1. Accommodations and Interventions Joshua Cantor, Ph.D., ABPP Department of Rehabilitation Medicine

2. Accommodations and Interventions For children with chronic or slow to resolve symptoms, interventions may be necessary

3. Accommodations and Interventions Community integration and participation are important goals

4. Accommodations and Interventions Non-pharmacological therapies Speech therapy Occupational therapy Physical therapy Psychotherapy and other behavioral treatments Cognitive remediation (including cognitive orthotics)

5. Accommodations and Interventions Need for comprehensive neuropsychological assessment including cognitive and behavioral evaluation

6. Accommodations and Interventions Establish what accommodations are needed Previous functional level and co-morbid issues (e.g., learning disability) must be taken into account

7. Accommodations and Interventions Importance of coordinated approach involving treatment team, educators, family, coaches, etc.

8. Accommodations and Interventions Interventions cannot be delivered in isolation – they must be implemented across settings (school, home, sports teams, etc.). All parties including child must be educated about needs and goals

9. Accommodations and Interventions Interventions are typically environmental rather than internal

10. Accommodations and Interventions Accommodations and compensatory strategies should: capitalize on strengths circumvent or provide support with areas of weakness be consistently implemented be solution focused, not deficit focused emphasize structure

11. Accommodations and Interventions: Examples Attention: Position child in classroom to reduce distractibility (e.g., at front) Provide quiet, low distraction study area at home Discourage multi-tasking Encourage periodic breaks Cue child to stay on task as needed

12. Accommodations and Interventions: Examples Memory difficulties: Allow note takers or tape recorders in class Use reminders and a calendar and other cognitive supports (e.g., smartphones) Use testing methods adapted to memory difficulty (e.g., multiple choice) Encourage repetition and rehearsal

13. Accommodations and Interventions: Examples Processing speed: Slow down pace when possible Allow rest periods Repeat material Don’t rush or challenge the child

14. Accommodations and Interventions Kids with TBI are at risk for social isolation and behavioral problems so social skills, participation, and mental health must be addressed

15. Accommodations and Interventions Importance of brain health (sleep, exercise, healthy diet, avoidance of toxins, etc.)

16. Accommodations and Interventions The Family Advocacy Counseling and Training Services Program (FACTS) Information re services in NYS Links to rehabilitation services and support groups Training for family members, service providers, and educators to understand impact of TBI Support with special education Individuals who sustained a brain injury prior to the age of 22 and live in New York State are eligible Funded by the Office for People with Development Disabilities (OPWDD) BIANYS.org

17. Thank you