Assessment Intervention and School ReEntry for Children with

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Assessment, Intervention, and School Re-Entry for Children with Acquired Brain Injuries Kerry Hankins, MA,

Assessment, Intervention, and School Re-Entry for Children with Acquired Brain Injuries Kerry Hankins, MA, CCC-SLP Vanderbilt Bill Wilkerson Center Email: Kerry. a. Hankins@vumc. org Dana M. Bryant, M. Ed. , CCC-SLP Vanderbilt Bill Wilkerson Center Email: Dana. Bryant@vumc. org Wendy Ellmo MS CCC-SLP, BCNCDS Brain Links, TN Disability Coalition wendy_e@tndisability. org 1

Financial Disclosure Financial: Ø Salary through Vanderbilt Bill Wilkerson Center Ø TN Disability Coalition,

Financial Disclosure Financial: Ø Salary through Vanderbilt Bill Wilkerson Center Ø TN Disability Coalition, ACL Grant Non-Financial: Ø Talk with Me Tennessee board member Ø Consultant to Healing Heads Foundation 2

Learning Objectives 1) Participants will be able to identify and interpret assessment tools for

Learning Objectives 1) Participants will be able to identify and interpret assessment tools for the pediatric acquired brain injury population 2) Participants will be able to develop functional goals and treatment strategies for the acquired brain injury population 3) Participants will learn to develop appropriate school reentry plans including goals and accommodations in IEPs and 504 plans for the pediatric acquired brain injury population 3

According to ASHA…. “The functional impact of TBI in children can be different than

According to ASHA…. “The functional impact of TBI in children can be different than in adults—deficits may not be immediately apparent because the pediatric brain is still developing. TBI in children is a chronic disease process rather than a one-time event, because symptoms may change and unfold over time (De. Pompei & Tyler, in press; Masel & De. Witt, 2010). ” 4

Key Ideas � Cognitive after a TBI will vary greatly and no two students

Key Ideas � Cognitive after a TBI will vary greatly and no two students will present alike. � Cognitive time. changes are unlikely to disappear fully over � Negative consequences may not be seen immediately, but may present themselves as developmental demands reveal deficits. � An injured brain is less likely to meet the demands of the increasingly complex tasks that children encounter as they grow older Drazinksi (2014) 5

Assessments � Formal Assessment � Informal Assessment � Parent Interview � Behavioral Observation 6

Assessments � Formal Assessment � Informal Assessment � Parent Interview � Behavioral Observation 6

Parent Interview �The patient and family goals �Vision �Hearing �Behavior �School �Baseline Functioning �Malingering

Parent Interview �The patient and family goals �Vision �Hearing �Behavior �School �Baseline Functioning �Malingering �Medical Status- Medications �Physician who is following them after rehab �Psychosocial and Emotional impact on the patient and family 7

� 10 Case Study Example year old previously typically developing male � Traumatic �

� 10 Case Study Example year old previously typically developing male � Traumatic � brain injury due to sledding accident. CT Scan: Left-sided acute skim subdural hematoma, scattered acute subarachnoid hemorrhage � Hearing and Vision – WNL � Continuum of Care: Acute care hospitalization, inpatient rehabilitation, day rehabilitation, then transitioned to outpatient services 6 months post injury. Followed by the PM&R clinic at Vanderbilt � Parent Concerns: Reading, Personality Changes, Attention, Language. � Needs: Caregiver education, direct therapy, transition to the school system, development of the IEP 8

Standardized Tests PTBI � Children 6 -16 years. � Assesses: orientation, receptive language, attention,

Standardized Tests PTBI � Children 6 -16 years. � Assesses: orientation, receptive language, attention, word fluency, vocabulary, verbal expression, immediate and delayed recall, narrative comprehension and recall, visual memory, and organization. Comprehensive Test of Non-verbal Intelligence Ø Children: 6 years-89 years and 11 months Ø The CONTI-2 measures the ability to reason, problem solve, identify logical and abstract relationships, solve mental puzzles, and form meaningful associations. Associated with academic success 9

Standardized Tests Behavior Rating Inventory of Executive Function- 2 nd Edition Ø Children 5

Standardized Tests Behavior Rating Inventory of Executive Function- 2 nd Edition Ø Children 5 -18 years Ø Parent, Teacher, and Self-Report forms Ø Assesses executive function and self-regulation in children and teens Ø Beneficial measure for functional goal formulation 10

