1. Traumatic Brain Injury (TBI) Rehabilitation Programs for Younger Children and Adolescents Vanderbilt Bill Wilkerson Center: Pi Beta Phi Rehabilitation Institute

2. Populations Served Pi Beta Phi Rehabilitation Institute Since 1988, the mission of the Pi Beta Phi Rehabilitation Institute at Vanderbilt Bill Wilkerson Center has been service to children and adults with acquired brain injuries.

3. Services Provided Our services focus on the most primary and persistent concerns after post acute recovery from TBI: memory, executive functions, academic learning skills, speech- language abilities, & social communication. Additionally, we provide therapies to improve functional self- care, safety, mobility, strength, range of motion, balance and coordination, and feeding and swallowing. Depending upon the age of the client, our therapy programs are aimed at readiness for school, school reentry, classroom placement, and selection of appropriate supports for academic success.

4. Age 3 to 10 Therapy Services Speech-Language Pathology: Evaluation and tx of cognitive- communicative & academic skills, and social communication. Occupational Therapy: Evaluations and tx to address physical, visual, perceptual, and cognitive abilities limiting functional independence, safety, and school academic success.Pre-school/School-Age/Academic Develop language-literacy and handwriting skills, Improve executive functions and attention and class room performance Assistance with IEP and classroom/school placement.

5. Age 11 – 21 Therapy Services Speech-Language Pathology: Evaluation and treatment targeting cognitive-communicative deficits, academic skill development, and social communication. Occupational Therapy: Assessment and treatment targeting physical, visual, perceptual, and cognitive deficits that influence independence in activities of daily living, safety, and academic success. Driver Evaluation/Training Physical Therapy: Assessment and treatment targeting physical problems, such as decreased mobility, balance, coordination, dizziness, weakness, that influence independence and safety in daily activities. Middle School, High School, & College Academic Entry/Re-entry Conduct a comprehensive evaluation of the student’s cognitive deficits to identify barriers to academic success. Comprehensive treatment plan is developed with goals targeting reading comprehension, listening skills, speech, writing, attention, and memory

6. Physical Therapy Evaluation of balance and vestibular function, including a neurological screen – Oculomotor function – Vestibular screening – BPPV assessment (video goggles) – Dynamic visual acuity/Gaze stability ( inVision computerized testing) – Dynamic gait assessment Examine use of sensory cues for balance (vestibular, visual, somatosensory) – Computerized dynamic platform posturography (Neurocom Smart Equitest)

7. Physical Therapy Balance/vestibular rehabilitation – Oculomotor training – Vestibulo-ocular-reflex (VOR) training – Functional balance retraining – Dynamic gait training Dual-task activities to incorporate cognitive skills Incorporate relevant functional tasks, including sports specific activities

8. Balance Disorders Laboratory (BDL) The BDL is a diagnostic clinic where specially-trained audiologists conduct tests to help physicians determine the cause of dizziness, disequilibrium and vertigo. The BDL specializes in unique treatment options, and assess conditions using the most current testing techniques and technologies (e.g. head impulse, rotational, and videonystagmography testing).

9. Driver Evaluation and Training Evaluate patients to determine if they are able to safely drive a vehicle in a variety of environments. If patient is able to benefit from intervention – train patients to drive without risk. – train the use of adaptive driving equipment.

10. How to refer…

11. Multidisciplinary TBI Clinic Collaboration between PBPRI, Acute Care SLP Service, and Trauma Surgery Director – Oscar Guillamondegui, MD