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ACQUIRED BRAIN INJURY presented by FRANCESCA A. LaVECCHIA, Ph.D. Chief Neuropsychologist Brain Injury & Statewide Specialized Community Services Massachusetts Rehabilitation Commission
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AGE of ONSET CONGENITAL (PRENATAL) -Genetic -Chromosomal -Multifactorial -Unknown ACQUIRED (PERINATAL GERIATRIC)
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LOCUS of CNS DISORDERS INTRINSIC vs. EXTRINSIC FOCAL vs. MULTIFOCAL vs. DIFFUSE
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VELOCITY of CNS DISORDERS STATIC PROGRESSIVE -RAPID -SLOW INTERMITTENT
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ETIOLOGY OF ACQUIRED ENCEPHALOPATHIES INFECTIOUS NEUROTOXIC METABOLIC TRAUMATIC NEOPLASTIC VASCULAR DEGENERATIVE/DEMENTING
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NEUROEPIDEMIOLOGY: STUDY POPULATIONS INTERNATIONAL NATIONAL REGIONAL FACILITY/AGENCY-BASED
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NEUROEPIDEMIOLOGY: METHODOLOGY Uniform Hospital Discharge Data Set (UHDDS) Sampling Survey Studies Registries Surveillance Studies (e.g., Centers for Disease Control)
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FACTORS AFFECTING RECOVERY and OUTCOME AGE SEVERITY of NEUROLOGICAL INSULT DISORDER/DISEASE-SPECIFIC DETERMINANTS PROGNOSIS
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FACTORS AFFECTING RECOVERY and OUTCOME NATURE of COMPLICATIONS PREMORBID CONDITIONS (e.g., Psychiatric Disorder, Developmental Disorder) TIMELINESS, ACCURACY, and ACCESS to DIAGNOSTIC and TREATMENT SERVICES
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FACTORS AFFECTING RECOVERY and OUTCOME PARTICIPATION in REHABILITATION OTHER POST-INJURY RISKS/FACTORS (e.g., substance abuse) SUPPORT of FAMILY/SIGNIFICANT OTHERS
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LONG-TERM SEQUELAE NEUROCOGNITIVE COMPROMISE -Dementia (progressive disorders) -Mental Retardation (e.g., Shaken Baby Syndrome) -Specific Neuropsychological Deficits (e.g., aphasia, memory disorder) NEUROBEHAVIORAL/NEUROPSYCHIATRIC DISORDER -Personality Change -Depression
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LONG-TERM SEQUELAE MOTOR DEFICITS and PHYSICAL DISABILITY -Paralysis (pyramidal disorder) -Extrapyramidal disorder (e.g., Parkinsonism) SENSORY IMPAIRMENT -Visual (e.g., visual field impairment) -Auditory -Other sensory impairment
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OTHER ASSOCIATED CHALLENGES COMPROMISED EDUCATIONAL OUTCOME COMPROMISED VOCATIONAL OUTCOME SOCIAL ISOLATION
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OTHER ASSOCIATED CHALLENGES SUBSTANCE ABUSE INSTITUTIONALIZATION INCARCERATION HOMELESSNESS
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CONTINUUM of SERVICE NEEDS
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ACUTE INTERVENTIONS (Disease/Disorder-Specific) EMERGENCY DEPARTMENT SERVICES SPECIALIZED INPATIENT CARE (e.g., Trauma Unit) EVALUATION and TREATMENT by MEDICAL SPECIALISTS (e.g., Neurosurgery, Neuro-oncology)
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POST-ACUTE INTERVENTIONS INPATIENT/OUTPATIENT REHABILITATION SKILLED NURSING/LONG-TERM CARE FACILITY -Persistent Disorder of Consciousness -Slow to Recover -Progressive Disorder -Homeless with significant residual sequelae COMMUNITY-BASED SUPPORTS (e.g., VNA, Home Health Care)
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ONGOING TREATMENT NEEDS NEUROLOGY NEUROPSYCHOLOGY SUBSTANCE ABUSE NEUROPSYCHIATRY REHABILITATIVE THERAPIES (e.g., maintenance PT/OT, cognitive remediation)
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COMMUNITY-BASED SUPPORT NEEDS SPECIAL EDUCATION VOCATIONAL REHABILITATION/EMPLOYMENT AVOCATIONAL SERVICES (e.g., Day Program, Volunteer Opportunities, Club house) COMMUNITY LIVING SUPPORTS (e.g., Personal Care, Supported Living Services, 24/7 residential) ACCESSIBLE/AFFORDABLE HOUSING
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COMMUNITY-BASED SUPPORT NEEDS COMMUNITY INTEGRATION (e.g., access via transportation) CASE MANAGEMENT (e.g., advocacy; linkage to resources and entitlements) SOCIAL/RECREATIONAL/LEISURE OPPORTUNITIES ASSISTIVE TECHNOLOGY SUPPORT SERVICES for FAMILY/SIGNIFICANT OTHERS (e.g., respite, BIA Support Groups)
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