Visions RainbowA Magazine for Brain and Spinal Cord Injury Professionals, Survivors and Families Rainbow Rehabilitation Centers Inc.

FALL 2014 www.rainbowrehab.com Volume XI No. 3 Post-traumatic Amnesia What kind of recovery can be expected after a person experiences a traumatic brain injury? Experts look to the length of time an individual remains in post-traumatic amnesia for clues.

Sensory Integration in the Classroom Adapting to a child’s difficulty in processing input from their environment Encouraging School Success How Rainbow school liaisons support students and their teachers President's Corner

KEY TO IMPROVEMENT 2014 Employee Survey Results

By: Bill Buccalo, President Rainbow Rehabilitation Centers

Some of the employment categories where ainbow is a people business. People taking care of people; people we saw the most significant improvements inspired by each other; people making or breaking the company are outlined here. reputation, and the list goes on. I love working at Rainbow because of the Administrative people I work with and work for. Many of my fellow employees feel the ‚‚ Spirit of teamwork same. I wrote this article on the heels of our quarterly Employee of the ‚‚ Overall employee morale Season luncheon (See page 25.) This long standing event is one of my ‚‚ Communication between employees and management favorite Rainbow traditions. Employees, clients, families, and the commu- Rehabilitation Assistants nity can nominate employees for special recognition. The stories shared ‚‚ Spirit of teamwork are truly inspiring. We understand that a key to this business revolves ‚‚ Seeking out and implementing around how people treat, value, communicate, and listen to each other. employee ideas ‚‚ Rainbow’s focus on employee safety In the spirit of listening, Rainbow recently completed the 2014 Employee ‚‚ Communicating Rainbow’s Opinion Survey to gain information on how employees feel the com- corporate direction pany is performing in a variety of areas. We were pleased to learn that Residential Program Managers employees feel the company is moving in the right direction. Overall, the ‚‚ Recognition of employee 563 employees who participated scored Rainbow higher in nearly every contributions category as compared to 2013. Rainbow’s overall score improved to an ‚‚ Overall employee morale “Above Average” rating. ‚‚ Communication between employees and management Rainbow strives to be the market’s provider of choice. To achieve this sta- ‚‚ Rainbow’s focus on continuing tus, stakeholders must be highly satisfied with our services. Listening to education employees, just like the need to listen to customers, is incredibly impor- ‚‚ Communicating Rainbow’s corporate tant. Meetings held with all employees this summer resulted in some direction Rainbow U Staff wonderful dialog regarding areas where the company can continue to ‚‚ Use of employees’ skills and improve. While the overall improvement noted in the survey is direction- experience ally outstanding, Rainbow is committed to working with all employees on ‚‚ Rainbow’s ability to solve customer further improvement in results.  service issues ‚‚ Rainbow’s tangible benefits Therapists ‚‚ Recognition of employee contributions ‚‚ Overall employee morale ‚‚ Rainbow’s tangible benefits ‚‚ Communicating Rainbow’s corporate direction

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Features On the 2 President's Corner – Employee Survey Results Bill Buccalo, President, Rainbow Rehabilitation Centers Cover The length of time that a person 4 Medical News – Sensory Integration in the Classroom experiences post-traumatic Katherine Dumsa, MS, OTR/L, CBIS amnesia may be a predictor of 6 Clinical News –Post-traumatic Amnesia the severity of their injury. Carolyn A. Scott, Ph.D.

12 Survivor Perspective – David Abrams Barry Marshall, Editor

16 Therapy Corner –Encouraging School Success Barry Marshall, Editor 20 Conferences and Events News at Rainbow Page 6 19 Rainbow U—Fish On! 22 Artists display work at brain injury conference 24 New Professionals at Rainbow 25 Employees of the Season 4 12 19

800.968.6644 www.rainbowrehab.com

Our mission is to inspire the people we serve to realize their greatest potential SM

Editor—Barry Marshall Copyright September 2014 – Rainbow Rehabilitation Centers, Inc. All rights reserved. Published in the United Associate Editor & Designer—Celine DeMeyer States of America. No part of this publication may be Contributor—Nick Galluch reproduced in any manner whatsoever without written permission from Rainbow Rehabilitation Centers, Inc. Contact the editor: [email protected]. E-mail questions or comments to: [email protected]

2 | RainbowVisions RainbowVisions | 3 Medical news

Objects such as fidget toys and therapy balls offer sensory feedback that may help calm hypersensitive children thoughtout their school day.

