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Episode
Kate Grandbois: Hello, everyone. Welcome to SLP Nerdcast. I'm very excited to welcome a group of multidisciplinary clinicians here to talk to us about, uh, interprofessional collaboration in brain injury.
Um, if [00:02:00] anyone listens to this podcast regularly, they know that I know very little about brain injury, and I'm really excited to learn from these two expert guests today. So please join me in welcoming Tracy Callahan and Abby Yelensky.
Tracey Callahan: Hey. Bonjour. Hello. Yeah, hey.
Kate Grandbois: Before we get started, I wonder if you all could tell us a little bit about yourselves.
Tracey Callahan: Uh, sure. Um, my name is Tracy. I am a speech pathologist. I am a seasoned speech pathologist, uh, with a few gray hairs that have been colored other ones.
Um, I've been working in some form of the medical aspect of speech pathology for almost 20 years now, and really enjoy working with brain injury and are really passionate about, um, collaborating with other professionals. And, um, Abby and I, uh, both really love this topic and we're excited to talk about it.
Abigael Yelensky: [00:03:00] I'm Abby. I have been an occupational therapist for, oh my goodness, um, 18 years, maybe a little over- ... who's counting? I'm also a certified brain injury specialist and certified neuro specialist. I'm in private practice, and I work with pediatric and adolescent population primarily. Um, and my passion is in, um, traumatic brain injuries, acquired brain injuries.
I really value working in the community, helping with community re-entry back into school systems after, um, a client has left the re- um, rehabilitation and acute phase of an injury. Um, I especially love being in collaborative practice and getting to work with people like Tracy and other disciplines, um, which really just, um, adds to patient care and my own personal knowledge.
Kate Grandbois: That's wonderful. I'm so excited to speak to you both today and learn more about this, uh, world of inter-collaborative, interprofessional collaborative practice and brain injury. I also just wanna say thank [00:04:00] you for using the word seasoned instead of old- ... because I also consider myself in that category. Um, before we start talking about all the fun clinical stuff, I do need to read our learning objectives for the day.
Learning objective number one, define and explain the benefits of interprofessional collaborative practice in post-brain injury rehabilitation and care. Learning objective number two, describe the barriers and analyze the negative impacts that fragmented care and communication have on patient satisfaction and recovery.
Learning objective number three, identify and highlight the role of the patient and family in the ICP team. And learning objective number four, describe and identify practical strategies and ways to advocate for interprofessional collaborative practice across the entire care team, inclusive of the patient and family.
For anyone who would like to know about the financial and non-financial disclosures of our guests today, as, including myself, please, uh, cruise on over to our [00:05:00] website, um, and the course landing page. The link to the course landing page is in the show notes. You will also find a link to take the post-test if you are using this episode for ASHA CEUs.
Now that that is all behind us, where would you brilliant humans like to begin?
Tracey Callahan: I figure we would just begin by maybe just using a working definition just to make sure that we're all on the same page. Um, there's a lot of different ways to call it interprofessional collaborative practice, collaboration, um, and it all gets down to the exact same thing.
So we're using the World Health Organization definition. So collaborative practice happens when multiple healthcare workers from different professional backgrounds work together with patients, families, carers, communities to deliver the highest quality of care. It allows healthcare workers to engage any individual whose skills can help achieve the local health goals.
So, um, it looks, uh, a little bit different [00:06:00] in, um, the medical world than it does in a school, than it does in an EI. Um, but at the crux of it is just making sure that everybody is on the same page and that we're collaborating together so that we can make sure to provide the best care
So in the, in the, uh, in the hospital, the different teams that you might have, uh, include child life, which is one that's super important for anybody who's working in pediatrics. I think that child life specialists are amazing.
Um, when my son was in the hospital, one of the first things that I did was to reach out to the child life specialist. Um, the respiratory specialist, it might be speech therapist, occupational therapist, nurses. Um, it could be the, the CNA who's helping the patient to get out of bed. Everybody is on the team, and everybody is working towards the goals of the client or the patient.
Um, and in the hospital there is a big focus on what the goals of the patient and the [00:07:00] caregivers are. So that might be, if it's an adult, it might be, you know, a, a husband, a wife, or a spouse, or it might be a parent, or it might be an uncle. Um, but everybody is an important member of the team.
Kate Grandbois: I'm gonna hop in with a comment because you've already touched on a few things that I think are really important in our field in general.
The first being, um, the importance of m- multiple brains, right? We talk about that a lot on this, on this show. More brains are always better than one brain. And I think what's unique about that in speech pathology is our scope of practice is so wide, and we can't be experts in everything. So having other professionals to draw from and, and help further our learning is such a benefit to the entire team.
The second thing I just wanna emphasize, I love that you brought up b- uh, the, uh, patients and families as part of the care team because that is such a [00:08:00] important component of evidence-based practice that I think is, um, undervalued and maybe not centered as often as it should be. Um, so thank you for bringing up both of those things.
Tracey Callahan: And I think- Thank- ... for seasoned clinicians- ... such as ourselves- ... um, we may remember a time where we were told that we are the expert, and we are- Right ... to tell the client or the patient what is wrong, what needs to be fixed, how it's going to be fixed, if it's fixable, um, the- whereas now the, the families and the patients themselves are being centered a lot more.
And I think that there, and we'll talk about it later, but there are a lot of benefits to that. Um, and it's so important that we make sure that we're communicating with the patients, um, to make sure that those goals are met. So no more of the SLP is in charge of- Yep ... this, the OT is in charge of this. [00:09:00] It is something that is shared, and we really need to collaborate to make sure that the goals are met.
Abigael Yelensky: And Kate, similar to, um, just to go back to your first point, um, the, like ASHA, uh, occupational therapists have the American Occupational Therapy Association, which is our governing body, and they actually have a statement, um, on their website that really discusses, um, that complex challenges are best addressed by a diverse team.
I think it's also really important, too, when you're talking about a multidisciplinary, uh, team, it even might include multiple OTs on the team or multiple speech and language pathologists, because my specialty, um, in the neuro piece, I'm not a driver re- rehab OT or, um, adaptive tech is not my area, so I will often refer to other OTs that have that as a specialty.
Um, so I think that's also important to just note that
Tracey Callahan: Yes, I cannot do an AAC assessment.
Abigael Yelensky: Mm-hmm.
Tracey Callahan: I mean, I'm licensed to do- Yep ... AAC assessments, [00:10:00] but though it's in, within my scope of practice, it's not within my scope of competence- Yep ... um, and there are too many factors to keep track of. So I know many times there'll be an AAC specialist that's part of the team, um, maybe, uh, as a speech therapist and an occupational therapist- Yeah
even for access, given different mobility challenges.
