BI-ISIG Moving Ahead - ACRM

G l o b a l M u l t i d i s c i p l i n a r y r e h a b i l i t a t i o n r e s e a r c h

Contents Message from the ChairMessage from the Chair . . . . . . . . .1

Letter from the Editor . . . . . . . . . .2

BI-ISIG General Business Meeting Minutes — May 2012 . . . . . . . . 3 – 7

Join us at the 2012 Sheldon Berrol Memorial Chautauqua! . . . .8

BI-ISIG Task Force (TF) Updates . . .9

2012 Pre-Conference Offerings by BI-ISIG Task Forces . . . . . . . . . .9

Brain Injury Policy Page . . . . . . . . 10

Mid-Year Meeting Memories . . . . 10

BI-ISIG News Briefs . . . . . . . . . . . 11

ronald seel, phd

Vancouver

BI-ISIGBRAIN

INJURY INTERDISCIPLINARY SPECIAL INTEREST GROUP

Don’t miss the largest interdisciplinary rehabilitation research conference in the world — the ACRM Annual Conference: Progress in Rehabilitation ResearchREGISTER: www.ACRM .org

Continued on page 2

Seems like we just finished meeting in Nashville, and our annual conference in Vancouver, Canada, 9-13 October is already upon us. This year’s annual meeting has a number of noteworthy BI-ISIG sponsored events. The Cognitive Rehabilitation and Pediatric/Adolescent Task Forces are leading a two-day and one-day pre-conference educational event, respectively. The Disorders of Consciousness Task Force, in collaboration with the TBI Model Systems DOC Special Interest Group, is leading a half-day pre-conference course on ethical considerations and practice. This year’s Sheldon Berrol Memorial Chautauqua will bring together a wide range of stakeholders from the U.S. and Canada to discuss patient care provision and “When Should Rehabilitation End?”

Thanks to all of you who attended the BI-ISIG Mid-Year Meeting (MYM) in Nashville. The Executive Committee (EC) and task force chairs had a highly productive planning meeting to identify ways in which we can improve your membership value; these meetings will now occur regularly at the annual conference and MYM. We sponsored partial scholarships for five early-career BI-ISIG members to attend the MYM. Based on 2011 BI-ISIG member recommendations, we offered continuing education credits at the MYM. Over 110 persons attended the two-day Cognitive Rehabilitation training seminar.

Thanks also to attendees (over 50%) and non-attendees who completed the post-MYM survey. The most beneficial aspects of the MYM included face-to-face collaboration with task force members (86%), networking opportunities (81%),

opportunity to advance task force projects efficiently (71%), and opportunity to meet

new colleagues (62%). Importantly, 100%

of respondents were pleased with the overall value of attending a task-force meeting. At the annual meeting BI-ISIG Summit, we will present attendee and non-attendee survey data, as well as proposed plans to further improve membership value.

I’m pleased to report that our annual operating budget has expanded from $4,500 two years ago to $19,100 for 2012-13. This level of financial support allows us to continue Early Career scholarships for the 2013 MYM, support speaker travel to our sponsored Chautauqua at the annual meeting, update our brochures, website and social media, and have funding available to support task-force products.

The last two years have come and gone amazingly quickly. As this is my final “Message from the Chair,” I thank the 2010-12 EC for their hard work and friendship. Lance Trexler, PhD, will assume the EC Chair at the end of the Annual BI-ISIG Summit in Vancouver and will do a fantastic job. He has already begun organizing task force chair meetings to assure a smooth transition. Joshua Cantor, PhD, provided excellent input, was an advocate for brain injury issues, and

www.ACRM.org

9–13 OCTObER 2012

Volume 27 Number 2

A biannual publication for members of the BI-ISIG

Moving Ahead

2 BI-ISIG | Brain Injury – Interdisciplinary Special Interest Group / Volume 27 Number 2

kept us well-organized as Secretary. Risa Nakase-Richardson, PhD, worked hard to improve our budget and communication with our virtual office. Donna Langenbahn, PhD put out an updated, high-quality Moving Ahead newsletter and created a media committee to examine other modes of communication. Kristen Dams-O’Connor, PhD as Early Career Officer negotiated with the ACRM Board to extend reduced membership and annual conference registration rates up to five years post-training to attract and retain more early-career professionals.

I also thank two BI-ISIG EC members who have completed their terms. Joe Marcantuono, PhD, served as our Programs/Awards Officer and played a key role in developing the 2011 and 2012 Chautauquas. J. Preston Harley, Past Chair, ends his second 6-year commitment to the BI-ISIG EC and I thank him for providing a historical perspective on BI-ISIG matters, as well as for his lifetime commitment to the BI-ISIG.

Lastly, I thank our unsung heroes of the ACRM virtual office. Jon Lindberg, CAE, Executive Director, has been a big advocate for the BI-ISIG, reflected in his support for our expanded budget. Kay Fitzpatrick, CAE, Director of ACRM Community Relations, Cindy Robinson, Marketing Coordinator, and Signy Roberts, Graphic Designer, have been good listeners, fast learners, hard workers, and creative change agents. They are everything we could ask for in an association staff.

I look forward to seeing everyone in Vancouver.