4 | RainbowVisions RainbowVisions | 5 www.rainbowrehab.com FALL 2014 Sensory integration in the classroom HOW DOES IT HELP THE CHILD WITH A BRAIN INJURY?

By: Katherine Dumsa, MS, OTR/L, CBIS Rainbow Rehabilitation Centers

Sensory processing is the brain’s ability to interpret What modifications can we make to the classroom? information from the environment and determine Occupational therapists provide sensory integration therapy S how to respond with emotion, attention and motor to create a “sensory diet” to regulate or provide stimulation to responses. Sensory processing dysfunction may affect young improve and maintain optimal functioning. The sensory diet children, individuals diagnosed on the autistic spectrum and can be carried over from school into the home to provide strat- someone who has sustained a traumatic brain injury. egies for the child to utilize independently. Adaptations within While symptoms and presentation can vary highly between the school may include: individuals, symptoms seen in children with sensory processing • A sensory space—An area to be active and physical or to disorder include: clumsiness, unwanted behaviors, agitation, be calm with quiet time difficulty in a structured environment and trouble relating to • Activities to provide touch and texture—Play-Doh®, peers or siblings. beads, stress ball The National Institute for Neurological Disorders completed research showing a breakdown of synaptic activity following • Alter lighting—natural or soft lighting that may be difficult injury to the brain. The breakdown often depletes commu- for visually impaired individuals nication and normal responses between neurons. Following • Improve classroom seating—adjust chairs for optimum fit, a traumatic brain injury, a child may have difficulty process- provide textures (therapy ball) or a vibrating cushion for ing input from their environment. This is described as hyper sensory feedback or hypo responsive to stimuli. Hyper-responsive individuals may have anxiety, respond intensely or be resistant to change. • Physical activities/sports in between classes Hypo-responsive children can present as lethargic and slow to • Fidget toys—large bands for student to stretch legs while respond with reduced motivation to participate. seated, theraputty for hands How does this affect the child’s daily functioning? • Programs to provide sensory stimulation such as A child that is hypersensitive to sensory information can also “Handwriting Without Tears” be referred to as a “sensory seeker.” A child will seek sensory input to help regulate and calm them throughout the school Occupational therapists play an important role in the evalu- day. This may present as: ation and treatment of children with sensory processing dis- • Insatiable desire for sensory input, highly active orders. While the treatment plan is individualized, it takes a full treatment team including the family, therapists and school • Poor safety awareness, poor perception of pain teachers to facilitate a successful • Fidgety, difficulty sitting in chair at school environment for the student at home and in school. v • Easily bored Symptoms stated above will affect the level of arousal References NINDS, (2002) Traumatic Brain Injury: and ability to sustain attention in a learning environment. Hope Through Research, NIH Publication Development of language, motor and cognitive skills along No. 02-2478 with social interaction can all be delayed. Retrieved from http://www.ninds.nih. gov/disorders/tbi/detail_tbi.htm

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AmnesiaBy: Carolyn A. Scott, Ph.D. Rainbow Rehabilitation Centers

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When a friend or family member experiences a traumatic brain injury, your natural reaction may be to ask how severe the injury was and what kind of recovery can be expected.

Medical providers and those involved in acute, sub-acute, and long-term rehabilitation are also interested in understanding the severity of the injury, as this is important information to have in order to address the second question: how will the injured individual