Kate Grandbois: So I have a question that could be jumping the gun, and I always, I always do warn our guests ahead of time that if I ask a bad question, it's not a trick. It's a very genuine question. So I mean, in, in reviewing these ideas of scope of competency and, and thinking about our scope of practice, um, the importance of interprofessional collaboration, how the patient and the family really needs to be centered, and thinking about that as, like, a lens, as, or like a backdrop to what we're talking about, why is this particularly...
why are these variables particularly important when it comes to brain injury? Like, what, what sets this [00:11:00] apart? What makes this a little bit more... It's, it's important everywhere, but how is it- Mm-hmm ... how is it unique to brain injury recovery?
Abigael Yelensky: I think brain injury, um, touches on so many different pieces, right?
You have mobility. You have the social-emotional piece, language. Um, I think there are so many different, like, providers or players on the court involved, and when you leave, I know, um, Tracy mentioned who's in-hospital care team. But when they leave that hospital setting, there are so many more people involved.
So if you're talking about, um, adults returning to some jo- to jobs or, uh, students going back to school, I think there are just so many players because it's such a complex, um... Traumatic brain injury is so complex, and it touches upon so many different elements of physical, psychosocial, um, emotional development that I think that there just needs a lot of different lenses and-
Tracey Callahan: Yeah, and then it's traumatic brain injury or acquired brain injury.
Mm-hmm. There are, [00:12:00] the, there are so many complex factors. For example, sleep. If somebody is not sleeping well, then they do not have the energy to participate in speech therapy. Um, and it's, it's different for a person who has a brain injury to not- Be getting sleep than it is for a teenager who's working on their Rs and Ls perhaps, and just was up late on their phone with their friends.
Um, so they really do need their sleep. It is very important, and if they're not able to sleep and they're not able to be present for therapy, that's problematic. So, um, communication between the different care providers works to solve problems like that, where, um, the care provider might not even know that that's a problem.
Um, there are so, there are so many things that people with brain injuries are addressing, and their appointments with their physiatrist might be, like, 15, 20 minutes, and they [00:13:00] just need to get this one small thing that is the most important thing for them addressed, and everything else might just sort of fall apart.
Um, and so by having a care team that's communicating with each other, then the family can use that time really well at the physiatrist to address their issues, and then the other issues that the speech therapist or occupational therapist need to have addressed, they can communicate all of that. Um, it also takes some of the burden away for the families and caregivers and for the patients, where we know that many times with brain injury, communication can be affected.
Um, fatigue, um, is also, can be very high. And so communicating all of the things going on in their life, uh, to the care team can take away from their ability to be present to participate in their rehab.
Kate Grandbois: I appreciate the reminder of the complexity, um, [00:14:00] of this particular presentation when it, when it comes to, um, not only medical complexity, but systems complexity, which is I think maybe a, a good segue into this second learning objective, which is really about barriers to care.
And, you know, all of us work in systems that have limited resources, right? We, none of us have unlimited money and time. I wish we did. That would be amazing, but we don't. And I, I wonder if you could start talking to us a little bit about how these barriers, like, the, the realistic real world barriers that we face as clinicians that prevent this gold standard of care for persons who are recovering from brain injury.
Tracey Callahan: Um, I definitely... That's high on our list to talk about, but before we get to that, we just wanted to make a comment on why it's so important. Um- Mm-hmm ... outside of that, it is having to do with survival rates. And Abby, if you wanted to [00:15:00] just touch on that piece.
Abigael Yelensky: Um, sure. Um, I think it's... There have been studies that show, uh, decreased mortality, increased patient outcomes when you have a multidisciplinary team.
There was one study that particularly looked at a stroke unit, um, that had multidisciplinary approach. Um, and it- they showed to have decreased cardiovascular, neurological, and immobility related deaths compared, um, with a unit that was not following this model. Um, and I think before we even get into barriers, it's so important to really just step back and look at all the benefits, um, the benefits to caregivers, which Tracy had already mentioned.
Um, it's often left to the family and the client themselves to piece together care, piece together therapists, their medical team, multiple different hospitals, multiple different agencies, um, which can lead to caregiver burnout pretty quickly. They, they leave the hospital where there was a case manager or a social worker that was really helping to integrate all [00:16:00] of this, and now suddenly they are on their own.
Um, there are medical benefits, um, speaking with physicians, um, in terms of dosage, seeing how different medical changes are impacting the client at home, um, and being able to speak with other disciplines that are working. We're able to then relay that to the medical staff and really, um, because the client is at the center of this all, is really helping, uh, to educate and to have them become aware of what their body's feeling, if they're noticing changes, and how they can express that also.
Tracey Callahan: We all understand that interprofessional cor- collaborative practice or collaboration, whatever you wanna call it, is really important, but there are quite a few barriers that exist to that. I think any speech therapist out there that's listening or occupational therapist, um, is already probably pulling up some of those things in their head, the barriers that they have, um, on a day-to-day level.
Um, and we've sort of sketched out as [00:17:00] four areas, so there's systematic barriers, organizational barriers, structural, and then interpersonal. Um, so when we're thinking about systematic barriers, I know this is a big thing right now with reimbursement and billing and coding, but m- much of the time that we spend talking to other care providers is not reimbursable.
It is something that is done on your own time, and we know that, uh, we need to be providing really, a really high level of patient care. Um, and, and how do you find the time on your own time to communicate with this? Um, we understand that, uh, f- care will be really fragmented. Like Abby was saying, you might have an OT in one place, an SLP in another place.
Um, the husband or wife is unable to come to the session, so how do you communicate what has happened if the person is really struggling with communication? Um, and, uh, another barrier is, [00:18:00] uh, consent. Sometimes, this is, this is something that I personally am working on with a client of mine where they don't want to release some of the things that we're working on.
Um, they wanna... And, and so it's helping them figure out that it would be helpful for your partner to understand that memory is difficult for you right now because that's going to have a direct impact on their life, and that it- they should know that you're working on your memory right now. Um-
Abigael Yelensky: It's also consent with each s- different provider needs a different consent form- Yep
as well. So, um-
Tracey Callahan: Uh, so there's a lot of extra paperwork- Mm-hmm ... um, that goes with providing, um, this collaboration to make sure that it's HIPAA compliant
Abigael Yelensky: So some of the orgas- organizational barriers, um, that we see is a lack of shared data. Uh, every hospital, every provider has their own, um, EHR system, um, so it's not as simple as just logging into, um, one chart [00:19:00] the way you might when you're at a rehab or in a hospital.