BI-ISIGBRAIN


As the BI-ISIG heads for Vancouver, we look forward once again to an interna-tional venue with our near northern neighbors. Established in 1867 as “Gastown,” Vancouver is the eighth largest Canadian city; its urban population is 603,000, and over 2.3 million reside in the metropolitan area. As one of Canada’s most ethnically and linguistically diverse cities, 52% of its people do not have English as a first language. The second-largest ethnicity is Chinese (29%), and Vancouver boasts two Chinese-language newspapers. Vancouver is well known for its beauty and temperate climate, and tourism is its second-largest industry. It is also a noted center of film production (known as “Hollywood North”), theatre, music, dance, film festivals, museums, art galleries, media, and a vibrant nightlife scene, with dining, bars, and nightclubs, mainly in the districts of Granville, Gastown, and Davie Vil-

lage. Vancouver has high rankings worldwide as a “liveable city,” although the cost of living is considered high. It has hosted the 1954 British Empire and Commonwealth Games, Expo 86, the World Police and Fire Games in 1989 and 2009, the 2010 Winter Olympics, and 2010 Winter Paralympics.

Thus, we head to Vancouver, anticipating an annual meeting with another tremendous agenda and three pre-confer-ence offerings sponsored by BI-ISIG task forces! We also note the continuing and/or renewed productivity of the BI-ISIG task forces, and look forward to getting together, as possible, to advance the many potentially impactful projects noted in the minutes in this issue. Our membership list has stayed above 400, and we have welcomed many new members, many of them early-career individuals, to our ranks.

My thanks once again to Kay Fitzpatrick, ACRM Missions Director, who is a steady and sure guide in getting the newsletter to production. Thanks also to Signy Roberts, who is responsible for the new “look” of our newsletter. Both of these women have worked hard to help produce the current issue of Moving Ahead amid long lists of other duties.

As always, tell us your feedback, and we hope to see you in Vancouver!

Letter from the Editor

donna langenbahn, phd

Continued from page 1

Tel: +1.317.471.8760 www.ACRM.org

ExEcutivE committEE

ChAiRRonald Seel, PhDShepherd CenterAtlanta, Georgia

Tel: +1.404.367.1240, Fax: +1.404.350.3081

ChAiR ElECtLance Trexler, PhD

Rehabilitation Hospital of IndianaIndianapolis, Indiana

Tel: +1.317.879.8940, Fax: +1.317.872.0914

iMMEdiAtE PAst ChAiRJ. Preston Harley, PhD

Neuropsychology InstituteChicago, Illinois

Tel: +1.630.293.4321, Fax: +1.630.293.4297

tREAsuRERRisa Nakase-Richardson, PhD

James A. Haley Veterans HospitalTampa, Florida

Tel: +1.813.972.2000, Fax: +1.813.903.4814

sECREtARyJoshua Cantor, PhD

Mount Sinai School of MedicineNew York, New York

Tel: +1.212.241.8850, Fax: +1.212.241.0137

PRogRAM/AwARds offiCERJoseph Marcantuono, PhD

Rusk Institute of Rehabilitation MedicineNew York, New York

Tel: +1212.263.6181, Fax: +1.212.263-5***

EARly CAREER offiCERKristin Dams-O’Connor, PhD

Mount Sinai School of MedicineNew York, NY

Tel: +1.212.241.8850, Fax: +1.212.241.0137

EditoR, Moving AhEAdDonna Langenbahn, PhD

Rusk Institute of Rehabilitation MedicineNew York, New York

Tel: +1.212.263.6163, Fax: +1.212. 263.5166

ACRM stAffJon Lindberg, MbA, CAE, ACRM CEO

Email: [email protected]: +1.317. 471.8760, Fax: +1.317.471.8762

Kay Fitzpatrick, CAEEmail: [email protected]

Tel: +1.248.320.2696

donna langenbahn, Phd, Editor

Ron seel, Phd, BI-ISIG Chair

3ACRM | American Congress of Rehabilitation Medicine

Mild TbI Task Force

Girls and Women with AbI Task Force

Friday, 18 May 2012Welcome and AnnouncementsRon Seel, ChairThe Mid-Year Meeting of the Brain Injury Special Interest Group (BI-ISIG) of the American Congress of Rehabilitation Medicine (ACRM) was convened in Nashville, Tennessee on 18 and 19 May 2012 at the Loews Vanderbilt Hotel. BI-ISIG Chair Ron Seel welcomed the meeting attendees and introduced the BI-ISIG. New members were introduced, and Ron explained the mission of the BI-ISIG and the role of members. He then introduced each of the task force chairs and asked him/her to give a brief overview of each task force and its current project(s).

COGNITIVE REHABILITATIONKeith Cicerone & Donna LangenbahnCo-ChairsThe group is now working on its fourth systematic review of cognitive rehabilitation with TBI and stroke to cover the period 2009-2013. An initial review paper covering cognitive rehabilitation research for other neurological conditions has been submitted

to Archives. The task force has been involved with ACRM’s initiative to conduct cognitive rehabilitation training based on the new manual Cognitive Rehabilitation Manual: Translating Evidence-Based Recommendations into Practice which itself stemmed from the task force’s series of systematic reviews. The task force will also continue to work on producing fact sheets based on the reviews.

COMMUNITY-BASED TREATMENT Ann Marie McLaughlinCo-Chair

Ann Marie reported that the task force is currently working on two primary objectives: creation of a compendium of models of care and a systematic review of home and community-based care research. The task force is seeking members with research backgrounds.

DISORDERS OF CONSCIOUSNESSRisa Nakase-RichardsonCo-Chair

Risa reported that the task force has joined forces with other groups to expand its membership by including members of the VA emerging consciousness program and the TBI Model Systems disorders of consciousness (DOC) group. Risa reported that the group has been engaged in several activities, including 1) creation of DOC content at the ACRM annual meeting including a four-hour pre-course on the ethics of treating DOC patients; 2) a presentation in November in Atlanta; 3) an Archives special issue on DOC including research and commentary; and 4)

expansion of the task force’s focus to post-traumatic confusion and syndromes of impaired consciousness.