recover? Continued on page 8

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Post-traumatic Amnesia

Continued from page 7 There are multiple methods to assess the severity of a traumatic brain injury Understanding how long someone is in post-traumatic (TBI). Providers look at loss of conscious- ness score on the Glasgow Coma Scale, confusion is important in labeling the severity of the injury, and and how long it takes someone to follow it can be helpful for predicting outcomes from the injury as well. directions after their injury. Providers also consider the length of time an indi- vidual who experienced a TBI remains in difficulty with attention and memory) as well. The duration of post-traumatic post-traumatic amnesia (PTA). (Nakase-Richardson, Sherer, Yablon, confusion or post-traumatic amnesia has PTA was described in the 1930s by Nick, & Trzepacz, 2004; Sherer, Nakase- been shown to predict return to work Russell (1932) and Symonds (1937) as Richardson, Yablon, & Gontkovsky, (van der Naalt, van Zomeran, Sluiter, & a loss in full consciousness and there- 2005). Minderhoud, 1999) and level of cooper- fore an inability to make new memories Regarding cognitive impairments, ation (Silva et al., 2012) in rehabilitation. (Trzepacz, Kean, & Kennedy, 2011). This deficits in attention and memory are Severity of confusion has been shown definition was tweaked some so that particularly pronounced during PTC. to predict productivity and employ- for the past several decades PTA was These difficulties with sustaining atten- ment one year after injury (Nakase- defined as a period of disorientation tion and forming new memories add Richardson, Yablon, & Sherer, 2007; and difficulty consistently making new to the individual’s overall confusion Sherer, Yablon, Nakase-Richardson, & memories following TBI. The resolution and misinterpretation of their surround- Nick, 2008). It is also important for us to of PTA was complete when an individual ings. Additional behaviors that may be understand whether someone is in PTC, was consistently oriented and able to observed in someone in PTC include because it influences how clinicians tar- make new memories. However, many difficulty sitting still and a desire to pace, get treatments and expectations. researchers and clinicians recognized or someone who is often fidgeting with There are resources available for fam- that this definition of PTA did not fully their feeding tubes or wheelchair lap ily members and friends who have loved capture the spectrum of impairments belt. Agitation may also be noted when ones in PTC. The Rancho Los Amigos commonly found early in the recovery someone curses, yells at family, and Levels of Cognitive Functioning Scale from a TBI. refuses therapies. As noted above, some (see sidebar at right) describes the cogni- Post-traumatic confusion (PTC) is a fluctuation in abilities is not uncom- tive and behavioral functioning of a TBI term that better captures the deficits indi- mon during PTC. An individual in PTC survivor as it is likely experienced by viduals may experience as they recover may appear able to focus during therapy family and therapists. Levels IV, V, and VI after their injury. Specifically, Stuss et one day and unable to focus and follow all describe the period of post-traumatic al. (1999) described a post-traumatic instructions the next day. This does not confusion. The scale also provides confusional state as a “transient organic mean that the individual is motivated expectations for behavior and recom- mental syndrome with acute onset one day and not the next, although mendations for interacting with an indi- characterized by a global impairment variations in motivation are normal and vidual in PTC. of cognitive functions with a concurrent to be expected during the long course of Clinicians at Rainbow can also serve disturbance of consciousness, increased recovery. as a resource to understand your family psychomotor activity, and a disrupted Clinicians can track PTC proactively member who remains in PTC. Given the sleep-wake cycle.” Individuals who have and serially until an individual “clears” cognitive deficits present in an individual regained consciousness after a TBI but from the confusional state. This measure- in PTC, much of the treatment is repeti- who remain in PTC may demonstrate ment can be carried out by neuropsy- tive and environmental in nature. For decreased daytime arousal, fluctuations chologists or therapists with standardized example, an environment with reduced in cognitive and behavioral symptom tools. Understanding how long someone stimulation (low lights, no television/ severity, psychomotor agitation, affec- is in PTC is important in labeling the limited background noise and distrac- tive lability, perceptual disturbances, severity of the injury and it can be help- tions, and limited simultaneous visitors) and impaired cognition (in particular, ful predicting outcomes from the injury can be helpful. Individuals should be

