1. Brain Injury In Their Own Words Cynthia Boyer, Ph.D March 20, 2013

2. BRAIN INJURY AWARENESS MONTH Awareness Advocacy Prevention

4. Scope of the Problem An estimated 5.3 million Americans –more than 2% of the population – currently live with identified disabilities caused by TBI 2 million people sustain a brain injury every year Every 15 seconds someone sustains a TBI Leading cause of death until age 44 4 th leading cause of death overall Each day 5,500 individuals sustain a TBI

6. Prevalence 5.3 4.7

7. Causes of TBI General Population 9% Unknown 28% Falls 20% Motor Vehicle/ Traffic 3% Pedal Cycle 11% Assult 19% Struck by/against 1% Suicide 2% Other Transport 7% Other

8. A Silent Epidemic

9. Traumatic Brain Injury Is Not... A new onset mental disorder Just emotional stress An acquired mental retardation The effects of prolonged drug/alcohol abuse

10. Severity of TBI Moderate to Severe 15% of all TBIs Typically hospitalized “Identified as a TBI” Known and followed by medical community Mild 85% of all TBIs Seen ER or MD office “Identified as a concussion” Not followed by medical community in many cases

11. What happens in a TBI ? Nerve fibers within specific areas of the brain are severed…never to be regained Nerve fibers are stretched…resulting in inefficient and slowed functioning Onset of physical, cognitive and behavioral changes after the TBI reflect impaired functioning due to these broken or stretched nerve fibers

13. Factors Influencing Recovery Cause, location, and severity of injury Length of coma and PTA Time elapsed since the injury Age of the individual Intellectual level pre-injury Personality characteristics pre-injury Overall medical health

14. Recovery….. Can take weeks, months, or years Progresses most rapidly in the first six months Is slow and usually incomplete

15. Risk of Repeat Brain Injuries After 1 st TBI, risk of second injury is 3 times greater After 2 nd, risk of third injury is 8 times greater

17. AS HEAD INJURIES ACCUMULATE…

18. Physical Problems Overall slowing Clumsiness Decreased vision/hearing/smell Dizziness Headaches Fatigue Increased sensitivity to noise/bright lights

19. Thinking Changes Attention Reduced concentration Reduced visual attention Inability to divide attention between competing tasks Processing speed Slow thinking Slow reading Slow verbal and written responses Communication Difficulty finding the right words, naming objects Disorganized in communication Learning and Memory Information before injury is intact Reduced ability to remember new information Problems with learning new skills

21. Combined, TBI changes result in persons served… Having difficulty remembering or learning new information Being inconsistent in their performance Having poor judgment and decision making abilities Having difficulty generalizing to new situations Lacking awareness of these difficulties

22. Lack of Self Awareness Inability to accurately assess their own abilities Unaware of the impact of their behavior on others May result in overestimation of skills/abilities

23. Lifestyle Changes Loss of Independence Implementation and acceptance of assistive devices/strategies

24. Long Term Challenges Post TBI  Vocational and/or school failure  Family life/social relationships collapse  Increased financial burden on families and social service systems  Alcohol and drug abuse  Chronic depression/anxiety

25. How Brain Injury issues “manifest” in the real world…. Mental fatigue Slowed processing speed Difficulty transferring “new learning” into memory – affects sequential thinking Problems with Executive Function Social Skill problems Tired, “lazy” Dragging work out Inconsistent learning – “you had it yesterday and not today, faking” Behavior problems, ADHD, messy, Can’t get along with others

26. One World…for everyone Every brain is unique and every person with a brain injury is unique

27. Thank You!