GIRLS AND WOMEN WITH ABI Yelena Goldin-Lauretta for Chair Angela Colantonio

Yelena reported that the task force is focusing on identification of gaps in research relating to women and girls with TBI and building an international group of researchers and clinicians to address these issues. Findings from the international workshop regarding priority issues for girls’ and women’s health and quality-of-life after TBI were recently published in Brain Injury. Four new members joined the group at the meeting.

BI-ISIG General Business Meeting 18 & 19 May 2012Loews VanderbiLt HoteL — nasHViLLe, tn

2010-2012 BI-ISIG Executive CommitteeRon seel, Phd, Chair Risa nakase-Richardson, Phd, Treasurer

lance trexler, Phd, Chair elect Joshua Cantor, Phd, Secretary

J.Preston harley, Phd, Immediate Past Chair Joseph Marcantuono, Phd, Program/Awards Officer

Kristen dams-o’Connor, Phd, early Career Officer donna langenbahn, Phd, Communications Officer

Jon lindberg, MBA, CAE, ACRM executive Director (ex officio)

Minutes

bI-ISIG General business Meeting


PROGNOSIS AFTER TBI Rose BiesterCo-Chair

Rose reported that the task force has completed the TBI information surveys for survivors and family members to fill out regarding information that they have received since their (or their family member’s) brain injury. The proposal is undergoing IRB review. Potential recruits are being identified for this study.

PEDIATRIC/ADOLESCENT Julie Haarbauer-KrupaCo-Chair

Julie is co-chairing the task force with Joe Marcantuono. They are working on a pediatric conference in 2013 and a journal article.

LONG-TERM ISSUES Rose Biester for Co-Chairs Tom Felicetti & Flora Hammond

Rose reported that a book on long-term issues is in preparation and close to completion. The task force’s Falls Tip Sheet is under review by the ACRM Communication Committee. The task force is discussing adopting the Galveston recommendations on long-term issues. Phil Morse suggested collaborating with the Stroke Networking Group on these issues, where there are common problems and advocacy needs.

MILD TBI Ron Seel for Chair Steve Macciocchi

The group intends to work on developing a new definition of mild TBI in collaboration with other interested groups. They are recruiting experts for the revision. ACRM organizational approval will be needed first. The task force has also identified providing education at conferences as a primary goal. Mark Sherer will talk to Kathy Bell regarding working with the TBIMS Mild TBI SIG. Joe Giacino will be acting as a liaison with the NIH group on mild TBI.

USE OF TECHNOLOGY Murdo Dowds

This is an exploratory group at present. Murdo is investigating creating a new task force to examine use of technology and aids following TBI. He is seeking persons interested in brainstorming a mission for the potential task force.

Secretary’s Report Joshua Cantor, SecretaryThe minutes from the 2011 BI-ISIG Annual Business Meeting were unanimously approved.

Treasurer’s Report Risa Nakase-Richardson, TreasurerRisa presented a proposed budget of $19,140 (Revenue of $8,794 and in-kind contribution from ACRM of $10,346). She reported that the BI-ISIG is exploring new

sources of revenue. Ron reported that 50% of profits from the Cognitive Rehabilitation Manual and training will go to the BI-ISIG. The BI-ISIG has also developed other products and should continue to do so (e.g., the Falls Tip Sheet from the Long-Term Issues Task Force will be disseminated in Archives).

ACRM President’s Report Tamara BushnikACRM PresidentTamara welcomed the membership and expressed ACRM’s strong support for the BI-ISIG, the networking groups, and task forces, as well as the growing role of early career individuals in the BI-ISIG and ACRM. She highlighted the importance of early career representation in the organization (e.g., on the BOG) and of mentoring of early career ACRM members. She reported that ACRM has hired branding and marketing consultants and that information on their recommendations will be passed on in the coming months. ACRM will also be taking the lead in a coalition of 18 rehabilitation organizations, with the goal of producing consistent messages when dealing with policy and legislation issues and addressing rehabilitation-related issues in health care reform. Keith Cicerone stressed the need to emphasize brain injury as a chronic condition. A lucrative contract was signed with Elsevier for Archives. Tamara paid tribute to Judy Reuter’s service to ACRM and stated that Judy will be honored at the Vancouver meeting. The 2013 meeting will be budget conscious and follow a revised model in the hands of Jon and his team — RFPs will

bI-ISIG business Meeting

Teresa Ashman, Rose biester, Murdo Dowds, Ron Seel

Mild TbI Task Force


go out to various cities (with input from IRSG, the BI-ISIG, and the BOG). The organizational model of ACRM will be changing and the BOG will focus more on strategy than managing implementation of decisions — the latter will be handled by Jon.

ACRM CEO Report Jon LindbergACRM CEOJon expressed the organization’s commitment to the BI-ISIG. He reported that the Cognitive Rehabilitation Manual is selling well (around 400 sold to date) and asked that members rate it on amazon.com. He reported that the organization is exploring 2013 conference venues, including New Orleans, Chicago, Las Vegas, and Orlando. He asked that BI-ISIG members suggest venues. ACRM is hoping for 1,000 registrations. The site for the 2013 MYM is to be decided within six to eight weeks. Ron thanked Jon for his commitment and hard work and stated that he will survey the membership regarding preferred venues for the MYM.