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Rancho Los Amigos Levels of Cognitive Functioning Scale exposed to natural daylight to assist in Coma levels are commonly assessed by two different scales; the Glasgow Coma reducing daytime fatigue and resetting Scale and the Rancho Los Amigos Scale. The Rancho Los Amigos Scale is most circadian rhythms. When communicat- helpful in assessing the patient in the first weeks or months following an injury, ing with an individual who is in PTC, because it does not require cooperation from the patient. These Rancho Levels are statements should be clear, brief and based on observations of the patient’s response to external stimuli. They provide a at a slower pace in order to maximize descriptive guideline of the various stages a brain injury patient will experience as comprehension. he/she progresses through recovery. When post-traumatic confusion Rancho Los Amigos Scale 8 Levels: An understanding of the eight levels pro- resolves, an individual may continue vides insight into the progression through recovery and rehabilitation. to demonstrate deficits related to their I. No Response - Patient appears to be in a deep sleep and is unresponsive to injury. Regardless of where they are in stimuli. their cognitive recovery, the clinicians and rehabilitation assistants at Rainbow II. Generalized Response - Patient reacts inconsistently and non-purposefully to are equipped to help manage the symp- stimuli in a nonspecific manner. Reflexes are limited and often the same, regard- toms they demonstrate and help propel less of stimuli presented. them towards recovery. III. Localized Response - Patient responses are specific but inconsistent and are What follows is an example of a client directly related to the type of stimulus presented, such as turning head toward a who arrived for treatment in a post-trau- sound or focusing on a presented object. He may follow simple commands in an matic confusional state. inconsistent and delayed manner. Case Study: IV. Confused-Agitated - Patient is in a heightened state of activity and severely confused, disoriented, and unaware of present events. His behavior is frequently Mr. Jones bizarre and inappropriate to his immediate environment. He is unable to perform Mr. Jones is a 45-year-old man who was self-care. If not physically disabled, he may perform automatic motor activities injured when the car he was driving was such as sitting, reaching and walking as part of his agitated state, but not neces- struck by another vehicle that lost control sarily as a purposeful act. and crossed the highway median. EMS V. Confused-Inappropriate, Non-Agitated - Patient appears alert and responds was called by a witness to the accident to simple commands. More complex commands, however, produce responses and when they arrived, Mr. Jones was that are non-purposeful and random. The patient may show some agitated behav- found to be unconscious in his car. Mr. ior in response to external stimuli rather than internal confusion. The patient is Jones was transported to the hospital highly distractible and generally has difficulty in learning new information. He can where he was found to have a fracture to manage self-care activities with assistance. His memory is impaired and verbaliza- his left leg and several ribs, and he had tion is often inappropriate. cuts and bruising on his arms and face. Imaging of his brain demonstrated a TBI VI. Confused-Appropriate – Patient shows goal-directed behavior, but relies on with subarachnoid hemorrhage, intracra- cueing for direction. He can relearn old skills such as activities of daily living, but nial hemorrhage, and hemorrhagic con- memory problems interfere with new learning. He has a beginning awareness of tusions in both frontal lobes and the left self and others. temporal lobe. VII. Automatic-Appropriate – Patient goes through daily routine automatically, After being stabilized medically, Mr. but is robot-like with appropriate behavior and minimal confusion. He has shallow Jones transferred to an acute rehabilita- recall of activities and superficial awareness of, but lack of insight to, his condition. tion unit at the local hospital. He then He requires at least minimal supervision because judgment, problem solving, and transferred to a residential rehabilita- planning skills are impaired. tion facility for continued rehabilitation VIII. Purposeful-Appropriate – Patient is alert and oriented and is able to recall services and a supported environment. and integrate past and recent events. He can learn new activities and continue in When Mr. Jones arrived, he remained home and living skills, though deficits in stress tolerance, judgment, abstract rea- confused (Rancho level V) and therapists soning, social, emotional, and intellectual capacities may persist. Continued on page 10

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Post-traumatic Amnesia

Continued from page 9 began to assess his cognition so that therapies and the environ- possible to improve Mr. Jones’ sense of control over his envi- ment around him could be targeted to maximize his recovery. ronment. Environmental cues to help orient Mr. Jones were On a standardized measure of orientation, Mr. Jones was added to his room, and he was encouraged to wear his watch. noted to know his name and birthday but he could not This sense of control and assistance with reorientation resulted remember his age. He was able to identify the month but not in more appropriate language and fewer refusals of therapy. the date or year and when asked what time it was, he glanced To address sleep issues and pacing, Mr. Jones was encour- at a nearby clock to provide the right answer. Mr. Jones knew aged to be up and active during the day, and the drapes in his he was in rehabilitation and working on his legs in therapy, but room were opened to increase his exposure to sunlight. Mr. he could not recall how he had been injured or provide further Jones was also directed toward pleasant activities when he details about the consequences of his accident. When given paced or became irritable. Therapists worked to improve Mr. prompts, Mr. Jones became more accurate, but he remained Jones’ span of attention in sessions and team members pro- confused. He could not remember the name of the team mem- vided frequent breaks, repeated instructions, and checked for ber who worked with him daily, but he was able to remember comprehension in consideration of Mr. Jones’ level of confu- the names of his children and wife. Furthermore, Mr. Jones sion and difficulties with attention. Working with his physi- was noted to be unable to focus on a conversation or therapy cian, medications were reviewed to minimize any negative exercise for longer than a few minutes. side effects that they may have on cognition. Family members At times, Mr. Jones became irritable. He would pace around and Mr. Jones were provided with education about brain injury the home, swear at therapists or direct care staff, and refuse and recovery from injury. therapies. His family noted that this behavior was not typical Over time, Mr. Jones became more oriented to his surround- for Mr. Jones. They were embarrassed despite reminders from ings and less irritable. Serial evaluations indicated that Mr. his therapy team that this agitation was not uncommon for Jones cleared post-traumatic confusion after 67 days. While someone who had an injury like his and who was at that point he continued to demonstrate areas of cognitive weakness, his of recovery. In addition, Mr. Jones had disturbed sleep. progress in therapy accelerated, and discharge plans were The treatment team worked together to determine if there developed so that Mr. Jones could return to his home safely were specific triggers for Mr. Jones’ agitation and discovered while continuing therapy as an outpatient. His successful tran- that he felt he had been treated like a child in the hospital and sition was another indication of progress in his recovery from that he wanted more independence. To address his concern, brain injury. v therapists and team members provided options whenever