Um, scheduling is really hard. We're all back-to-back. Um, seeing d- I take, I think, the majority of my phone calls with other clinicians happens in my car commuting between visits. I'm sure Tracy can speak to that as well. That is, most of my meetings are in my car. Um, and it's difficult, uh, it's difficult to implement this because you're working with so many different people with different schedules, um, and even sometimes getting buy-in from other clinicians that might not have the experience with a multidisciplinary approach, and so that you're first possibly educating other members of your team, too, as to why this is so important, um, which we'll speak later on the importance of education, um, in this area
Tracey Callahan: And then, um, one of the things that I think, um, is a big one for me is the case coordination, is that if somebody is in- inpatient in a rehab hospital, for example, they'll have a case coordinator, and that person is making sure [00:20:00] that all of the I's are dotted and the T's are crossed, and that everything that needs to be happening is happening and in the timeline that it should happen.
It is a very complex system, especially when you pull in things like insurance coverage. Um, and it can be difficult for anybody to manage. Um, I know my dad was in the hospital this year, and he needed a lot of support. And my mom called me crying and saying like, "I just can't figure this out. You know, there's three different EMRs that I cannot figure out what's going on."
So I had to come in and play care coordinator and break everything down, and to read all the information in the EMR. And you know, how lucky that we are that I can read, um, all of this and understand what it means. But for somebody who is not, um, in the field, it's very difficult.
Abigael Yelensky: It's falling on a family member or spouse or a child, and that is also changing their role where they want to just be mom, dad or wife, husband, [00:21:00] and now they are really case coordinator.
Tracey Callahan: Yes. And, uh, so that, that role is difficult because then you have to make sure everything is being done, and sometimes you have to be very mean about it. Um, but it, it gets done. Um, another issue is, uh, a structural barrier. So one of the things that can be difficult is the hierarchies that exist. Some of these hierarchies are spoken, some of them are unspoken.
I think anybody that's worked in, you know, these big teams before knows what that's like, where there's one person who's decided that their opinion on what is going on is the most important, and it can be difficult to have that person hear you out and to help troubleshoot together as a team i- within this hierarchy.
And that can lead to, um, degradation of team cohesion because then people are picking sides for this, and then you end up with a, a lack of common goal when that happens. So when you can provide, [00:22:00] um, when you can participate in this collaborative practice right from the beginning and make sure that everybody is on the same page, it really does help to decrease these, um, these different, uh, structural issues that can come up
Kate Grandbois: I'm popping in with another self-reflection, 'cause I'm sitting here listening to you two kind of thinking about the complexity of all of this.
And I, I first wanna comment on the very real burden of care coordinating and how our systems, our healthcare system in general, and I know that's like a sweeping generalization, but we don't account for the stress that falls on caregivers, what that does to a caregiver's health, the grief or other emotional, um, things that they might be experiencing as a result of their loved one n- now living with a disability or having just gone through, you know, a, a traumatic medical experience.
Um, [00:23:00] and it's, it's, I think, such an important thing for us as therapists to remember because in many instances, and please correct me if I'm wrong, we end up having a longer term relationship with that family and can work to cultivate trust, um, and can work to coach and counsel. And I, I say to my therapists in our clinic all the time, sometimes it's therapeutic if you just sit there and listen.
And that is- ... you know, especially when you feel like, "Well, I didn't do anything today. I didn't do any of my activities. I didn't..." But, but it, really cultivating a relationship with these families and these caregivers can be such a therapeutic- Yeah ... experience because the burden of care coordination is so significant, and it's invisible.
It's a completely invisible load that very few systems are willing to even name. Um, so I really
Abigael Yelensky: appreciate it. That's a message I give to students o- sorry, that's a message I give to students often is that, um, OD students that I take, is that sometimes all you need to do is hold space.
Kate Grandbois: Yeah.
Abigael Yelensky: And that [00:24:00] has the most therapeutic value of anything else you will do that day.
And it is hard as fixers or professions that wanna just get in and help to realize, like, what that means.
Kate Grandbois: Right, especially when we get no, no, no formal training in counseling. Asha, if you can hear me, can you please fix that? Because we, we have, we have so, we do so much counseling. It's such a huge component- Absolutely
of our jobs, um, to hold space and to center the needs of someone else. Yeah. And of course to center the needs of someone else, we have to de-center our own needs, which takes a whole lot of inward reflection, another thing that we don't really talk about enough, um, as a field. Anyway, now I'm off on a soapbox.
Coming back to my original point, I, I appreciate, um, you mentioning the burden and I, I just, I wanted to emphasize that. The second thing I wanted to bring up is related to hierarchies, because there is a real power differential in a room full of people. And sometimes, like you said, that power differential is explicit because I have MD after my name, or I have more letters, or I'm in a leadership position and you [00:25:00] aren't, or...
You know, there's so many organizational factors that, that seep into this. There are also cultural factors, right? H- the way we view people in positions of relative power to ourselves. And the, the thing I was reflecting on while you all were talking was How, h- again, under, under-discussed how important it is and how under-discussed it is to be kind, to, to have- I mean, I know it sound, it sounds like such a small thing.
Yeah. But sometimes being kind is hard, especially if we're not being respected or listened to or someone else has brought their ego into the room, right? Mm-hmm. And then we have to make space for, for so-and-so's ego, right? Mm-hmm. But the attitude that we bring can have such a positive influence on group dynamics, especially when those power differentials, um- Mm-hmm
exist, and I, I just think that's such a- Absolutely ... that's such a great point, and I'm so glad you brought it up.
Tracey Callahan: And I, I imagine that- Yeah ... you know, people who are [00:26:00] listening can think of examples in their life that this has happened, either personally or professionally. Um, and it, it's something that almost every patient, um, that we work with, we've experienced that.
However, you know, making sure to communicate with the families-
Kate Grandbois: Mm-hmm ...
Tracey Callahan: to make sure that what- whatever we're recommending is based on the goals that they have, I think that's one of the things that really helps with making sure, regardless of, you know, if there's a doctor who feels really strongly about something and we feel an opposite way as a speech therapist, um, that we make sure that we're centering the patient and the family in that decision-making process, um, which is- I-
very important.
Abigael Yelensky: Um, I think I've been really fortunate to develop relationship with some of the physiatrists in the area, I'm sure Tracy has, too, um, because when you work in such a sort of niche area, um, it is often the same providers, and I think there is that needing to almost prove yourself as a clinician at the beginning.
But then they really [00:27:00] value, um, I'm not seeing what the person's function is day to day and, and what their goals are. And so, um, I think w- I've, uh, been able to get to a place where I can recommend where I think Botox should be injected or if there was too much or too little for tone management, or, um, if w- why I think a splint might not be appropriate.
And so I think it's just, um, continuing to, like, advocate for your profession, um, and sort of prove your competency to help with some of that, I think. Um, just-
Tracey Callahan: Yeah, and it's all of the stuff that, like you were saying, Kate, we don't get enough time- Yeah ... in grad school, um, about it- Yeah ... but, you know, we've all have, we all have the aphasia decision tree- Mm-hmm
memorized, you know?
Kate Grandbois: Yeah.
Tracey Callahan: That, you know, many classes on that, and not as- Mm-hmm ... not as many about how to- Yeah ... help your patient advocate- Advocate ... in the system- Yeah ... that is, um- You know, very difficult for people to advocate in.
Kate Grandbois: And how to do that with empathy. Yeah. And not show up as the, "Do this because I said so."
Yep. "I'm the [00:28:00] expert. I have the, all these fancy letters after my name." Holding, you know, being both of those things at the same time is not easy. I mean, it's a skill. I think back to myself as a new grad, and it is, as my 11-year-old would say, extreme cringe. I think about how I behaved, uh, you know, in trying to guide families, and there was a lot of that.
In my personal experience, I think it's, it's not something that came easily to me. I really had to work at it.
Tracey Callahan: Yeah.
Kate Grandbois: But anyway- I think we all have- ... this is not a therapy session for me. Um, it can be- I think we, I think we- ... but that, that's a way less fun show. I think- We're
Abigael Yelensky: holding the space for our fatigue.
We all have the, and we all have those experiences. I actually, I'm a mom of twins, and I remember my first year with the twins and thinking back to, like, not understanding why there wasn't s- follow-through as a new clinician with s- a set of premature twins, and then I had my own years later and I was like, if I could go back and apologize to that family.
Totally. Like, I get it. I... And so I think you-
Kate Grandbois: Totally ...
Abigael Yelensky: that's through experience, you learn, and every year, I think you reflect [00:29:00] and become a better clinician in the end.
Kate Grandbois: Yeah. Yeah.
Abigael Yelensky: Right. Um, I think that brings us into interpersonal barriers. Um, so that's really, like, the clarity of your role and scope of practice, and as you already mentioned, our scope of practice is so wide, but that doesn't necessarily mean, um, I should be doing everything I'm actually allowed to practice under my OT license, and it really means saying, "I don't, this is not my specialty.
I need to bring somebody else in who it is." It means saying that to a family also, and, um, in my experience, they really respect that, when you don't know the answer to something and I say, "Let me research this. Let me reach out to colleagues." And I think that is really putting your ego aside, because we don't know everything and we learn so much from other professionals, and we learn so much from the families and clients that we work with.
Um, and I think just going into every day knowing that you are a student still, no matter how long you've been in the field. Um, other interper- personal barriers are really the poor communication, um, and that's sort of tied into some of the schedule d- [00:30:00] difficulties. Um, and just every clinician might have a different way they wanna send through text, have a phone call.
Um, some are resist- some people are resistant to change, which is, which is challenging. Um, and the other is really concerns for, uh, confidentiality, um, and how are we sharing, um, communication? How are we sharing information, making sure that we're HIPAA compliant, um, making sure there's no breach of confidentiality, and so that's something that I think we really have to be, um, very careful with.
Tracey Callahan: And then, um, one thing that I wanted to mention was, um, you know, depending... I, I live in the Boston area, and I am lucky that I have many different clinicians that I could call, um, if it's something that I don't, I don't know what to do or how to do it. I don't have that, um, I don't have difficulty finding somebody to help me treat a patient or a mentor.
Um, but for some people who are in, you know, a more rural area or, you know, there are other [00:31:00] systematic barriers and you are the speech therapist or you are the OT and you need to work through it, then, um, another thing that, uh, you know, we, we talk a little bit about this, this education piece, um- Mm-hmm ... and figuring out, um, getting a little bit into the s- uh, strategies there is, is finding a way to help educate on that piece of things.
So if I was a o- uh, SLP in a rural area and there are no other speech therapists, um, to reach out and educate on how to do some of more of the, like, AAC things or, um, to reach out to another OT, um, to learn more. And so, um, educating, um, like continuing education as well as leaning on other colleagues, um, for SLPs in, in areas where there isn't this density, I think is another thing.
Okay. Um, I think it's time to talk about some of the [00:32:00] practical strategies. Um, so having made a lot of mistakes over the course of my career, um, which I feel like probably many of us have, um, I've come up with some different practical strategies. So has Abby, and, um, Kate, you may have as well.
Um, but what we tried to do was to organize this more specifically when we start to think about it from the lens of brain injury. Um, so one practical strategy that exists is, uh, team meetings. So in a hospital, team meetings happen pretty regularly. So doctors round on their patients. Um, patients have access to their doctors on a daily or weekly basis.
Specialists can come to them. Specialists can check in at these meetings. Uh, people take notes. You have access to everybody in one room, and it's amazing. And the amount of, uh, of problems you're able to solve and the efficiency that you can have is really high. [00:33:00] Um, and it, but this looks different at different locations.
Um, so, you know, speaking from the standpoint of a hospital, you have all of the medical team there, but what you don't have is the home team. So if this is a pediatric patient, the school won't be at that meeting. It will just be the medical team
Abigael Yelensky: Um, I work a lot with families and advocacy during IEP meetings, um, because, uh, our majority of states, as Tracy said, do not have somebody from the school team involved in discharge planning or meetings, um, which means when it's time for school re-entry, there is a big gap.
The school system does not have the training or specialists to accommodate a student returning to school. Um, additionally, and for anybody familiar with the IEP process, there's a three-year, um, re-evaluation to determine qualification, and then an annual, um, meeting, which is to establish [00:34:00] goals for each year.
Um, when you're working in, uh, with brain injury population, progress is much faster than that. There is changes from week to week. Um, and so goals that were set to be re-evaled for a year might have already been, been surpassed. And so I think it's really important, um, to communicate to the team that we need more frequent check-ins and that, um-
Tracey Callahan: Yeah, and, um, you know, there's, for...
I saw your eyebrows kind of go up when we talked about progress, Kate, but for people who have brain injury, when they have a, um, a solid team involved and they're working hard, they can make progress, um, day to day, week to week. And then, um, these plans that have been put in place are completely useless- Yeah
in a two-week time. Yeah. Um, one of the reports that I've gotten from a patient that I work with is that, you know, the, um, aide that was [00:35:00] working with them insisted on doing some hand-over-hand stuff for mobility after the patient was able to walk independently, and she could not get, though she communicated this to the aide, she could not get the aide to stop physically helping her.
And she said, "It's embarrassing, and everybody's looking at me, and I want her to stop." And she said, "I l- I have to. It's in the IEP, and it says that I have to provide this level of support." Um, and so then there was this sort of, like, back and forth that we had about that. And so that's why we had recommended having more frequent IEP meetings for this particular client because progress was occurring at a really fast rate, and the team that was, you know, day to day at the school did not feel, um, comfortable making the changes without having explicitly written into the IEP
Kate Grandbois: I'm, like, kind of, uh, uh, obviously I don't have a very good poker face.