Standardized Tests � TOPS � Children 6 -12 years � Assesses: Inferencing, Sequencing, Pragmatics,

Standardized Tests � TOPS � Children 6 -12 years � Assesses: Inferencing, Sequencing, Pragmatics, Predicting, Problem Solving � TOPL � Children: 6 -18 years � Assesses: Self Regulation, Auditory Comprehension, Perspective Taking, Cognitive Flexibility � SEE � Children: 6 -12 years � Assesses: Understanding Facial Expressions, Identifying Common Emotions, Recognizing Emotional Reactions, Understanding Social Gaffes, Understanding Tone of Voice � TAPS � Children: 6 -12 years � Assesses: Auditory Attention, Auditory Memory, Listening Comprehension, Language Processing, Narrative Comprehension, Cognitive Flexibility, Working Memory, 11

Standardized Test Considerations � Environment: � Distractions Quiet vs. Noisy � Fatigue � Behavior

Standardized Test Considerations � Environment: � Distractions Quiet vs. Noisy � Fatigue � Behavior � Motivation � Self-Correction � Impulse Control � Length of time needed to administer assessments 12

Assessment Considerations Cognitive Stall: As young children with TBI develop, behavioral and cognitive problems

Assessment Considerations Cognitive Stall: As young children with TBI develop, behavioral and cognitive problems might continue to emerge Specifically in the preschool population (5 years and younger) may not demonstrate academic or behavioral difficulties until several years following their brain injury. Do not just use 85 -115 score range to assess eligibility for services 13

Referrals for Further Testing � School Psychologist or Learning Specialist ◦ Academic Testing ◦

Referrals for Further Testing � School Psychologist or Learning Specialist ◦ Academic Testing ◦ IQ Testing ◦ May add other tests � Neuropsychological Testing: Gold Standard for TBI Testing ◦ Brain-Behavior Relationships ◦ Academic Testing ◦ IQ Testing ◦ Specific Domains of Cognitive Function ● Attention ● Memory ● Executive Functioning ● Visual-spatial Function ● Information Processing

Case Study- Assessment 16

Case Study- Assessment 16

Casey’s Assessment Language: Oral and Written Language Scales Second Edition: Listening Comprehension Standard Score:

Casey’s Assessment Language: Oral and Written Language Scales Second Edition: Listening Comprehension Standard Score: 80 Percentile Rank: 9 Oral Expression Standard Score: 77 Percentile Rank: 6 Oral Language Composite Standard Score: 77 Percentile Rank: 6 Interpretation: Moderate Observations: • Incorrect responses were marked incorrect- however, to assess therapeutic strategies, many of the testing items were presented again with visual supports, re-wording of stimuli, and extended wait time. When given these modifications, Casey was successful on many items that were initially incorrect. 17

Casey’s Assessment Articulation: Arizona Articulation and Phonology Scale 4 th Edition- Mild dysarthria. 100%

Casey’s Assessment Articulation: Arizona Articulation and Phonology Scale 4 th Edition- Mild dysarthria. 100% intelligible in conversational speech. Noted difficulty with rate of speech and intonation.

Casey’s Assessment Cognition: Pediatric Test of Brain Injury (PTBI). Ability Score Orientation 26 Following

Casey’s Assessment Cognition: Pediatric Test of Brain Injury (PTBI). Ability Score Orientation 26 Following Commands 11 Naming 12. 5 Word Fluency 15 What Goes Together 73 Digit Span 6. 5 Story Retelling- (Immediate) 36. 5 Yes/No/Maybe N/a Picture Recall 32 Story Retelling- (Delayed) 13 Observations: Performance Category Very Low High Low Moderate Low ______ High Very Low Strengths: Spatial Orientation, Visual Memory Weaknesses: Auditory Memory (immediate and delayed), Temporal Orientation, Word fluency, Word Retrieval.

