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Work and Traumatic Brain Injury

It is with great pleasure that the Project Career team members are the guest co-editors of this special issue of WORK which is focused on work and traumatic brain injury (TBI). The issue contains 10 articles some of which are authored by the Project Career team members. As with all mansucripts, these Project Career manuscirpts have gone through a rigorous double-blind peer review process. It is our hope that this special issue will bring increased attention to the importance of research, funding, advocacy and care to persons with a TBI and their families/caregivers.

We endeavor to help you better understand the impact of a TBI by introducing two case studies: John and Sandra.

John is a 34-year-old white male who acquired a TBI in 2009 while serving in the Marine Corps in Afghanistan. He is also diagnosed with Post-Traumatic Stress Disorder (PTSD) and regular suicidal ideations. After spending time in the Wounded Warrior Battalion, he was medically discharged from the Marine Corps in 2011.

Sandra, a 22-year-old white female, was celebrating and cheering on runners when she acquired her traumatic brain injury (TBI) in the Boston terrorist attack bombings. She was only feet away from the second bomb and was knocked unconscious from the explosion. Sandra was an undergraduate student at a local college.

What do John and Sandra have in common? They are among the approximately 1.7 million Americans who sustain a TBI annually [1]. Responding to this serious public health concern in the United States, in 2013, an interdisciplinary group l came together under the leadership of Kent State University’s College of Education, Health and Human Services Center for Disability Studies, to apply for a National Institute for Disability, Independent Living, Rehabilitation and Research (NIDILRR), US Department of Education grant. The five-year grant (2013–2018) was funded and ‘Project Career: Development of an Interprofessional Demonstration to Support the Transition of Students with Traumatic Brain Injuries for Postsecondary Education to Employment’ wasstarted.

Project Career is managed by Kent State University in collaboration with Boston University, JBS International, Inc., and West Virginia University. The goal of the Project Career demonstration project is to develop, implement, and demonstrate a technology-driven, long-term, and resource-rich individualized support program. It merges the use of cognitive support technology (CST) and vocational rehabilitation (VR) practices to improve the career readiness and long-term employment outcomes of civilian and veteran post-secondary students with TBI [2]. The Project attains this goal through the (1) psychometric evaluation of postsecondary students with TBI relative to their assistive technology, personal, academic, and career objectives and needs; (2) provision of CST training to 150 students over the 5-year demonstration; (3) matching students with mentors; (4) provision of vocational case management; (5) provision of job development and placement assistance; and (6) provision of an electronic portal regarding accommodation and career resources.

Project Career accomplishes these objectives through each of the three university’s Technology and Employment Coordinators (TECs) who counsel and support students with TBI in meeting academic and career objectives. The TECs address cognitive challenges using the ‘Matching Person with Technology’ assessment process to accommodate CST use (iPad and selected applications (apps)). JBS International provides the project’s evaluation.

Reconsider the the earlier identified two case studies. John was referred to Project Career by one of his professors. He has worked with his TEC for three years. During his initial TEC meetings, he completed the intake, Matching Persons and Technology assessments, and baseline assessments. Based on information gathered from these assessments and the personal interview, it was determined that his major challenges included: cognitive deficits, time management, isolation, note taking and being behind in class assignments. Between John’s first and second TEC meeting, he experienced a period of depression related to his TBI event. John reported feeling that he was always going to be behind and never able to catch up on work or with his peers. He regularly missed classes and assignments. John is currently a junior and pursuing a multi-disciplinary studies degree. During the last three years John continued to deal with bouts of depression and academic challenges. He addressed his depression by continuously striving to complete his degree and at almost every meeting with his TEC stated that he could not do it without the support of the TEC and the help of the iPad and apps. Through the apps he has learned time management and has figured out how to add social activities to his schedule. He no longer lists loneliness as a challenge. He has also learned note taking techniques which have helped him succeed in the classroom. He now reaizes that he will experience lifelong challenges because of the TBI and is adjusting his expectations accordingly. John has been active in supporting the Veterans in his community and works on several committees dedicated to Veterans. He ultimately would like to open a counseling center for Veterans with PTSD.

Sandra was referred to Project Career by an athletic trainer in February of 2014. Her goals at that time were to successfully complete her degree in special education, attend graduate school, and obtain a teaching position in special education after graduation. During the intake with the TEC, Sandra indicated that since her brain injury she had been experiencing forgetfulness, issues with reading comprehension, difficulty understanding what others are saying, trouble with concentration, difficulty organizing her schedule, keeping track of assignments, and anxiety. She was provided with an iPad with apps, such as 30/30, for time management and Planner Plus for organization, planning, and time management. These apps provided her with greater control over her demanding school, work and social schedule. Sandra was matched with a special education teacher as her mentor based on her career goals. Sandra and her mentor discussed networking, job responsibilities, peraths to licensure, and challenges in the workplace. Sandra was able to shadow her mentor and speak with other special education teachers. Project Career supported Sandra in developing her resume, preparing job applications, managing the interview process, and accommodations and disclosure strategies. She has obtained full time employment as a special education classroom teacher.

Finally, we hope you will join our Learn at WORK webinar on Wednesday, November 15 1-2pm EST, where the Project Career team will discuss one of the articles in this special issue, Perceived benefit of iPad apps among college students with Traumatic Brain Injury (TBI). You can register for this complimary webinar at: https://attendee.gotowebinar.com/register/3415532095909897988

Thank you,

Guest Co-Editors

Dr. Phillip Rumrill, Dr. Deborah J. Hendricks, Eileen Elias, Dr. Karen Jacobs, Anne Leopold, Amanda Nardone, Elaine Sampson, Deborah Minton & Dr. Marcia Scherer

Learn more about Project Career at: http://www.projectcareertbi.org/

References

[1] 

Faul M , Xu L , Wald MM , Coronado VG . Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002–2006 Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2010.

[2] 

Hendricks D , Sampson E , Rumrill P , Leopold A , Elias E , Jacobs K , Nardone A , Scherer M , Stauffer C . Activities and interim outcomesof a multi-site development project to promote cognitive supporttechnology use and employment success among postsecondary studentswith traumatic brain injuries. NeuroRehabilitation 2015;37:449–458,449.