About the author

Carolyn A. Scott, Ph.D. Psychologist Dr. Scott earned her Ph.D. in Clinical Psychology at Wayne State University. After an internship at the John D. Dingell VA Medical Center, she completed specialized post-doctoral training in Neuropsychology and Rehabilitation Psychology at the Rehabilitation Institute of Michigan. While there, Dr. Scott worked with individuals who had experienced traumatic brain injuries, stroke, spinal cord injuries, and other neurological and orthopedic conditions on both an inpatient and outpatient basis. In addition to other responsibilities, Dr. Scott provides client and team consultation services and brief and expanded neuropsychological evaluations at Rainbow Rehabilitation Centers, Inc.

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References: Nakase-Richardson, R., Sherer, M., Yablon, S.A., Nick, T.G., & Trzepacz, Silva, M.A., Nakase-Thompson, R., Sherer, M., Barnett, S.D., Evans, C.C., P.T. (2004). Acute confusion following traumatic brain injury. Brain Injury. Yablon, S.A. (2012). Posttraumatic confusion predicts patient cooperation 18(2):131-142. during traumatic brain injury rehabilitation. American Journal of Physical Medicine and Rehabilitation. 91(7): 1-4. Nakase-Richardson, R., Yablon, S.A., & Sherer, M. 2007). Prospective comparison of acute confusion severity with duration of post-traumatic Stuss, D.T., Binns, M.A., Carruth, F.G., Levine, B., Brandys, C.E., Moulton, amnesia in predicting employment outcomes after traumatic brain injury. R.J., Snow, W.G., & Schwartz, M.L. (1999). The acute period of revoery Journal of Neurology, Neurosurgery, and Psychiatry. 78:872-876. from traumatic brain injury: Posttraumatic amnesia or posttraumatic confusional state? Journal of Neurosurgery. 90(4): 635-643. Russell, W.R. (1932). Cerebral involvement in head injury: a study based on the examination of two hundred cases. Brain. 55:549-603. Symonds, C.P. (1937). Mental disorder following head injury. Proceedings of the Royal Society of Medicine. 30:1081-1094 Scherer, M., Nakase-Thompson, R., Yablon, S.A., & Gontkovsky, S.T. (2005). Multidimensional assessment of acute confusion after traumatic Trzepacz, P. T., Kean, J., & Kennedy, R. E. (2011). Delirium and brain injury. Archives of Physical Medicine and Rehabilitation. 86: 896- posttraumatic confusion. In J.M. Silver, T.W. McAllister, & S.C. Yudofsky 904. Textbook of traumatic brain injury: Second edition (pp.145-171). Arlington, VA: American Psychiatric Publishing, Inc.. Scherer, M., Yablon, S.A., Nakase-Richardson, R., & Nick, T.G. (2008). Effect of severity of post-traumatic confusion and its constituent symptoms van der Naalt, J., van Zomeren, A.H., Sluiter, W.J., Minderhoud, J.M. on outcome after traumatic brain injury. Archives of Physical Medicine and (1999).One year outcome in mild to moderate head injury: the predictive Rehabilitation.89(1): 42-47. value of acute injury characteristics related to complaints and return to work. Journal of Neurology, Neurosurgery, and Psychiatry. 66:207-213.