Treatment 20

Treatment 20

6 Approaches to Cognitive Rehabilitation 1. 2. 3. 4. 5. 6. Personalized Education Cognitive

6 Approaches to Cognitive Rehabilitation 1. 2. 3. 4. 5. 6. Personalized Education Cognitive Strategy Training Use of Assistive Technology Direct Training of Cognitive Processes Training Specific Skills Environmental Management Beyond Workbooks: Functional Cognitive Rehab for TBI, Mc. Clennan & Sohlberg, ASHA Webinar 2017

Goal Formulation � Goals ◦ ◦ should Be functional- incorporate assistive technology and use

Goal Formulation � Goals ◦ ◦ should Be functional- incorporate assistive technology and use of strategies Be motivating for pt and family Build on pt strengths Target areas of notable weakness � Examples ◦ ◦ ◦ of cognitive rehabilitation areas Attention Recall Sequencing Problem Solving (inferencing, deductive reasoning, etc) Figurative Language 22

Attention Treatment ▶ Alertness and Arousal ▶ Sustained Attention- Maintain attention over a period

Attention Treatment ▶ Alertness and Arousal ▶ Sustained Attention- Maintain attention over a period of time to complete a task. ● Play with one toy for 2 minutes ● Attend to a book ▶ Selective Attention- Attend to stimuli that is important and be able to disregard stimuli that is not. ● Attend to a book with therapy door open ● Attend to a structured activity when the cabinet door is open ● Attend to homework activity when a sibling is talking 23

Attention Treatment ▶ Alternating Attention- Ability to switch between activities. ● Joint attention during

Attention Treatment ▶ Alternating Attention- Ability to switch between activities. ● Joint attention during play ● Take notes off of a white board in class ▶ Divided Attention- Multitasking ● Studying for a test while listening to music ● Eating a snack and watching television. ▶ ▶ Hemi-Neglect Modality Specific 24

Attention Treatment ▶ Visual Supports ● I need a break ● Eyes in the

Attention Treatment ▶ Visual Supports ● I need a break ● Eyes in the Group ● Brain in the Group ▶ Whole Body Listening ● Michelle Garcia Winner ▶ Have family talk to their MD about possible medical interventions to pair with therapy. 25

Attention Treatment ▶ Classroom Management/Accommodations ● Noise Canceling Headphones during tests ● Preferential Seating

Attention Treatment ▶ Classroom Management/Accommodations ● Noise Canceling Headphones during tests ● Preferential Seating ● Assistive Technology ● ● ● Apps - use with caution Assignment notebooks Graphic Organizers Voice Recorders Timers Visual reminders - sticky notes ● Frequent Brain Breaks ● Movement Breaks 26

Attention Treatment ▶ Meta. Cognitive Strategies ● If the patient has awareness of their

Attention Treatment ▶ Meta. Cognitive Strategies ● If the patient has awareness of their attention deficits, work together to determine situations where their attention is the worst (classroom, study time, etc. ) ● Identify strategies together that work to improve attention ● Example: Attention Monsters and Attention Superheroes 27

Casey’s Goals: Attention Example goal: Casey will independently identify distractions and implement attention strategies

Casey’s Goals: Attention Example goal: Casey will independently identify distractions and implement attention strategies to complete functional and academic tasks in ¾ opportunities.

Memory Treatment ▶ Short Term: Ability to story information in your mind for a

Memory Treatment ▶ Short Term: Ability to story information in your mind for a short duration ● Working Memory: incorporates dynamic aspects of holding onto information and manipulating it ▶ Long Term: Unlimited Memory with no decay ● Episodic: Memory of events ● Semantic: Storage of facts ● Procedural: Acquisition of perceptual motor skills and sequences ▶ Anterograde: Difficulty remembering events occurring after brain injury. New learning ▶ Retrograde: Inability to retrieve information stored prior to brain damage 29

Memory Treatment “In an effort to restore lost memory, some clinicians subject clients to

Memory Treatment “In an effort to restore lost memory, some clinicians subject clients to direct training via memory calisthenics such as digit span, list learning, paper and pencil tasks, and computer software programs. Clients are exposed to novel information, asked to perform manipulations on it, and then recall it on demand. This follows the physical rehabilitation model of exercise, with repetition through drill work to boost strength. Despite the apparent popularity of such tasks, many investigations have proven that this approach is ineffective. Improvements in circumscribed tasks can be achieved, but generalization to unscripted or unstructured activities rarely occurs Avery & Kennedy, 2002). 30

Memory Treatment Contextualized: A common rehabilitation approach is to attempt to use an intact

Memory Treatment Contextualized: A common rehabilitation approach is to attempt to use an intact system to support a deficient one Build your patient’s “meta” skills by building awareness of memory deficits. Allow your student to identify situations where their memory is impacting their school/life performance 31

Errorless learning — minimizing or eliminating errors during the acquisition phase of learning (e.