Media Committee Report Donna LangenbahnCommunications Officer Donna stated that there is a new look for the latest issue of Moving Ahead (more like the ACRM brand), done in collaboration with the ACRM office, and she invited feedback on it. The BI-ISIG needs to determine how Moving Ahead will be paid for in the future, as ACRM will not fund it after this issue. The Media Committee will focus on how social media can be used (Michael Fraas and Mary Pat Murphy and Sam Backhaus), with the idea that it would primarily be a vehicle for communications with people outside ACRM. Mary Pat Murphy is working on updating the BI-ISIG website with a focus on putting information into the public area (mainly about task forces) and the goal of attracting new members. Ron thanked Donna for all her hard work

Program/Awards ReportJoe MarcantuonoProgram/Awards Officer Joe reported that Gary Ulicny will be spearheading the Chautauqua, which will focus on the topic of when rehabilitation ends. He also requested volunteers to assess posters for the Strauss Award at the annual meeting.

Other BusinessRon paid tribute to Irene Parisi who co-chaired the Mild TBI Task Force and died on 14 April 2012.

Ron stated that he will send out questions about what the BI-ISIG can be doing to give added value for membership. Ron also summarized the recommendations from the Executive Committee lunch with the task force chairs regarding knowledge translation for clinicians

Mark Sherer requested nominations for ACRM fellows as the fellows committee cannot nominate people itself. Ron stated that he will review the BI-ISIG member list to identify potential ACRM fellow candidates. Joe suggested that the BI-ISIG generate nominations for fellows and other ACRM awards list every year.

Ron stressed the need for an annual calendar to meet BI-ISIG deadlines and ACRM deadlines.

Jon Lindberg, Tamara bushnik

Marcel Dijkers, Gale Whiteneck

Kristine Kingsley, Joe Marcantuono, Linda Laatsch

ACRM Staff Jenny Richard, Signy Roberts, Cindy Robinson

bI-ISIG business Meeting


Saturday, 19 May 2012Welcome and AnnouncementsRon Seel, ChairRon called the meeting to order.

Treasurer’s Report Risa Nakase-Richardson, Treasurer Risa reported that a discrepancy between the bylaws of ACRM and the BI-ISIG regarding the status of surplus funds has been resolved to the BI-ISIG’s advantage. The BI-ISIG’s reserve fund is approximately $9,500 and will remain in the BI-ISIG treasury. A $2,500 budget is available for fact sheets. The budget was voted on and approved by the BI-ISIG membership.

Task Force UpdatesRon called on each task force chair to report an update of business accomplishments during their MYM session time.

COGNITIVE REHABILITATIONKeith Cicerone & Donna LangenbahnCo-ChairsKeith reported that the task force will focus on its fourth systematic review with a revised approach by simultaneously using the traditional criteria and new criteria that will allow AAN scoring when needed. The task force will seek endorsement from the Clinical Practice Committee of the review as a practice parameter. There will be continuing review of other medical diagnoses (cancer, critical illness, etc.) under Donna’s leadership. The focus on knowledge translation and use of fact sheets and other materials (for consumers instead of professionals) will

continue. The task force will also continue its efforts to promote and update the Cognitive Rehabilitation Manual and to train trainers, etc. The training group, under Lance Trexler’s guidance, will focus on this endeavor. Creating educational seminars was also discussed (e.g., in using team approaches to cognitive rehabilitation and training clinicians to do single subject designs).

DISORDERS OF CONSCIOUSNESSRisa Nakase-RichardsonCo-ChairRisa reported that five new members joined the DOC task force at this meeting. The task force set the following objectives focusing on rehabilitation opportunities and advocacy for DOC patients: 1) Conduct an updated review of outcomes research for DOC within one year; 2) Create a letter advocating for rehabilitation opportunities for patients with DOC to be used with insurance companies (to be updated every three years) with plans to make it available through the ACRM website; 3) Seek funds for piloting cost-effectiveness research; 4) Develop guidelines for minimal requirements for DOC rehabilitation; 5) Create a paper and a conference submission to examine chronic issues, incorporating the concept of post-traumatic confusion.

Keith Cicerone asked if materials for consumers regarding rehabilitation of DOC are being considered to help them be educated consumers and not be taken advantage of. Phil Morse raised the issue of whether there are enough institutions available to care for this population.

USE OF TECHNOLOGY Murdo DowdsTwo new people expressed interest in joining this group. There was some discussion during their MYM session, but no established direction. Ron stressed the need to decide on a project and seek out needed expertise.

MILD TBI Ron Seel for Chair Steve MacciocchiRon reported that the group had a good turnout. Topics to be addressed in a mild

TBI (mTBI) review paper were discussed, as was the assessment and definition of mTBI. Topics were identified for different areas of mTBI (e.g., sports concussion). Rose Biester is acting as secretary for the group. Ron will examine systematic reviews and definitional efforts currently under way to make sure the task force is not duplicating others’ efforts. An interactive forum is to be set up online to share information.

COMMUNITY-BASED TREATMENT In writing from Ann Marie McLaughlin, Co-ChairA detailed review of a draft survey of community-based treatment providers has been completed. This survey focuses on assessing the state of the art of community-based rehabilitation for brain injury, models of care, and unmet needs. A finalized survey will be disseminated in the next few months. Issues related to IRB, data analysis, and dissemination are being discussed. The group will have monthly conference calls to move the project forward.

AT Task Force exploratory meeting

General business Meeting

Keith Cicerone and Donna Langenbahn


Ann Marie McLaughlin

PEDIATRIC/ADOLESCENT Joe MarcantuonoCo-ChairTwo people who participated in the 2011 ACRM workshop attended their meeting, and some people were involved by phone. A pediatric pre-conference for Vancouver is being planned with four to five speakers focusing on intervention effectiveness to sustain momentum from the 2011 pediatric meeting. ACRM will support funding speakers. Marcel Dijkers stated that five pre-courses are already being conducted that were vetted, and this intention will sap attendance from other pre-courses. It was agreed that this concern needed to be addressed with the BOG and program committee. The task force will focus on recruiting and retaining members and on a 2013 pre- or post- conference workshop. The task force wants ACRM to be the premier research base for pediatrics (translational research in particular, as this is a needed and in-demand area). There is strong competition, however. They will undertake a new systematic review of pediatrics cognitive and behavioral intervention research in ABI. Ron suggested checking the literature for recent systematic reviews. The task force is focusing on creating a larger-scale networking group on pediatric rehabilitation. There is a need for, and interest in, training and knowledge translation efforts for pediatric clinicians outside of ACRM in rehabilitation centers that the task force should endeavor to meet.

