Accommodations and Interventions

1. Accommodations and Interventions Joshua Cantor, Ph.D., ABPP Department of Rehabilitation Medicine

2. Accommodations and Interventions • For children with chronic or slow to resolve symptoms, interventions may be necessary

3. Accommodations and Interventions • Community integration and participation are important goals

4. Accommodations and Interventions • Non-pharmacological therapies • Speech therapy • Occupational therapy • Physical therapy • Psychotherapy and other behavioral treatments • Cognitive remediation (including cognitive orthotics)

5. Accommodations and Interventions • Need for comprehensive neuropsychological assessment including cognitive and behavioral evaluation

6. Accommodations and Interventions • Establish what accommodations are needed • Previous functional level and co-morbid issues (e.g., learning disability) must be taken into account

7. Accommodations and Interventions • Importance of coordinated approach involving treatment team, educators, family, coaches, etc.

8. Accommodations and Interventions • Interventions cannot be delivered in isolation – they must be implemented across settings (school, home, sports teams, etc.). • All parties including child must be educated about needs and goals

9. Accommodations and Interventions • Interventions are typically environmental rather than internal

10. Accommodations and Interventions • Accommodations and compensatory strategies should: • capitalize on strengths • circumvent or provide support with areas of weakness • be consistently implemented • be solution focused, not deficit focused • emphasize structure

11. Accommodations and Interventions: Examples • Attention: • Position child in classroom to reduce distractibility (e.g., at front) • Provide quiet, low distraction study area at home • Discourage multi-tasking • Encourage periodic breaks • Cue child to stay on task as needed

12. Accommodations and Interventions: Examples • Memory difficulties: • Allow note takers or tape recorders in class • Use reminders and a calendar and other cognitive supports (e.g., smartphones) • Use testing methods adapted to memory difficulty (e.g., multiple choice) • Encourage repetition and rehearsal

13. Accommodations and Interventions: Examples • Processing speed: • Slow down pace when possible • Allow rest periods • Repeat material • Don’t rush or challenge the child

14. Accommodations and Interventions • Kids with TBI are at risk for social isolation and behavioral problems so social skills, participation, and mental health must be addressed

15. Accommodations and Interventions • Importance of brain health (sleep, exercise, healthy diet, avoidance of toxins, etc.)

16. Accommodations and Interventions • The Family Advocacy Counseling and Training Services Program (FACTS) • Information re services in NYS • Links to rehabilitation services and support groups • Training for family members, service providers, and educators to understand impact of TBI • Support with special education • Individuals who sustained a brain injury prior to the age of 22 and live in New York State are eligible • Funded by the Office for People with Development Disabilities (OPWDD) • BIANYS.org

17. Thank you