Errorless learning — minimizing or eliminating errors during the acquisition phase of learning (e. g. , Baddeley & Wilson, 1994) ● Clearly define the instructional target(s) (e. g. , information, multi-step skills, cognitive strategies). ● Ensure the target is relevant and personally meaningful to the client. ● Minimize errors during the acquisition phase (i. e. , errorless learning), particularly for those with more severe impairments. ● Provide high rates of correct practice. ● Provide opportunities to practice over increasingly longer periods of time (i. e. , spaced retrieval). ● Use multiple training examples. https: //www. brainline. org/article/effective-instruction-optimizing-outcomesfollowing-abi 32

Memory Treatment Internal Memory Strategies: ● Verbal Rehearsal ● Visualization ● Sing a Song

Memory Treatment Internal Memory Strategies: ● Verbal Rehearsal ● Visualization ● Sing a Song ● Rhyming ● Associations ● Make a Connection ● Acronyms ● Mnemonics ● Chunking ● Gestures 33

Memory Treatment External Memory Strategies ▶ ▶ ▶ ▶ ▶ Post it notes Calendars

Memory Treatment External Memory Strategies ▶ ▶ ▶ ▶ ▶ Post it notes Calendars Reminders Apps Checklists Daily Planners Class Schedule and school map “Cheat Sheet” for tests Memory log https: //www. brainline. org/article/life-changing-apps-people-brain-injury 34

Casey’s Goals: Memory Example Goal: Casey will independently use an effective memory strategy to

Casey’s Goals: Memory Example Goal: Casey will independently use an effective memory strategy to remember information in classes with 80% accuracy as measured on quizzes and tests.

Executive Functions Definition: set of processes required to manage one’s self or resources (attention,

Executive Functions Definition: set of processes required to manage one’s self or resources (attention, memory, problem solving, sequencing, inferencing, deductive reasoning, etc) Executive function is considered the highest form of human cognition (Helm-Estabrooks, 2000 Examples of daily living tasks that require executive fx skills: Cooking, cleaning, dressing, driving, school and work assignments, etc. Treatment can be: ▶ Restorative ▶ Compensatory ▶ Both: “compensatory strategies can have restorative outcomes 36

Executive Functions ▶ ▶ ▶ Organization Emotional Regulation Impulse Control Goal Setting Planning Self

Executive Functions ▶ ▶ ▶ Organization Emotional Regulation Impulse Control Goal Setting Planning Self Correction Predictions Inferencing Problem Solving Safety Awareness Reasoning Time Management 37

Executive Functions ▶ Activities: ● Functional - must have a meaningful impact ● Patient

Executive Functions ▶ Activities: ● Functional - must have a meaningful impact ● Patient Centered ● Use assistive technologies or external aids whenever possible ● Have student develop goals and monitor their own progress ● Make sure your activities can generalize into home/school environments 38

Casey’s Goals: Executive Functions Ø Ø Ø Task Initiation Sequencing Multi-steps Problem Solving Emotional

Casey’s Goals: Executive Functions Ø Ø Ø Task Initiation Sequencing Multi-steps Problem Solving Emotional Regulation Inhibition Impulsivity Example Goal: Casey will plan, prep, organize, and complete functional and/or academic tasks with minimal prompting and the use of external aides as needed in 4/5 opportunities.

Awareness � Very often impacted by TBI � Different from Denial � m. TBI

Awareness � Very often impacted by TBI � Different from Denial � m. TBI often Hyper-aware � Types ◦ Intellectual ◦ Emergent ◦ Anticipatory

Casey’s Goals: Awareness and Self-Advocacy � Often becomes frustrated or discouraged when unable to

Casey’s Goals: Awareness and Self-Advocacy � Often becomes frustrated or discouraged when unable to complete a task Example Goal: Casey will identify cognitive breakdowns in functional/academic situations and will initiate the use of a visual support/strategy to advocate for his needs when he misses information (more info, slow down and repeat, etc. ) Example Goal: Casey will accurately identify tasks as easy/hard for him in 8/10 opportunities.