LONG-TERM ISSUES David Krych for Co-Chairs Tom Felicetti & Flora HammondThe Falls Tip Sheet is back with the ACRM Communication Committee to be approved for inclusion as a tear-sheet in Archives. There will be vote on it. There has been no progress on other fact sheets. The long-term vision of the task force is to promote understanding of TBI as a chronic condition and application of chronic disease management approaches and models. A “road map” based on this year’s Galveston conference will be coming out in November in Brain Injury Professional.

The task force is exploring contacts who can support these efforts.

PROGNOSIS AFTER TBI Dave KrychCo-ChairNew members have joined. There was discussion of a survey of information received by consumers and families and inclusion/exclusion criteria. After IRB approval it will be sent to the products committee. It is anticipated that dissemination will take place via state organizations. The task force is exploring pathways for this. The task force is also considering ways to create a user-friendly article with positive impact (e.g., regarding frequency of information provided to consumers and modalities of provision).

GIRLS AND WOMEN WITH ABI Yelena Goldin-Lauretta for Chair Angela ColantonioYelena reported that four new members have joined the task force. Men were encouraged to join too. The group will continue to focus on identification of disparities in treatment, policy, and research on women and girls with ABI. Literature reviews are currently being conducted. The group will also re-analyze existing datasets to focus on women’s and girls’ issues. Focus groups are being conducted with women with brain injury in Canada. The task force is interested in multiple topics, including homelessness, domestic violence, sports, long-term care, and aging. They are looking at ways to obtain funding for a literature review and to build a network to support participation of researchers, clinicians, and survivors. Knowledge translation is also a focus. Workshops were conducted at conferences in Canada and in Edinburgh, and

were well-attended. An ACRM symposium is to be conducted in 2012. The Canadian members are focusing on policy impact and meeting with ministers and policy makers (e.g., regarding homelessness). The group is interested in expanding its membership.

Other BusinessRon announced that the membership will be surveyed on Mid-Year Meeting venues and areas for improvement in the months ahead.

AdjournmentIt was moved and seconded that the meeting be adjourned.

Respectfully submitted, Joshua Cantor, PhD Secretary BI-ISIG

bI-ISIG Early Career Scholarship Award WinnersZachary Bayer, Kacey Little Maestas, Yelena Goldin-Lauretta, and Angela Yi

Ralph Marino, Joe Giacino


Join us at the 2012 Sheldon Berrol Memorial Chautauqua!

“When Does Treatment End, and How Do We Decide?”

The Chautauqua has always been a venue in which to address timely and sometimes controversial issues. Indeed, Dr. Shelly Berrol, the honoree of this annual BI-ISIG sponsored event, did not shrink from the big questions in brain injury assessment, treatment, and advocacy, acting always with the foresight and integrity that won him respect and acclaim. One of Shelly’s passions was ethical practices in rehabilitation, and when John Banja and Larry Cervelli launched the inaugural Chautauqua in his name in 1994, they set the precedent for these annual sessions to explore values, ethics, and humanism in brain injury rehabilitation.

Given the current climate of healthcare reform, as well as the ongoing perceived conflict between those who advocate for brain injury treatment and those whose role is to manage treatment allocation under concerns of cost effectiveness, the topic of the 2012 Chautauqua, “When Does Treatment End, and How Do We Decide?” is a fitting Chautauqua topic and should generate great discussion. With the broad range of stakeholders in the decisions made about rehabilitation, the Chautauqua session will include a panel of individuals who represent different constituencies related to the topic, but who are not always in attendance at, or even members of, ACRM and the BI-ISIG.

With Gary R. Ulicny, PhD, FACRM as moderator, this year’s Chautauqua will examine the personal, professional, and health system rationales behind decisions to continue or stop brain-injury treatment. Dr. Ulicny, who was ACRM President 2010 – 2011, has served as the President and CEO of Shepherd Center, Atlanta, GA, since 1994. During his tenure at Shepherd, he has overseen a major expansion of the hospital, the addition of an acquired brain injury treatment program and comprehensive pain institute, expanded research, national marketing of the hospital, and increased overall capacity from 100 to 152 beds.

The following comprise the 2012 Chautauqua panel of participants:

• Charles Wheeler, III, a brain-injury survivor, is currently completing his PhD in Rehabilitation Counseling;

• Ryan Tisinger, a family member of a brain-injury survivor, is also a community and web-based advocate for obtaining appropriate services for people with brain injuries;

• Mark Bayley, MD, FRCPC, Medical Director of Toronto Rehabilitation Institute’s Neuro-Rehabilitation Program, and researcher in brain recovery and rehabilitation best practice, has sought to identify the most effective rehabilitation approaches and to advocate for their adoption as standards of care;

• Adam Seidner, MD, MPH, Medical Director of the Workers Compensation Division of Travelers Insurance, has presented widely on topics surrounding cost effectiveness and decision making in rehabilitation treatment;

• Leslie Small, MS, currently Vice-President of Clinical Operations for Paradigm’s Catastrophic Care Division, and previously at Learning Services, has been involved extensively in developing and implementing new programs and facilities focused on providing post-acute healthcare delivery in a cost-effective environment.