I mean, you saw [00:36:00] my facial expression just kind of expressing, you know, surprise. Um, at, at the... It wasn't so much the rate of progress, it was the complete and utter mismatch between documentation and systems level procedure, right? Policy and procedure- Yep ... with h- w- totally misaligned with the level of care and need.
Um, and knowing that, you know, that we're, we're talking about systems that are not nimble. You're not gonna get a totally different IEP process from a, from a school- Yeah ... right? This is a ph- Yeah ... this is a state regulated-
Abigael Yelensky: Yep ...
Kate Grandbois: you know, policy level thing. Mm-hmm. Um, and so I, I just think it's, it's wild and, and for all of these school-based SLPs who are listening, um, first of all, recognition that, like, everybody's doing their best, right?
Every, the, the systems are what they are and we're all working within them. Yeah. But [00:37:00] also, it's so good to recognize that sometimes the systems don't match the need, and that's not anybody's fault. That's the, you know, it, it is the way it
Tracey Callahan: is. Absolutely.
Kate Grandbois: Um, and when we know better, we can do better, like calling additional meetings, you know, putting some- Putting more effort and priority into communicating for when progress does not match up with your level of documentation and progress- Yeah
monitoring.
Abigael Yelensky: And I, I think it requires some creativity, um, I think on our, on everybody's part. So for example, um, having it added into the IEP that the, a co- a phone, a consult with outside home providers, um, will happen on a regular basis. That's one way to increase communication that we've found really effective.
Um, so I'll speak, um, monthly with the school-based OT to go over what we're seeing at home, the progress that's made. Um, I know Tracy does the same with, um, SLPs and speech. Yeah.
Tracey Callahan: And I, I'll say that when, um, that [00:38:00] sometimes that can be difficult to have added into- Mm-hmm ... the IEP, but what I pushed back with is that you, the outcomes will be better.
The student will be safer at school, and, um, you will hear from the parent a lot less- Yeah ... um, on a regular basis about these questions if we can do it, um, and just have, you know, a very efficient 10 or 15-minute talk, um, if possible, um, to discuss any issues. Um, I've, I've had standing meetings for patients who are changing very frequently.
Um, it's not appropriate for every student, so... And again, this is very specific to either traumatic or acquired brain injury that you would need more frequent contact, um, with the school and with the IEP team. Um, you know, but a, a barrier to that is that, you know, insurance is not reimbursing that time. It can be difficult to find [00:39:00] the time with the school, um, but it is something that's really important.
And then for adults with brain injury, um, scheduling meetings, um, with the team at work before they return to work so that they can work on planning to return to work, what barriers might exist, what changes or accommodations or modifications to their workload might need to happen. Um, we recommend that for all of our adult clients who are returning to work- Yeah
in whatever capacity. And having that meeting ahead of time where everybody is sitting down and knows that we're gonna listen- Mm-hmm ... um, make a plan, um, that communication before the return is, is extremely important.
Abigael Yelensky: It also lets us know sort of what are the, um, job requirements and what are things that we can maybe, um, sort of replicate at home to start working on.
Tracey Callahan: Yeah. And then, you know, if, if- If patients or families are used to this really frequent [00:40:00] communication in a hospital setting, and then they transition home and they're now getting only, um, access to the SLP at school, 'cause there are some people who are in school and that is the only access to speech therapy maybe that they have, um, they only really get access to that person once a year, that can be very difficult, um, for them.
So from the patient perspective, we have heard from patients and families that more frequent team meetings help with their anxiety- Mm-hmm ... help with communication, carry over, and functionality at home. Um, but it, you know, the barrier to that is finding the time. So advocating as much as you can, and then from the speech therapy perspective to say, "Yes, this is an important thing and worth the time, um, to do that."
Um, another thing that I love is, um, I love, uh, Microsoft Excel. Um, I don't know if that's a hot take, but I really love I love, I love Excel. This... I know. My friends were making [00:41:00] fun of me for this yesterday actually. I'm a
Kate Grandbois: Google Sheets girl,
Tracey Callahan: don't get mad. Yeah, Sheets. Oh, man. Um, so Sheets, Excel, whatever product- Love it
it is with cells in there, um, I love using this, um, to communicate, um, what's happening and what has happened during the session. So creating a shared communication log across providers and across families can be really helpful. Some people I've worked with have said that they prefer a physical notebook, um, which is great, and I will, I will use the physical notebook, but I will also take pictures of things, 'cause things can get lost.
And if there's only one copy of it and that gets left in an Uber or a Lyft, then it's gone and you don't have access to it. So having something that is on a, a shared device, um, that people can enter things in is really, is really, really been helpful for me and it's been helpful for families as well. [00:42:00] Um, thinking about, um, from a speech therapy goal, um, one of the things that I work on with my patients with brain injury at the end of the session is recalling what we did, why we did it, um, and if, you know, what we thought was difficult.
And so this really seamlessly works in with speech therapy goals to have them enter in themselves what did we work on in speech that day, so that when they get home, if their parent or if their partner asks what happened in speech and they can't remember, the, uh, partner or parent can say, "Okay, let's check the log and let's see what's happened there."
And that's one pretty easy way that we can, um, communicate with family members and other care providers just by entering things into this type of a living document.
Abigael Yelensky: We also try to have a question column, so if a question comes up during a session, either, um, a question I have or a question the client has, maybe, um, we can add it there to say, "Let's, let's put this here to see if one of your other providers might have the answer if it's something that I don't know," or, "That's a great question that I think, [00:43:00] uh, speech would really be the one to answer that.
Let's put it down so that, um, they know to address it."
Tracey Callahan: Yeah, and parents often, parents or, um, caregivers will often ask a question to me-
Abigael Yelensky: Mm-hmm ...
Tracey Callahan: you know, based on what that, whatever was entered in there. Um, you know, they might ask questions to us, but they, um, they wouldn't have had the opportunity maybe to email because things just get very busy.
Yeah. But having everything in one place to just try to remove barriers for, um, the patient and the family, um, using some type of a shared communication log is really helpful.
Abigael Yelensky: It's also been a way to show, um, progression and really help the client feel like, "Oh, look what I've done today versus what I did a few weeks ago or a month ago."
And so just another way to also really help, um- Help the client-
Kate Grandbois: Yeah ...
Abigael Yelensky: um, see their own progress. Yeah.
Kate Grandbois: I, I love the idea of a shared communication log. [00:44:00] Um, and I'm als- I'm also thinking about just the day and age we live in with AI. I'm sure Excel has similar functionality, and since I'm more familiar with Google Sheets, I'll use that as a, as an example.