Pediatric TBI in the Schools

Pediatric TBI in the Schools

Concussion • Functional vs. structural injury -Chemical Cascade 43

Concussion • Functional vs. structural injury -Chemical Cascade 43

Common Symptoms following Concussion Cognitive/Communication • Feeling dazed or in fog • Word finding

Common Symptoms following Concussion Cognitive/Communication • Feeling dazed or in fog • Word finding problems • Slowed information processing Emotional/Behavioral • • Irritability Quick to anger Decreased motivation Cries easily Physical • Headaches • Changes in vision • Sleep disturbance • Fatigue • Balance/Dizziness • Sensitivity to light/sounds Project BRAIN 2017

Signs and Symptoms

Signs and Symptoms

For Young Children. .

For Young Children. .

Rates of Development for the Four Regions of the Brain 5 Distinct Periods of

Rates of Development for the Four Regions of the Brain 5 Distinct Periods of Maturation % of maturation increments 6 P-O 4 P-O parietal/ occipital C P-O T 2 C F-T 0 1 3 5 7 9 P-O T C C central (limbic & F-T age increments 11 13 15 17 19 21 brainstem) T temporal F-T frontal/ temporal

Tennessee TBI Eligibility Guidelines Definition: Traumatic Brain Injury means an acquired injury to the

Tennessee TBI Eligibility Guidelines Definition: Traumatic Brain Injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one (1) or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.

Returning to School • Begin with fewer hours spent at school • Rest periods

Returning to School • Begin with fewer hours spent at school • Rest periods during the day (quiet place for lunch, study hall in library, etc. ) • Clear expectations • Accommodations for standardized testing (504) https: //cbirt. org/back-school/return-school-plan Project BRAIN 2017

Challenges in the School Setting �Academic & behavior changes may not immediately be linked

Challenges in the School Setting �Academic & behavior changes may not immediately be linked to the injury �Many students with brain injury are not appropriately identified for accommodations �Challenges that result from a TBI can be similar to those of students with other disabilities Project BRAIN 2017

Casey’s Classroom Modifications and Accommodations: � � Extended time Small group or individual test

Casey’s Classroom Modifications and Accommodations: � � Extended time Small group or individual test setting to minimize distractions Frequent breaks during testing Read information aloud (maybe more than once) � Present material slowly, reinforce, repeat � If possible, eliminate timed tests � � Allow longer time to complete work without penalty Modify or shorten workload if needed Assess Casey’s knowledge over shorter rather than longer time periods Choose testing formats that will best assess his knowledge � Incorporate technology � Short, simple instructions � � Check for understanding; repeat and clarify as needed Use a limited number of choices to assess knowledge Pair verbal with visual information (for comprehension) Give semantic or phonemic cues to aid retrieval

Psychosocial 1. Impaired ability to perceive, evaluate, or use social cues or context appropriately

Psychosocial 1. Impaired ability to perceive, evaluate, or use social cues or context appropriately that affect peer or adult relationships; 2. Impaired ability to cope with over-stimulation environments and low frustration tolerance; 3. Mood swings or emotional liability; 4. Impaired ability to establish or maintain self-esteem; 5. Lack of awareness of deficits affecting performance; 6. Difficulties with emotional adjustment to injury (anxiety, depression, anger, withdrawal, egocentricity, or dependence); 7. Impaired ability to demonstrate age-appropriate behavior; 8. Difficulty in relating to others; 9. Impaired self-control (verbal or physical aggression, impulsivity); 10. Inappropriate sexual behavior or disinhibition; 11. Restlessness, limited motivation and initiation; and 12. Intensification of pre-existing maladaptive behaviors or disabilities.

Casey’s Psychosocial Suggestions for School � Look for ways to include him socially. Buddy

Casey’s Psychosocial Suggestions for School � Look for ways to include him socially. Buddy up. Where can he participate? Clubs, manager, etc. � Watch mood over time. � Social skills group? � Educate kids about how to help him. � Educate each next set of teachers.

