hiring individuals with traumatic brain injuries (tbi) education employees about tbi michelle...
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Hiring Individuals with Traumatic Brain Injuries
(TBI)Education Employees About TBI
Michelle Maultsby, PhD, CRCAssociate 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
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• Have an understanding of traumatic brain injury (TBI)
• Be able to identify characteristics and symptoms
• Gain knowledge about other disabilities commonly 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
LEARNING OBJECTIVES
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• 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
TRAUMATIC BRAIN INJURY (TBI)
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• Can result in various forms of impairment
• Cognitive
• Emotional/Behavioral changes
• Physical manifestations
• Social
• Vocational
• Other areas of person’s life
TRAUMATIC BRAIN INJURY Cont.
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• 1.4 million persons in the US with TBI (yearly) 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.
TBI STATS
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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.
Yearly Economics statuses for TBI
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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 affected
• Closed Head Injury
• Skull is not fractured
• Results from blow to the head or violent shaking of the head
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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
LEVELS OF TBI
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Moderate
• Loss of consciousness for few minutes or several hours Confusion, disorientation Physical Impairments Cognitive Impairments Psychosocial Impairments
• Symptoms may be permanent
LEVELS OF TBI
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Severe
•Remain in a coma for extended periods of time
•Permanent and more severe deficits
LEVELS OF TBI
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• Loss of response to sounds, light or touch• Response to stimuli is affected
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.
CHARACTERISTICS AND SYMPTOMS OF TBI
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• Impaired Communication Difficulty with speech (slurred) Difficulty using and understanding words Misarticulation Laborious speech Hesitancy Reduced vocabulary and grammar
CHARACTERISTICS AND SYMPTOMS OF TBI
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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.
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• Impaired Vision 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.
CHARACTERISTICS AND SYMPTOMS OF TBI
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• Hearing Impairments Difficulty interpreting sound Acquired hearing loss Ringing in the ear
CHARACTERISTICS AND SYMPTOMS OF TBI
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CHARACTERISTICS AND SYMPTOMS OF TBI
• Memory 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
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• Touch, taste or smell 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)
CHARACTERISTICS AND SYMPTOMS OF TBI
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• Endurance Physical fatigue Mental fatigue Altered sleep patterns
CHARACTERISTICS AND SYMPTOMS OF TBI
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CHARACTERISTICS AND SYMPTOMS OF TBI
• Bladder and Bowel function Incontinence Embarrassment
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• Epilepsy 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.
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.
TBI - ASSOCIATED DISABILITIES
TACE Center: Region IV, a project of the Burton Blatt Institute.Funded by RSA Grant # H264A080021. © 2012
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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.
MYTHS RELATED TO HIRING INDIVIDUALS WITH TBI
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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
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.
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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.
PREDICTORS OF EMPLOYMENT
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• Level of Severity
• Level of functioning/Improvement
• Receiving vocational rehabilitation services early on
• Knowing what services are available
• Knowing what to say to employers
PREDICTORS OF EMPLOYMENT
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PREDICTORS OF EMPLOYMENTKnowing what accommodations are necessary
• Shorten hours• Modified equipment• Modification of duties• Job restructuring• Rest breaks• Reassignment to different person• Modification of workplace• Training materials• Provision of readers
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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.
PREDICTORS OF EMPLOYMENT
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• Interest in Job
• On the job training
• Counseling and guidance
• Supportive work environment
PREDICTORS OF EMPLOYMENT
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PREDICTORS OF EMPLOYMENT
• 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.
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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 Americahttp://www.biausa.org/
• The Center on Outcome Measurement in Brain Injuryhttp://www.tbims.org/combi/
• Injury Prevention and Control: Traumatic Brain Injury (CDC)http://www.cdc.gov/TraumaticBrainInjury/index.html
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Comments & Questions
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Thank You
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Contact InformationMichelle 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
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Education CreditsCRCC 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
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Southeast TACE Region IVToll-free: (866) 518-7750 [voice/tty]
Fax: (404) 541-9002
Web: TACEsoutheast.org
My TACE Portal: TACEsoutheast.org/myportal
Email: [email protected]
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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)].