In addition to hearing the perspectives of these panel members, each attendee will have an opportunity to participate in the discussion. A chair will be placed in the audience with a microphone so that any attendee can simply take a seat in the chair and provide a point of view. As moderator, and because of his familiarity with the membership, Dr. Ulicny may take occasion to invite comments from attendees who he knows to be knowledgeable in areas being discussed.

Both Dr. Ulicny and the BI-ISIG sponsors believe that this Chautauqua will prove interesting, enlightening, and provocative, as he, the panel, and the audience explore topics and issues that range from the ethical to the financial to the logistical, all related to the continuation or cessation of rehabilitation treatment for people with brain injury.

Moderator: Gary R. Ulicny, PhD, FACRM

Gary R. Ulicny, PhD, FACRM and Joseph T. Marcantuono, PhDBI-ISIG Program/Awards Officer

GARY R. ULICNY, PhD, FACRM

To be presented at the 2012 ACRM-ASNR Annual Conference: Progress in Rehabilitation Research

The 2012 Sheldon Berrol Memorial Chautauqua will take place

Thursday, 11 October 2012 from 1:30 – 3:00pm


BI-ISIG Task Force (TF) Updates

2012 Pre-Conference Offerings by BI-ISIG Task ForcesThree of the BI-ISIG Task Forces are involved in offering diverse and unique interdisciplinary training/networking opportunities prior to the 2012 ACRM-ASNR Annual Conference.

COGNITIVE REHABILITATION TASk FORCE: “COGNITIVE REHABILITATION MANUAL TRAINING”

Tuesday, 9 October 8:00 am – 5:00 pm andWednesday, 10 October 8:00 am – 5:00 pm

This pre-conference workshop once again offers unique training for rehabilitation professionals on use of the Cognitive Rehabilitation Manual: Translating Evidence-Based Recommendations into Practice. Led by lance e. trexler, phd and featuring Dr. Trexler and the other editors of the Manual, this two-day course has a format expanded from that presented in Nashville, with the inclusion of specific case examples and targeted presenter/audience discussions. As previously noted, the emphasis is on training in evidence-based procedures featured in the Manual and stemming from the cognitive rehabilitation task Force’s three reviews of the effectiveness of cognitive rehabilitation.

PEDIATRICS/ADOLESCENT TASk FORCE: NETWORkING GROUP MEETING: “EFFECTIVE INTERVENTIONS FOR CHILDREN AND YOUTH”Tuesday, 9 October; 8:00 am – 5:00 pm

Led by pediatrics/adolescent task Force Chair Juliet haarbauer-Krupa, this networking opportunity will provide a forum for interdisciplinary input across broad topics of pediatric rehabilitation, including, but not limited to, brain-injury issues. Concerns regarding clinical assessment and treatment, research, clinical training, and patient advocacy will all be addressed. Attendance at this meeting is included in the conference registration fee.

DISORDERS OF CONSCIOUSNESS TASk FORCE: “MANAGEMENT CONUNDRUMS AMONG PATIENTS WITH SEVERE TBI: ETHICAL CONSIDERATIONS AND PRACTICE”Wednesday, 10 October; 8:00 am – 12:00 pm

Sponsored by the bi-isiG disorders of consciousness task Force, this course brings together experts in the assessment and management of persons with severe TBI and associated disorders of consciousness from across the nation. Experienced clinician-

researchers will present examples of common ethical challenges in the acute and long-term management of individuals with severe TBI faced by clinicians and researchers, highlighting also the sensitive issues that must be confronted when family members lack an accurate understanding of the patient’s prognosis. Cases will illustrate both management and ethical challenges facing clinicians and researchers along with shared practices for resolution. Presentations will be followed by a discussion among the panel on topics of ethics, rehabilitation medicine, and psychological impact. The distinguished faculty of this course include: Joseph Fins, MD, Weill Cornell Medical College, New York, NY; risa nakase-richardson, phd, Catherine Wilson, PsyD, Marissa McCarthy, MD, James A. Haley Veterans Hospital/ University of South Florida, Tampa, FL; Joseph t. Giacino, phd, Harvard Medical School, Boston, MA; doug Katz, Md, Boston University/Braintree Rehabilitation Hospital, Boston, MA; John Whyte, Md, phd, Moss Rehabilitation Research Institute, Elkins Park, PA; Stuart A. Yablon, MD, Baylor Institute for Rehabilitation, Dallas, TX; and brian Greenwald, Md, Mount Sinai School of Medicine, New York, NY.

Successful First Cognitive Rehabilitation Manual Training Workshop At Nashville Mid-Year MeetingMore than 100 participants attended the two-day inaugural Cognitive Rehabilitation Training workshop 20 and 21 May 2012, following the Nashville ACRM/BI-ISIG Mid-Year Meeting. Sponsored by the Cognitive Rehabilitation Task Force and ACRM, the workshop was under the leadership of lance trexler, phd, with faculty comprising the editors of the Cognitive Rehabilitation Manual: Translating Evidence-Based Recommendations into Practice. The first day of training included section presentations on the cognitive rehabilitation of disorders of attention, memory, executive function, social communication, and visuo-

spatial skills, with presenters dr. trexler, amy shapiro-rosenbaum, phd, edmund haskins, phd, Kristen dams-o’connor, phd, rebecca eberle, ccc-slp, and donna langenbahn, phd. The second day featured “master class” presentations by Keith cicerone, phd and Wayne Gordon, phd on cognitive rehabilitation case examples and clinical/research/policy issues. Overall feedback from participants was positive, with 82 percent noting that they would recommend the training to a colleague.