Physical/Motor Considerations • Fall Precautions • Mobility issues • Fine Motor Impairments • Seizures

Physical/Motor Considerations • Fall Precautions • Mobility issues • Fine Motor Impairments • Seizures Precautions • Dietary • Monitoring by physician with knowledge of brain injury • Medical clearance for returning to sports/activities

Casey’s Physical/Motor Recommendations � Closely monitored when walking and/or participating in physical activities �

Casey’s Physical/Motor Recommendations � Closely monitored when walking and/or participating in physical activities � Decrease demands for writing (decreased speed & coordination) � Extra time for paper and pencil tasks � Use word processing programs � Provide alternatives to handwriting

General Classroom Management Strategies � Structure the classroom environment as much as possible �

General Classroom Management Strategies � Structure the classroom environment as much as possible � Break tasks into component parts � Allow extra time to process information & to respond � Additional classroom adjustments: ◦ Direction instruction techniques ◦ Repetition and practice ◦ Cueing/scaffolding ◦ Modeling ◦ Decreased use of time limits ◦ Provide immediate and direct feedback

Additional Classroom Strategies � Integrate assistive technology: computers/ipads, alarms, recorders, calculators, apps � Agree

Additional Classroom Strategies � Integrate assistive technology: computers/ipads, alarms, recorders, calculators, apps � Agree on prompts, cue cards, gestures � Pace the work � Classroom buddy � Adjust work based on physical ability – headaches, handwriting, speed of processing � Develop organizational systems � Reward on-task behavior & avoid punishing off-task

Behavioral Issues • Help identify triggers -Always look at communication and cognitive demands •

Behavioral Issues • Help identify triggers -Always look at communication and cognitive demands • Practice alternative behaviors/responses • Quickly intervene (may need to do in the moment) • Prevent loss of friends • Prevent labeling • Prevent punishment Brain Links 2018

Brain Links – Brain Injury Specialists � Brain Links is a non-profit program of

Brain Links – Brain Injury Specialists � Brain Links is a non-profit program of the TN Wendy Ellmo Middle TN 908 -458 -7532 Wendy_e@tndisability. org Disability Coalition. � No cost resources � Enriching the lives of Tennesseans with brain injury by training and empowering the people serving them.

Resources � Brain Links � The Arc of Davidson County � Tucker’s House (wheelchair

Resources � Brain Links � The Arc of Davidson County � Tucker’s House (wheelchair ramps, house adaptations, etc. ) � Technology Access Center � Social Workers � CBIRT. org � brainline. org 60

Additional Resources Brainline. org http: //www. brainline. org/content/201 1/06/reap-the-benefits-of-goodconcussionmanagement_pageall. html TN Department of Health

Additional Resources Brainline. org http: //www. brainline. org/content/201 1/06/reap-the-benefits-of-goodconcussionmanagement_pageall. html TN Department of Health http: //www. tn. gov/health/article/tbiconcussion ESPN E 60 –Preston Plevretes https: //www. youtube. com/watch? v=F 4 fo. Y 1 Etm. Ko The Center on Brain Injury Research & Training http: //cbirt. org Centers For Disease Control and Prevention https: //www. cdc. gov/trau maticbraininjury/ CDC Heads Up TBI and Concussion https: //www. cdc. gov/head sup/index. html CDC Heads Up for Schools: Know Your Concussion ABCs https: //www. cdc. gov/head sup/schools/index. html Oregon Center for Applied Science http: //brain 101. orcasinc. c om/1000

References ▶(2011) “Accommodations Guide for Students with Brain Injury” Jeffrey Kreutzer, Ph. D and

References ▶(2011) “Accommodations Guide for Students with Brain Injury” Jeffrey Kreutzer, Ph. D and Nancy Hsu, Ph. D, Department of Physical Medicine and Rehabilitation Virginia Commonwealth University https: //www. brainline. org/article/accommodations-guide-students-brain-injury ▶Intervention for memory disorders after a TBI. Avery & Kennedy (2002). Neurophysiology and Neurogenic Speech and Language Disorders. ▶Project BRAIN: Working Together to Improve Educational Outcomes for Students with TBI. Denslow et al 2012. SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders. Vol 22/ 106 -118. ▶“Got (Treatment) Game? ” Dudley, Nikki (2016) The ASHA Leader. Volume 21, 42 -43. ▶Cognitive Rehabilitation Interventions for Executive Function: Moving from Bench to Bedside in Patients with Traumatic Brain Injury. Cicerone & Malec, 2006. Journal of Cogntive Neuroscience. 18. 17. 1212 -1222. 62