Depending on how you organize the sheet, I'm just thinking of, you know, coordinating with a school SLP. Um, I met someone yesterday who had 174 kids on her caseload. Um- Wow ... or s- another person that I met yesterday earlier this week, who is in a pediatric outpatient program with 100% productivity. So like, SLPs are busy.
We do not have a lot of time, but if you are assigned a shared communication log or you have a shared communication log with someone who is working in a different setting, you can quickly ask your Gemini AI or your Copilot, "Can you please summarize what's going on with patient XYZ?" Yep. And you could get a really quick and easy s- you know, three-sentence snapshot of, of what the updates are, um, because, you know, there are some tools and functionality to help us overcome some of [00:45:00] these time restrictions.
Like I said, none of us have unlimited money and time. Um, but leveraging some of these smart tools, if you wanna call them that, um, can be really, really helpful.
Abigael Yelensky: And- And with the shared Go- with the Google Sheets, I'll just tag the email of a provider that I might need an immediate answer from, so that if they don't have time to sit and go through the whole log, they will see exactly what we are needing them to respond to- That's a good idea, yeah
and it can be helpful.
Tracey Callahan: And then we, one of the, um, you know, just to reference back to the barriers again, um, we would need to make sure that we have, uh, the consent of the, the patient or guardian to be able to use this document and to share information. So one of the things that we need is a, a, some sort of a, a consent form to have communication and to make sure that the, the patient and the family understands how it's going to be used, that it's something that they will have access to, that we'll be sharing information that happened during the session, um, and that that might impact what they [00:46:00] want written in there if they know that everybody is going to be referencing it.
One thing that Abby works on is, um, you know, ADLs and, you know, for young teen girls, they don't necessarily want everybody to know, um-
Abigael Yelensky: Yep ...
Tracey Callahan: what they're working on for menstruation, you know? They don't necessarily need their, the, um, PT, who's- Yeah ... very cute, to know that- Yeah ... in OT, that's what we're working on.
Abigael Yelensky: Mm-hmm, and that's, that's definitely an, a perfect example of a time where I've said, um, "I think it would be helpful for your PT to know, uh, to know how we're getting into the bathroom and w- how, how I think standing for this task is best. Is it okay if I reach out just to this PT?" And so that's also just really giving, um, putting control in, um, our patients' and clients' hands because they don't often feel like they have a lot of control.
And similarly, there's often times where if they are, maybe a provider has left the team or they are [00:47:00] having a challenge with somebody to, that they know that they can at any point remove communication too, that this is really in their control and power. And so if there is somebody that is not making them feel comfortable, it's okay to, for them to set those boundaries as well.
Tracey Callahan: Mm-hmm. Um, there's, um, you know, it, the shared communication log, um, it does help to make, help everything get more streamlined. Um, but one of the things that it, it can help is to decrease the cognitive load, um, for the patient and for the caregivers. Um, one of the things that can happen, um, for people with brain injury is that they feel like they just have too many things to do, and then they don't know how to start.
And then, um, and then on top of that, they're feeling very fatigued, they're working on healing, um, and they're wor- um, working through, um, some mental health concerns. Um- Yeah ... and to just have a laundry list of things to do, anything that we can do to remove, um, some of those things from them is very helpful.
Abigael Yelensky: And keeping everything in one place. [00:48:00] I've even put in links to videos that I've made for them, and that way it's one place that they are going to, and not having to pull up emails or other sources. Um-
Tracey Callahan: And then one thing that Abby, Abby, uh, and I learned about was, uh, patient interests, because maybe- Yeah.
we're very busy working on one very specific task for returning to school. Exactly. Um, and then, um, you've got, like, a really good example. I'll let you tell it.
Abigael Yelensky: So I, we shared, um, we shared a client, and I discovered, um, because what child wants to do range of motion and upper body strengthening? Um, I don't even wanna have somebody-
sit and do that. Their main occupations are play, and that's what we should be doing. I discovered that they had a passion for Harry Potter. I brought a wand, and we used the wand to make spells in the air, um, getting all of the, um, physical movement we needed to be getting. And it just became so exciting, and then turned into getting a spell book and making [00:49:00] our own spells and wanting to pronounce some spell words.
And that was something I could share to say, "Hey, speech, can you, can you work on saying these long words- Mm-hmm ... I can't even pronounce?" Yeah. Because this is really exciting to them. And
Kate Grandbois: so it's- Wingardium Leviosa, what do you mean? Exactly.
Abigael Yelensky: Yeah. Um, and it was such a, that, that was the tool to suddenly open up range of motion and g- going against gravity and all these, and, and fine motor control and dexterity and hand placement to then hold a pen.
And so, um, it worked so well in our sessions, I was like, "Oh, I need to share this with the other providers so that they can incorporate this into their sessions." Exactly. And that was where it was put, into the shared log.
Tracey Callahan: And, um, the, uh, the Harry Potter example is- ... is a great, is a great one. But, um, with another client, w- we were needing to work on voice, and it was very difficult for them to access the core muscles.
And I- I've had two kids, I don't really have really great deep core muscles myself. Um- ... and so I reached [00:50:00] out to the other care providers and said, "Okay, we need to do some core activation because we're trying to work on deep breathing. Is this something that you- Mm-hmm ... can help me work on?" Um, they did, and, and I remember planks was something that I was needing to do with them in order to help with core activation.
And then, um, and then that led to the patient making fun of how briefly I was able to plank for.
Kate Grandbois: Oh my goodness gracious.
Tracey Callahan: Oh, yeah. They, they were planking. The client- Abby, yeah ... I have a brain injury and I can plank longer than you. Oh. And I was like, I don't really know if that's the flex. Um,
Abigael Yelensky: but it is really, it is really helpful.
There were some exercises where, which turned on one particular client's voice, and I was like, "This is so great. I notice when they're in this flexed position their voice comes on, and now I don't know what to do with that. And now- Mm-hmm ... I'm taking away speech therapy."
Tracey Callahan: Exactly. Yeah. I can, yeah. I did a lot of grunting and, um, maybe some four-letter words that came out in the- Yeah
planking position. [00:51:00] Um, but it was a starting point. And with, if we w- if I didn't know, um, that Abby was working with this client, and she didn't know I was working with this client and that we were working on voice at all, she might not have realized that it was important to share that information, that that was something that I was struggling with.
So this in- the interprofessional, uh, collaborative practice and the communication and the communication log is really how we came up with all of these things.
Abby, you had talked a little bit about, uh, putting some video recordings into the log. Um, and I know- Yeah ... you've done a lot of really great stuff with the use of video rec-
Abigael Yelensky: Yeah. And obviously with permission, once again, I find, um, video recording so helpful for a n- number of reasons. Um, I think, you know, a lot of us, if anybody's ever, like, had a knee injury or something that required PT, you're sent home with your, like, home exercise program of these, um, stick figure drawings doing these exercises, and that is just not, um...
