March is Brain Injury Awareness Month. Visit the Brain Injury Association of America web site to learn more about how to promote brain injury awareness in your community.

The NIDRR-funded Traumatic Brain Injury Model Systems projects research the spectrum of care from point of injury, through rehabilitation, to integration back into the community. They offer a number of resources, including The TBI National Resource Center, which provides relevant, practical information on TBI to all audiences.

The NIDRR-funded Center for Outcome Measurement in Brain Injury (COMBI) is an "online resource for those needing detailed information and support in regards to outcome measures for brain injuries. The measures included in the COMBI are commonly used in the field of brain injury rehabilitation and assessment. The COMBI is a collaborative project of 16 brain injury facilities or centers."

The Model Systems Knowledge Translation Center web site features TBI consumer information about a variety of topics, including cognitive and emotional problems after TBI, returning to school after TBI, and depression after TBI. According to the site, information about TBI and Vocational Rehabilitation is "coming soon."

Announcements: 

The Transitions RTC, part of the Center for Mental Health Services Research, a Massachusetts Department of Mental Health Research Center of Excellence, and the Community of Practice, Northeast Massachusetts, recently produced two tip sheets. My Mental Health Rights on Campus [PDF] gives college students with mental health conditions information about their rights, resources and rules while pursuing post-secondary education. My Must Have Papers [PDF] lists important papers everyone should have and offers suggestions for organizing them.

The Temple University Collaborative on Community Inclusion has launched a new research study examining the effectiveness of an Internet parenting education and social support program for mothers with a psychiatric disability. Participants will be compensated up to $100 for their participation. For more information, email momsupport@temple.edu or view the study announcement [PDF].

The call for proposals has been announced for OCALION 2012. This national forum on autism, assistive technology, and low-incidence disabilities (including TBI, hearing impairments, and visual impairments) will take place November 14-16, 2012 in Columbus, Ohio. Proposals are due April 30, 2012.

The Arc recently launched a National Council of Self Advocates (NCSA) and is inviting individuals with intellectual and developmental disabilities (I/DD) across the country to join. Its primary purpose is to empower persons with I/DD to voice their opinions about what is important to them and to ensure that they are afforded the same opportunities as everyone else to have a meaningful life in the community.

The Association of Maternal and Child Health Programs (AMCHP) recently released The Affordable Care Act and Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities [PDF]. This issue brief explores elements of the ACA that have implications for children and youth with ASD/DD.

The Exceptional Advocate is an online newsletter for military families with special needs.

On March 9th, the Southeast TACE hosted Career Exploration, Development and Planning for Consumers with SMI --Part 2. Presenters Charles Bernacchio, Ed.D., CRC and Eileen J. Burker, Ph.D., CRC, were joined by consultants Bonnie Schell, Obie Johnson, and Laurie Coker to discuss skill training and development, job seeking and support (preparing for interviews, job clubs, clubhouse models, drop-in centers, peer support, and individual placement services), disclosure and confidentiality, and suggestions and recommendations for VR counselors.

Supplemental resources from the webinar included the Executive Summary of Findings from the Employment Intervention Demonstration Program [PDF], prepared by Judith A. Cook, Ph.D., Principal Investigator at the EIDP Coordinating Center. According to the report, "The Employment Intervention Demonstration Program (EIDP) was designed to generate knowledge about effective approaches for enhancing employment among adults with severe mental illnesses." A few of the major findings include:

• "People with severe mental illness who received well-integrated and coordinated vocational and clinical services had significantly better employment outcomes than those who received non-integrated services."
• "Integrated employment services resulted in positive employment outcomes regardless of consumers' personal characteristics, diagnoses, work histories, receipt of SSA disability income, and functioning levels."
• "The more vocational services people with psychiatric disabilities received, the better the employment outcomes they achieved, especially among those receiving job development services."

The Substance Abuse and Mental Health Services Administration (SAMHSA) 2008 report, Self-Disclosure and Its Impact on Individuals Who Receive Mental Health Services [PDF], was also provided as a webinar resource to help VR Counselors learn how to work with mental health professionals to promote and support consumers when they're ready to make disclosure of their psychiatric condition.

The March 30th webinar, Job Development, Placement & Support Strategies for Consumers w/SMI, also featured Charles Bernacchio and Eileen J. Burker as presenters and Bonnie Schell, Obie Johnson, and Laurie Coker as consultants. This webinar examined effective approaches to use with employers, evidence-based practices to use for consumers with SMI, individualizing jobs, strategies for work supports, research on job modifications and accommodations, and identifying employment opportunities and job creation.

Here are just a few of the key points from the webinar:

• When working with employers, it is important to learn about their needs, as well as the workplace culture and available support.
• Stress positive current activities of the consumer; avoid negative past experiences if possible.
• Avoid the use of medical terms or jargon, which can confuse and potentially scare employers.
• Integrate Supported Employment with mental health treatment (employment specialists coordinate services with other mental health practitioners).
• Competitive employment is the goal.
• Personalized benefits counseling is important.
• Job search starts soon after consumers express an interest in employment.
• Continuous follow-along supports are essential.
• Consumer preferences must be considered.
• The types of job accommodations most frequently identified for use by people with psychiatric disabilities include flexible hours and scheduling; access to a job coach/support on the job; adjusting the training length or learning process to acquire job task skills; and modifying job duties.
• One job creation strategy involves: creating a Job Seeker Profile; convening a brainstorming group; gathering information from employers; creating a list of jobs and tasks; and conducting employer negotiations.

On March 21st, the Helping Your Team Improve Employment Outcomes for Individuals with the Most Significant Disabilities-Traumatic Brain Injury (TBI) Webinar Series kicked off with Strategies to Enhance Successful Closure Outcomes for Individuals with Disabilities with Traumatic Brain Injuries (TBI). This webinar was presented by Dr. Thomas Upton of the Rehabilitation Institute at Southern Illinois University-Carbondale, and Heaven Hollender, Program Director at NeuroRestorative in Chicago, Illinois.

The webinar provided an overview of TBI and standard functional limitations, reviewed one state's outcomes for customers with TBI, described common co-occurring disorders, and suggested a few ways VR Counselors can enhance customer outcomes.

Trauma to the brain results in organic changes in the nervous system, neurons, different parts of the brain, sensory systems, motor systems, and more. Functional limitations may be seen in the areas of mobility, self-care, self-direction, work skills, work tolerance, interpersonal skills, and communication. Limitations and rehabilitation outcomes may be influenced by a myriad of factors, including area and magnitude of injury, pre-injury functioning (including employment history), family support, and more.

The impacts of brain injuries center around three areas: physical, psychological, and psychosocial (personality, emotional, etc.). Some of the psychological/cognitive changes that may impact a person's return to employment include short-term memory issues, persistence (they don't stick with it - they get frustrated and break off, or they persist too much - they perseverate), and attention.

Frontal lobe impairment can impact executive functioning and result in decreased processing speed; poor organization and planning; and impaired problem solving, decision making and judgment.

Co-occurring disorders can present additional challenges for consumers and VR Counselors. People with TBIs may have PTSD, mental health issues (depression, bi-polar disorder, etc.), learning disabilities, intellectual disabilities and/or substance abuse issues. VR Counselors can help consumers choose appropriate treatment programs that follow holistic models (where the co-occurring disorders can be addressed).

Some of the keys to being employed after a brain injury include:

• Were they employed before the injury?
• Structure, structure, and structure put into their lives and into their workplace.
• Have people who are involved in the person's life involved in their recovery.

Customized Employment/Self-Employment/Employment:

Web Sites: