activities for people who are age 10 and up. “

Notes from our assessment:

This was really our first chance to have Jason assessed by someone that knew what they were doing (see our posts on doctors for more on that story). Tracy sat with Jason while he completed about 3 hours of testing on the tablet, I heard bits of her instructions as I worked and was impressed by how succinctly she explained the tasks and encouraged Jason throughout.

Post assessment Jason was exhausted to the point of experiencing a panic attack while trying to cook dinner. There were a lot of tears about how tiring the assessment was and how really truly unfortunate it was that this was our life 6 months into marriage. We didn’t know enough about what we were dealing with to make some good decisions about energy conservation that night. To anyone getting this assessment I would recommend not working before the assessment and planning to rest for the rest of the day or at least not having anything that HAS to be done.

BrainFX 360 includes the option for 3 people to answer questions and submit their views on the subject’s symptoms and behaviours post TBI. I was able to complete the survey for Jason (along with 2 others that saw him frequently during the first 6 months) and was excited to finally be able to give my opinions and have my chance to talk about what we were living with. All the input from those surveys is included in the final report.

A week later we were able to sit down again with Tracy and review the results of the assessment. She brought a beautiful document that compared Jason’s results to averages and clearly highlighted areas of difficulty and areas of success. This was the first time we had concrete data showing the difficulties Jason was living with and having them laid out for us allowed us to start planning how to make life work.

A month later Jason was invited to Toronto Rehab for an assessment. We were very happy to have the BrainFX 360 to show and the physiatrist we met with was amazed by how easy the report was to read. He spoke of other patients he met that spent thousands on assessments only to be given reports that were unclear and unreadable by other professionals. Brain FX 360 uses language and terms that are standard in TBI medical care and is easily understood by everyone we’ve worked with. In each case (including Tracy) health professionals have been able to read the reports and estimate where the bleeds were based on Jason’s symptoms.

The first two weeks of Toronto Rehab were assessments  – in total I think Jason spent about 13 hours doing assessments with various professionals. Often at the end of the day he would explain the assessments starting with “It’s like what I did on Tracy’s but like this….”. At the end of the two weeks we had the opportunity to review the results and build a treatment plan with the team and pretty much without fail the results of these long tests mimicked the results of BrainFX 360.

I am not trying to be so arrogant as to claim to have understood all the tests or to know if EVERY test could be supplemented by BrainFX 360. I am sure there are reasons people use the tests they do and I am grateful that we have SO much documentation about Jason’s abilities and challenges. But for those of you that don’t have the ability to attend a rehab program or have felt lost without some solid assessments – BrainFX may be the company you need to contact. I’m attaching a brochure from their website and I strongly encourage exploring their website and contacting their administrators to find out if they can help you.

BrainFxbrochure