It's not really [00:52:00] appropriate for somebody that's had a brain injury. And s- actually seeing the movement, actually seeing themselves going through the exercises is a great way for them to replicate it or anybody working with them to replicate it. Um, so I often will record, um, if there's any homework that we want done, um, I'll often record it.
Um, or if a family member isn't there and, um, and the client really wants to show them, like, what they've just achieved, it's another great way for them, um, to feel some ownership and get to, uh, get to share. Um, we've used videos for positioning. So, um, I may have a setup for how I think positioning will be best for sitting at a table, for writing, for eating, and then, um, Tracy might not have that set up but be able to say, "This is what I'm working with.
Here's a video of the environment. Can you help me adapt this?" And so that's another really great way that we can go back and forth. Um, one of the biggest ways I also use videos is actually for communicating with physicians. Um, so often when we are in the home and really working closely with somebody, [00:53:00] you will start to notice, you might notice, um, suspected seizures or other obviously, uh, comorbidities and complications from having a traumatic brain injury.
Um, and so the odds that that is gonna be replicated when the, the f- they are in the doctor's office for their, all of their 15 to 20 minutes is unlikely. Um, and I can describe it in an email, but if I can capture what I'm seeing and have some concern about, I'm able to s- have the family take it to the doctor or send it myself, um, with permission, and, um, so that they can see the, what I'm concerned about.
Um, it's also if I think there is any regression for some reason, I've also, just for my own knowledge, been able to document, like, um- I've been able to document changes going back to my own videos within a few days. Um, so I think it works for progress, it works for, um, any concerns for regression, it works for home exercise programs, and, um, just for really follow through-
Tracey Callahan: And I think-
continuity of care ... when, when I'm thinking about language barriers, um, I found it very helpful, if [00:54:00] the language that I'm speaking is not the language that the family maybe speaks at home-
Abigael Yelensky: Mm-hmm ...
Tracey Callahan: um, to show them what we're working on. If I don't have access to an interpreter, um, sh- physically showing them all of the steps, rather than just handing them something that's written or putting it just in the communication log.
I found that video recordings are really helpful when that happens. Um, for example, if somebody is, uh, on a s- specific dysphagia diet, where you have to have things cut, showing them what it looks like, what size that it needs to be, um, rather than saying, "Okay, you're an IDDSI five." Um, that doesn't mean anything.
Hand them the, the sheet with the triangles and the, and the pictures. It might not mean anything. It might be different than the food that they would eat at home. Um, so then, uh, it can be difficult to carry that over. So if you are working at, in home or in school, you can physically video, "This is what it looks like.
This is what the size looks like," [00:55:00] and then, um, it can be easier for families to understand.
Abigael Yelensky: There's often, uh, multiple caregivers involved in one house, right? There's a lot... There's could be night nursing, and so I think that's the other importance is that to make sure everybody's consistent, um, especially when I'm thinking about bed positioning or, like, facilitating transfers, and just really increasing somebody's independence.
And, um, I think that's another really great way to show them, um, this is how they're able to get themselves out of bed if we set up the environment this way.
Tracey Callahan: Um, and then, you know, from the cognitive linguistic perspective, I think that, um, it's can be really difficult for somebody who's had a brain injury to remember that they've been able to do something.
So I had a, a person that I worked with who was having, back to voice activation, such a difficult time speaking and getting their voice going, and then showing them a video that, "Here you are saying yes, you're saying no," um, and they did not remember doing [00:56:00] that. Um, and then seeing it felt really powerful for them.
Um, so don't sleep on video recording. It's- And I say video. Is that even the right word? Like, we're not using tapes
Abigael Yelensky: anymore. Uh, uh, I don't know what we should call it. I think, um, uh, I often will get, uh, s- students, ch- uh, like I said I worked with, I'll often get, um, emails from families showing me somebody using chopsticks, or, "I tied my shoes myself," and we've been working on that.
And I think it's such a great way for, uh, somebody to feel proud of themselves, and so much so that they want it recorded to share with me. And I, um, I... Those videos make me so happy because you know how much it means to that client that they hit a goal and wanted it documented to share with their therapist.
And, like, what an honor it is to- Mm-hmm ... have them wanna, wanna share it in that way, and so I think that's another way.
Kate Grandbois: Um, just for the sake of corroborating the power of video, um, I believe it [00:57:00] was many seasons ago, but at one point on this podcast, we interviewed a neurologist, and if I am not mistaken, she shared how powerful and helpful it was to see video of suspected activity or, or- Mm-hmm
things of concern. And I believe the context was around seizures. Yeah. Um, so it, it is truly a powerful tool- Mm-hmm ... to see it with your eyes. You know, see it for yourself. Here you go. Um, and of course, ju- just being considerate about all of those, you know, consents- Definitely ... and HIPAA-related things. It, it can be a really, really, really helpful tool.
Tracey Callahan: Um, and I know that we, we touched a little bit about, on this earlier, about getting help and getting training, um, is that if, you know, if somebody's out there listening who is gonna be working with somebody who has a brain injury and does not have the background in brain injury, they, they don't have a lot of experience, there's a lot of really great places that people can go and get support.
So a barrier could be [00:58:00] knowledge, and there's a lot of great organizations out there. So the Brain Injury Association of America has a lot of resources out there. Um, if it's an acquired brain injury, um, there is, you know, Aphasia Access out there that has a lot of training for speech therapists. So there's a lot of places to get help if it's, if it's something that you'd like to learn more about, or it's something that you don't feel comfortable treating, and, um, maybe you're a school-based SLP who has just been informed that a child with a brain injury is coming on your caseload, and you're not really sure where to start or what to do.
There's a lot of help out there- Yeah ... um, on the interwebs. Um-
Abigael Yelensky: Yes, General Pediatric Stroke Alliance, they, um, post webinars, um, so that people in other states have access to them. Um, so that's another resource.
Tracey Callahan: And then, um, I don't, I don't do driving. Um, Abby would be able to talk more about that, but one of the things that either my teens or adult patients, um, are really [00:59:00] interested in is driving again.
Uh, it's freedom for a lot of people. It is something that I think maybe we take for granted, being stuck in bumper-to-bumper traffic on the pike. Um, but that's actually what one of my clients said- Mm-hmm ... he just missed listening to, to sports- Yeah ... talk radio while stuck in traffic and everybody's honking.
I can't imagine missing that, but, but this client didn't. He really wanted to be, uh, working on driving again, and it's not obviously within my scope, but we talked through, okay, the, these are the cognitive things that we need to work on. Um, and then communicating, again, back to that interprofessional collaborative practice, communicating with OT and PT that this was a goal that the person had, that they mentioned to me, and I know it's going to take quite a bit of time for them to work towards this goal, um, and to communicate that to them so that they could access some of these resources.