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10 | RainbowVisions RainbowVisions | 11 Survivor Perspective Motivation. Persistence. Success. By: Barry Marshall Editor, RainbowVisions Magazine meet David Abrams

David Abrams has been making a name for himself in the David three times per week. His treatment goals revolved jewelry-making business over the last four years because of around his memory, high-level problem solving tasks and his high-quality work. He started working on this skill through executive functioning skills. a trade program in jewelry repair and stone setting at Groves “David actively participated in his rehabilitation, always High School in Birmingham, MI. completed homework tasks and utilized strategies that were He continued his work following high school through an provided to him in therapy sessions,” said Lisa. additional specialized program in engraving and precious David recalls working on leg strength with Physical Therapist stone setting in Virginia. He also worked as an apprentice for Tina Kowalski. He said he was 85% weight bearing on his a few years at MHG Jewelry Studio in Berkley, MI. His high- right leg and 15% on his left. Primarily in a wheelchair, he quality work is a result of years of experience; his additional used a platform walker for short distances. training and developing skills are in great demand. Few people Tina said that once his weight bearing precautions and cer- possess the skills that David has. vical collar were no longer in place, he quickly progressed. Life was good and headed in the direction David wanted. By the time he discharged, she and David were working on But on November 16, 2013 he was hit by a car while riding high-level balance and yoga-type activities, dynamic workouts his motorcycle. Thankfully, he was wearing a helmet at the including plyometrics, and high-intensity exercises targeting time of the accident. At the accident scene, he reportedly the core and legs. had altered levels of consciousness. As a result, he sustained She recalls that David regularly stayed after their one-hour a traumatic brain injury as well as fractures in his pelvis, the sessions to complete another 30-45 minutes of exercise on his occipital area of the skull, a nasal bone and his wrist. His own. brain began to swell on the back side of his head, and it was Tina noted that David was very motivated, made significant bleeding in a small area in the front. progress in a short period of time and was extremely involved David was transferred to Beaumont Hospital where he in his discharge planning. was flailing all four extremities and became combative. He “It was a struggle, but I had to get through it,” David recalls. required surgical repairs of his fractures, and spent a month “I might feel bad at the end of the day, but tomorrow was at Beaumont Hospital before discharging to Rainbow’s always a brand new one. Every day, I felt better.” NeuroRehab Campus (NRC) in Farmington Hills, MI. “She kicked my butt,” said David of Occupational Therapist He recalls questioning himself and wondering if he was Kori Morden. “She really put me to work, and I’m thankful for going to get past this. He wondered if this was the new reality that.” for him. Kori noted that because he was a highly skilled jeweler, A full array of therapies working on upper body strength, hand strength and dexterity David entered the NRC right before Christmas last year in a was important. David increased his upper body strength with wheelchair and wearing a cervical collar. For the next month, yoga, kickboxing and weight training. Though he felt unsteady he participated in a full array of intense therapies. He demon- and admittedly awkward doing these exercises, Kori said he strated to the therapists at Rainbow that he was very motivated mastered them. to get back to his life and his work. David improved his hand strength and dexterity through var- “My daily therapies were pretty intense,” he said. “At that ious coordination games and strengthening exercises. In fact point, I had the capacity to understand why I was there, and I he would often diligently do his hand strengthening exercises was beginning to accept it.” on his own outside of therapy. Speech & Language Pathologist Lisa Niziolek worked with Kori also worked with David on his medication Continued on page 14

12 | RainbowVisions www.rainbowrehab.com FALL 2014

Clockwise from left: David runs his own business, Jewelry Designs by David Abrams, from his work space in Berkley, MI. In appreciation of their hard work and support, David designed a Rainbow logo pendant for each of his NRC therapists. He has also created a piece for Rainbow’s booth at the Brain Injury Association of MI conference. In addition to design, David also repairs jewelry, resizes rings and sets new stones into existing jewelry.