Lance Trexler and Donna Langenbahn presenting at the Cognitive Rehabilitation Manual Training

Cognitive Rehabilitation Training attendees >


State Legislatures Active in TBI LawsBetween 2009 and 2011, at least 34 states passed laws to address TBI, with at least 14 states introducing some type of TBI legislation in 2012. The majority had to do with youth sports-related concussions; currently only Arkansas and Montana do not have this type of TBI legislation either introduced or enacted. Other legislation addressed TBI in veterans, appropriated funds to traumatic brain injury prevention or treatment programs, and would require insurers, hospitals and health maintenance organizations to provide insurance coverage for survivors of TBI. For a full list of enacted state TBI legislation between 2009 and 2012, see: http://www.ncsl.org/issues-research/health/traumatic-brain-injury-legislation.aspx.

TBI Act Reauthorization 2012The Traumatic Brain Injury (TBI) Act, H.R. 4238 was introduced by Representative Bill Pascrell, Jr. (D-NJ) and Representative Todd Russell Platts (R-PA) on 21 March 2012. As noted in our last issue this act supports US states and territories in improving access to service delivery and expanding advocacy services to individuals with TBI. It also supports funding to the Centers for Disease Control and Prevention (CDC) for studies on TBI education, prevention, incidence, and prevalence, provides for the funding and distribution of state grants, supports state advisory boards to coordinate services and administer funds, and directs the Secretary of Health and Human Services to establish and carry out a national plan regarding TBI activities in coordination with federal, state, and local agencies. For status and summary of this bill go to: http://www.govtrack.us/congress/bills/112/hr4238. We urge you to ask your member to co-sponsor the TBI Act, H.R. 4238 and also to serve on the Congressional Brain Injury Task Force.

AHRQ Funding Eliminated in House Subcommittee VoteA House appropriations subcommittee voted 18 July 2012 to support a controversial bill that would cut $1.3 billion from the Department of Health and Human Services (HHS), while also eliminating all funding for the Agency for Healthcare Research and Quality (AHRQ), which has produced important research on TBI. Cleared by an eight-to-six vote, the Labor, Health and Human Services (LHHS) bill would effectively prohibit any federal funding of patient-centered outcomes research conducted by AHRQ. The bill states that the agency would be “terminated” effective 1 October 2012. It would rescind all funds that haven’t been spent yet, and would “transfer” activities that fall under the agency. Other provisions of the bill include withdrawing funding from the prevention fund incorporated in the Patient Protection and Affordable Care Act. Discretionary funding in the amount of $150 billion is included within the cleared bill, $6.4 billion below last year’s amount. Proponents of the drafted bill say the included cuts target unnecessary, ineffective or lower-priority programs.

ACRM Health Policy Networking Group CreatedAt the 2012 MYM, ACRM sponsored a Rehabilitation Summit, attended by represen-tatives from over 22 rehabilitation organizations. The purpose of the Summit was to begin to open dialogue among rehabilitation organizations, to initiate consensus positions on rehabilitation topics affected by the Affordable Care Act, and to effect rehabilitation-related policy at the local and national level. ACRM’s status as the only interdisciplinary rehabilitation organization makes it an ideal central body to organize this initiative unrestricted by the interests of any one faction of rehabilitation. The Summit’s success led to the development of an ACRM Health Policy Networking Group, which is primarily focused on funding and issues related to rehabilitation research, and will continue to work with the Rehabilitation Summit. BI-ISIG members interested in the Health Policy Networking Group are invited to join to explore avenues for effecting change in brain-injury related policy. Please contact Gary R. Ulicny, PhD for information: [email protected].

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BI-ISIG News Briefs

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News Briefs items are solicited by email from BI-ISIG members and consist of publications, projects, and professional acknowledgments in brain-injury related areas. Responses represent only a sample of BI-ISIG members’ many professional accomplishments, and their listing here is intended to inform other members about ongoing research and other projects for the goal of promoting communication and collaboration.

Publications and ProjectsKeith D. Cicerone, PhD, Director of Neuropsychology, JFK-Johnson Rehabilitation Institute, Edison, NJ, reports publication with colleagues of an article in JHTR (first-author colleague Joanne Azulay is a BI-ISIG member) on the effectiveness of mindfulness training in reducing cognitive and emotional symptoms after mild TBI.

Allen W. heinemann, PhD, Director, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, notes a paper in Archives of PM & R on the use of neighborhood characteristics in the prediction of psychosocial outcomes following TBI. He was joined in the publication by several colleagues, including BI-ISIG members John Corrigan, Jenny Bogner, Marcel Dijkers, Cindy harrison-Felix, and Gale Whiteneck.

Douglas Katz, MD, Medical Director Brain Injury Programs, Braintree Rehabilitation hospital, Braintree, MA, notes an RCT appearing in New England Journal of Medicine examining amantadine effectiveness after severe TBI, which included several BI-ISIG colleagues: Joe Giacino, Flora hammond, Kathy Kalmar, Doug Katz, Mark Sherer, and John Whyte. He also has two articles in press with colleagues: one on treatment of metaphor interpretation deficits following TBI in JHTR (including BI-ISIG member Kristin Lundgren), and another on the contribution of fractional anisotropy in predicting memory rehabilitation outcome after TBI in Neurorehabilitation (including BI-ISIG members Theresa O’Neil-Pirozzi and Mel Glenn).