All right, Abby, do you wanna talk a little bit about funding for services?
Abigael Yelensky: Sure. Um, so as we've [01:00:00] already discussed, funding is definitely a barrier. Um, uh, through, um, we always recommend being connected with, um, associations like the Brain Injury Association of America, which can also help. Um, they do a lot of education on where to, uh, find different funding sources.
Um, there's the Waiver program, which, um, provides some, uh, funding for adult services. Um, there's the school districts, um, school-based therapy. Um, there's often, and this is often how I work too, um, when they don't have a certified brain injury, uh, specialist in the school, I've had many school districts that will contract, uh, with somebody that, with that experience.
So that's something that families, you can help families advocate for. Um-
Tracey Callahan: There's SSDI as well. Mm-hmm. So Social Security Disability Insurance as well that can help to cover things. Um- Mm-hmm ... and then, you know, when we talk about insurance, you know, your own personal health insurance, [01:01:00] um, people who have a brain injury, again, who are not driving, how do they get to where- Yes
they need to go for therapy? So, um, one of the things that I know has become more popular, you know, twen- you know, 2020 was, like, six, seven years ago now, but access to virtual therapy, um, through your insurance and working with your own health insurance to find a, a provider who maybe- Mm-hmm ... is in a different state, um- Yeah
but is able to provide that therapy virtually so you can access somebody who has that, um, knowledge in brain injury, has opened doors for a lot of clients.
Abigael Yelensky: There, um, there are times, too, reaching out to an employer if you're planning to return to the same job, um, and are they able to take some of the cost and do some, provide job training?
There are, um, several places of employment that will do that, um-
Tracey Callahan: Um, and then, um, you know, as far as funding goes, and I, I think that there's even, like, a, a Nerdcast! episode about this, you know, as it relates to adaptive [01:02:00] equipment and AAC stuff, and- Mm-hmm ... um, but schools can help bear the cost for some of these things.
So if somebody is really struggling with verbal communication and AAC is being recommended, and they are in a school, you know, sharing that with the school-based SLP and working through that.
Abigael Yelensky: Um, with equipment, I think even just having this network and multidisciplinary approach, there's oftentimes where I can mention we need something, and another family is done with it, and the therapist knows I have somebody that could pass it along.
And so there are times where that's appropriate, too, where there is, um, might not be coverage for it, but there are, um, there are actually durable medical equipment closets and places people can go to get that. And, and having a large team can also help, um, find some of those materials.
Tracey Callahan: And then, um, I know that we're running out of time here, but one of the things that, that I wanna just stress is that, um, you know, practical tip here, [01:03:00] that, you know, some people are gonna prefer written communication.
Some people are gonna prefer video. Some people want email. Some people want text. Um, some people want a phone call. Um, you know, leaning on what the client really wants, um, but what, but figuring out how they want that communication to occur and making sure that communication is occurring with the patient consistently and with other care providers consistently, and that this will help significantly to reduce confusion, um, 'cause they, um, it will be very clear.
Um, and then also taking into account any cultural or language factors when you're considering how communication is gonna be occurring.
Kate Grandbois: This was all incredibly helpful. Um, I, in our last minute, I was wondering You are both certified brain injury specialists, so you obviously, you know what you're doing.
Um, I wonder if you could speak to our [01:04:00] audience members who are new to this field, not necessarily speech pathology, but new to brain injury. You've already listed a wide variety of resources where we can go. We will have all of those resources listed in the show notes. Do you have any recommendations, any additional recommendations for where to get started, um, if, you know, someone is listening to this and has a student that they are realizing, "Oh, I should really kind of sink my teeth into this a little bit more," or maybe it's, they just find it really interesting?
Where can they go? What would you recommend as, like, the best next step?
Abigael Yelensky: I would definitely reach out to the, um, Brain Injury Association of America in your state chapter. I think that they can be a good resource. I think they might even be able to, um, they have a list of everybody that's certified in your state to even just, um, link up to have a mentor.
Uh, I think that's a really great start. I think there's, um, also a lot of, uh, journal articles, so even within, for example, like for OT, um, the Journal of American Occupational Therapy, like it can [01:05:00] specifically go and look, um, for research on treatment with brain injury. So I think starting there, doing sort of some, some research, and then also really just connecting with people in the field.
I think that's I, how I got started too, um, was really having a passion for this area and this, um, trying to learn from people around me. And I think everybody that's passionate about, um, brain injury rehab and neuro rehab, um, are really happy to, um, sort of take another clinician under their wings and really, uh, explain to them why it's so important, this multidisciplinary approach is so important.
Tracey Callahan: And then one thing that I think that the Brain Injury Association does really well, and especially the Massachusetts chapter, is centering brain injury survivors in the education- Mm-hmm ... that they're providing to say, "This is, this was my experience. This is what I, this is what was helpful. This is what wasn't helpful.
This is, um, this is something that I wish that I had known or wish that I had needed." Um, and n- to make sure that we're [01:06:00] centering people and families, um, of brain injury survivors when we're getting education on brain injury, because they have so much to teach us.
Abigael Yelensky: There's, um, an annual, uh, conference that's held, uh, that Tracy and I attend yearly, and, um, and that is where we learn the most, is from, um, people that have experienced brain injury themselves, and, um, and it's a really great way to bring, um, everybody together.
And so even just attend- starting to attend those conferences, I think you get so much knowledge and first-hand experience.
Tracey Callahan: And then for anybody who ha- who's looking for, um, aphasia or for acquired brain injury, there's an organization called the Aphasia Recovery Connection, which is really lovely, um- One thing that we didn't really touch on very much is how isolating the brain injury can be.
So you have this life that you're living, and it changes in an instant, and then you're often very isolated. Um, and it's really important to connect with other people and other [01:07:00] families. Um, a lot of people will crowdsource ideas on what to do, um, through these different organizations. So the Brain Injury Association of America, your local state chapter is one, and then if you're looking more for ABI, um, the Aphasia Recovery Connection is really, um, a great resource for that
Kate Grandbois: Awesome.
Thank you both so much for spending your time with us today. As always, I learned so much. I have no doubt that everyone listening learned a ton too. We really appreciate your time. Thank you so much for being here.
Tracey Callahan: Thank you. Thanks for having us
Outro
Announcer: Thank you so much for joining us in today's episode, as always, you can use this episode for ASHA CEUs. You can also potentially use this episode for other credits, depending on the regulations of your governing body. To determine if this episode will count towards professional development in your area of study.
Please check in with your governing bodies or you can go to our website, www.slpnerdcast.com all of the references and [01:08:00] information listed throughout the course of the episode will be listed in the show notes. And as always, if you have any questions, please email us at [email protected]
thank you so much for joining us and we hope to welcome you back here again soon.
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