RainbowVisions | 13 Survivor Perspective: David Abrams

Continued from page 12 management and meal preparation skills in anticipation of his challenging at times but David worked diligently throughout eventual return home. Kori noted that as David’s attention and the process according to Dr. Scott. David indicated he would memory improved, he made dramatic gains in his ability to like to take the test again to see how far he has progressed complete these higher-level tasks. He made several impressive since taking the first one. food dishes and always had the sense of humor to laugh it off if David said he enjoyed his sessions with Mental Health it didn’t turn out quite like he had planned. Therapist Anne Marie Caldwell. “You can just talk and be David said that in recreational therapy, he and Recreational yourself with her,” he said. “It was good to get out some of my Therapist Lauren Cetnar “worked to forget.” frustrations.” “You feel pain almost every single day,” said David, “and Anne Marie helped David with identifying coping strate- then there’s someone with a smile on their face and you smile gies to deal with stressors, negative feeling states and everyday back and forget about what you’re going through.” problems. He went on to say he couldn’t figure out why they played David may have entered the NRC in a wheelchair, but he Uno nearly every day for two weeks. And then he realized he walked out a month later. He credits his success to the thera- didn’t feel pain while they played. pists at the NRC. They challenged him. They pushed him. Vocational rehabilitation and returning to work was “I have more confidence in myself now,” said David. “I’ve extremely important to David. Vocational Therapist Maria King always been timid and never put myself out there. I still might said that he figured out in advance of starting back to work that be timid but I’m building up my own self-confidence because I he needed a quieter environment, so he arranged to start work had a team of people at Rainbow telling me I could do it.” in the afternoon and work into the evening when fewer people David discharged from the NRC and returned home. He were around. She said he was keenly aware of his fatigue and began outpatient therapy at Rainbow’s newest treatment center was not afraid to turn down work if he did not think he could in Farmington Hills, MI for three months. He continued his manage the time frame required by the customer. therapy regimen three times per week. He also successfully “David was one of the most motivated individuals I have ever completed a final driving assessment and was cleared to drive. worked with,” said Maria. “He is one of those patients that a He discharged from Rainbow completely on April 25 of this therapist goes back to in memory and celebrates. He reminds year because, according to David, “I surpassed all my goals.” us that we can make a difference, and that is why I got into this “The team at the NRC is stupendous,” said David. “What line of work.” blows my mind is that the people there make you feel like their David recalls being terrified to take his neuropsych exam. “It life is second to yours. I’ve never experienced anything like was a little frustrating,” he said. “It was a long day of working that. Such a helping hand. Great people to be around. They do your brain out—it’s really put to the test.” nice gestures and that’s what they do day in and day out, for Rainbow’s Neuropsychologist Dr. Carolyn Scott had been not just me, but all patients at the NRC. What they do there is consulted to assist with David’s treatment planning in January. amazing.” He completed several hours of testing that looked at his pro- David is back to work full time. When asked how he feels cessing speed, memory, problem solving, language, attention, now, he responds with “Great! My walking is not as good as it visuospatial, and academic skills. The testing can be boring or once was, but I’ll keep working on it.” v

It's about reaching your potential! Young Adult Program Vocational programming Designed to assist young adults in gaining meaningful employment and developing the skills necessary Therapeutic services to initiate and maintain long-term relationships. Residential services Flexible scheduling

800.968.6644 E-mail: [email protected] www.rainbowrehab.com

14 | RainbowVisions RainbowVisions | 15 www.rainbowrehab.com FALL 2014 no greater hope of recovery…

A full Continuum of Care including active therapy, community outings and supported living for individuals with medical needs. FEATURING Two 20-bed facilities Private rooms and baths Physician visits on-site Nursing services available on-site 24/7 Interdisciplinary treatment team Executive chef

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14 | RainbowVisions RainbowVisions | 15 Therapy Corner

School Liaison and Pediatric Divisional Director Sue Finney (above) communicates regularly with parents, students and school personnel. She has worked in the field of traumatic brain injury since 1992. At right, School Liaison Sheryl Carpenter works with a student at the Genesee Treatment Center during the after school program. Sheryl’s background is in occupational therapy and she also functions as the clinical manager of the Genesee Treatment Center.

16 | RainbowVisions RainbowVisions | 17 www.rainbowrehab.com FALL 2014

How Rainbow’s School Liaisons support students with brain injuries Encouraging School Success By: Barry Marshall Editor, RainbowVisions Magazine