James Malec, PhD, Director of Research, Rehabilitation hospital of Indiana, Indianapolis, IN, reports articles in Epidemiology, Brain Injury, JHTR, & Election Law Journal, and he and colleagues Flora hammond and Jacob Kean have published on TBI themes such as incidence, voting competence, and pre-surgical mapping of language and memory. They have newly funded grants in telehealth with mild TBI, and neurobiological mechanisms of affect recognition deficits. They have participated with BI-ISIG colleagues (Joe Giacino, Brian Greenwald, Kathy Kalmar, Doug Katz, Risa Nikase-Richardson, Ron Seel, Mark Sherer, and John Whyte) and others in exploring amantadine in recovery from vegetative and minimally conscious states; with BI-ISIG colleagues (Juan Arango-Lasprilla, Jeff Kreutzer, and Janet Powell) and others in studying relationships between race/ethnicity and symptoms after TBI; and with BI-ISIG colleagues (Risa Nakase-Richardson, Angelle Sander, and Mark Sherer) and others in examining caregiver/family functioning and participation outcomes in TBI.

Michael F. Martelli, PhD, NeuroLife Rehabilitation Neuropsychology, Richmond, VA, and Nathan D. Zasler, MD, CEO & Medical Director, Tree of Life and Concussion Care Center, Richmond, VA, report publications (along with colleagues) in Neurorehabilitation on community-based rehabilitation and sodium amytal use in neuro-rehabilitation, and a three-part publication on post-traumatic headache in Chinese Journal Of Rehabilitation Medicine. They also have several chapters on medical and legal issues surrounding TBI in an upcoming volume on Brain Injury Medicine (Eds: Zasler, Katz, & Zafonte), as well as in the upcoming “Handbook of Neurology” (Barnes & Good).

Farooq Rathore, MD, Combined Military hospital, Lahore Cantt, PB, Pakistan, notes several publications with colleagues in overviewing rehabilitation medicine in Pakistan, in the Pakistani Armed Forces, and in the aftermath of natural disasters. Farooq is a member of the Organizing Committee and chair of the Abstract Evaluation Committee for the 2nd International Rehabilitation Forum World Conference to take place in December, 2012 in Dhaka, Bangladesh.

Gerard M Ribbers, MD, PhD, Associate Professor, Rotterdam Neurorehabilitation Research, Rijndam Rehabilitation Centre & Erasmus MC, Rotterdam, Netherlands, and colleagues have published several articles in Archives of PM & R: a study of employment outcome three years after moderate to severe TBI, a study of upper-limb use in patients with chronic stroke, and studies of aphasia treatment, including use of melodic intonation therapy. Gerard and colleagues have several publications in press on metamemory training in stroke patients, mirror therapy for the hemiparetic arm, and a case report on akathesia in a TBI patient.

Mohamed Sakel, FRCP, Director/Consultant Neurorehabilitation, hon Senior Research Fellow, Engineering, University of Kent, Kent, UK, notes several publications from his group, including articles on the assessment and impact of limb spasticity (one in Archives of PM & R ). His laboratory is also involved in projects on human motion analysis, qualitative study of botulinum toxin therapy in spasticity, vestibular stimulation in the treatment of hemi-spatial neglect and low-awareness state, development of an “intelligent” wheelchair, the role of AT in assisting facial gesture recognition, and cost efficiency in neurorehabilitation.

Marcia J. Scherer, PhD, President, Institute for Matching Person & Technology, Webster, NY, has an article on matching technology for older adults with dementia in Ageing International. She also recently authored/co-authored a handbook of AT assessment, and a text on AT for individuals with ABI.

Joel Scholten, MD, Special Projects Director, PM&R Program Office, VACO, ACOS Rehab Services, Washington DC VA Medical Center, Washington, DC, reports a recent publication in Brain Injury with VA colleagues assessing the VA system of comprehensive evaluation for TBI in OEF/OIF veterans.

Laney Tate, PhD, Administrative Director, Pate Rehabilitation, Dallas, TX, reports an article on the factors associated with response to post-acute rehabilitation following severe TBI and another on the comparison of treatment effect versus natural recovery in persons with TBI. She also notes that Pate researchers are working on various projects utilizing fNIRS as an outcome measurement.

AcknowledgementsKeith Cicerone, PhD, Director of Neuropsychology, JFK-Johnson Rehabilitation Institute, Edison, NJ, received the 2012 Robert L. Moody Prize for Distinguished Initiatives in Brain Injury Research and Rehabilitation. Keith has also won the 2012 ACRM Elizabeth and Stanley Licht Award for scientific writing for the 2011 EBR of the effectiveness of cognitive rehabilitation for individuals with TBI and stroke. This paper was a product of the Cognitive Rehabilitation TF, and all authors are BI-ISIG members.

Allen W. heinemann, PhD, Director, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, received the Knowledge Translation Activity Award for the Rehabilitation Measures Database from the National Association of Rehabilitation Research and Training Centers.

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Rose biester, Preston Harley, Dave Krych, Marita de Leon

Risa Nakase-Richardson, Preston Harley, Joseph Giacino

Yelena bogdanova, Marcel Dijkers, Yelena Goldin-Lauretta, Gerry Voelbel

Lance Trexler, Linda Laatsch

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Farooq Rathore, MD, Combined Military hospital, Lahore Cantt, PB, Pakistan, was recipient of the Michael Moles Fellowship for 2011-2013, awarded by the World Association for Disaster and Emergency Medicine, as well as the Research Productivity Award for 2011 from the Pakistan Council for Science and Technology.

Marcia J. Scherer, PhD, MPh, President Institute for Matching Person & Technology, Webster, NY, was keynote speaker at the University of Haifa, Israel, and in Bologna, Italy, speaking on the Matching Person & Technology Model in assessment and intervention.

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Kristen Demertzis, Steve Macciocchi, Angela Yi

BI-ISIG | Brain Injury – Interdisciplinary Special Interest Group / Volume 27 Number 2

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