For over 20 years, Rainbow has been providing therapeutic outlines the educational goals and accommodations made for support to children in its pediatric program. Through therapy, the student. Few families have insight into this process. Sue counseling and activities, Rainbow works to set children up for and Sheryl are there to support families during the process success in their adult lives. and explain the rights of the child under the state of Michigan One important aspect of this is supporting them while going Educational Laws. to school. As individuals with brain injuries, the kids need extra Sue points out that Rainbow pediatric residential clients and support and understanding to be successful in school. those receiving tutoring support have educational goals listed Sue Finney, divisional director at Rainbow’s Oakland in their plans of care. Treatment Center, and Sheryl Carpenter at the Genesee School liaisons attend all IEP meetings to ensure the appro- Treatment Center, both work as school liaisons and child advo- priate accommodations are listed and enforced. They also cates for our pediatric clients attending school. ensure that the correct plan is written, be it an IEP or accom- Working with Educators modations based on the 504 plan (see sidebar on next page.) One of the first orders of business when a pediatric client It’s also important that the student receive appropriate tech- enters a school is to educate the school staff on traumatic brain nology, like an iPad or other communication device that can injuries. This includes teachers, para professionals and the help set them up for success. Sue and Sheryl assist with acquir- school’s special education division. ing the technology to ensure the client is able to effectively use “It’s important to open the lines of communication with all it, and that if needed, others around them can support it from a teachers,” said Sheryl. “I get their email addresses so I can get technological perspective. updated information on attendance, test dates, missing assign- Collaboration with Families ments and any behavioral issues that may be going on.” An integral part of the school liaison role involves spending Sheryl also tries to get an extra set of textbooks so if the child time with families. Their work assisting families with the IEP forgets their books, they can still work on homework while at process is an important part of what they do, but it is not all the treatment center. they do. Sue and Sheryl also educate families on an ongoing Sue and Sheryl work with the school’s occupational and basis regarding brain injury education, providing information physical therapists as well as the speech pathologists to update about the school, assisting them with access to homework hot- them on the goals for the child and provide them with any lines (so that families are alerted about tests or quiz dates), and medical information they need to know. just being an all-around resource. Because students may exhibit maladaptive behaviors, Communication is important in the whole process and school liasons will make sure that successful behavior plans Rainbow’s school liaisons find themselves central to all inter- are shared with the school team. A therapist can go into the ested parties, including insurance companies, physiatrists, and school to assist and educate teachers how to safely handle the external case managers. behavior. Children living with brain injuries have needs both in and Establishing a Plan out of school, and Sue and Sheryl work diligently to help them Typically, an Individual Education Plan or IEP is developed that succeed! v

16 | RainbowVisions RainbowVisions | 17 What’s the difference between an IEP and a 504 plan? An IEP or Individual Education Plan is mandated by the Individuals with Disabilities Education Act (IDEA), a What's new at federal law that ensures specially designed instruction to meet the unique educational needs of children with disabilities such as brain injury. Individuals who do not qualify for special education services through IDEA may be eligible for accommodations under a 504 Plan. Here are a few basic differences.

IEP 504 Plan An IEP is the indivdualized plan mandated by IDEA. IDEA Section 504 of the Rehabilitation Act of 1973 requires is a federal statute whose purpose is to ensure a free and schools to eliminate barriers that would prevent a student appropriate education for children with disabilities. from participating in the programs and services offered. An IEP is a legal document that includes goals and A 504 Plan outlines educational services and objectives, and specifies the educational services accommodations to be provided to the student such as to be delivered free of charge to the family. extra time for tests or repeated/simplified instructions. Services specified may go beyond those offered to Services specified are limited to accomodations that give students in the general curriculum such as speech students an opportunity to fully participate with their peers. therapy, counseling or individual instruction.

An IEP meeting is required before any change A meeting is not required for a change of placement. in placement or services is made.

An IEP is to be reviewed each year or earlier if it is A 504 Plan requires yearly reevaluations or periodic review. not fulfilling the educational needs of the child.

References Michigan Administrative Rules for Special Education (MARSE). (2013). General Provisions. Michigan Department of Education, Office of Special Education. Retrieved from http://michigan. gov/documents/mde/MARSE_Supplemented_with_IDEA_Regs_379598_7.pdf Section 504 of the Rehabilitation Act of 1973 | ADAAA & Section 504. (2014, May). National Center for Learning Disabilities. Retrieved from http://www.ncld.org/disability-advocacy/learn-ld-laws/adaaa-section-504/section-504-rehabilitation-act-1973 Section 504 and IDEA Comparison Chart. (2014, August). National Center for Learning Disabilities. Retrieved from http://www.ncld.org/disability-advocacy/learn-ld-laws/adaaa-section-504/section-504-idea-comparison-chart

Independence:

Where do you want to go and when do you want to get there? We have one of the largest service areas in Michigan so chances are good that we’re going your way. Experienced drivers are also specially trained in caring for individuals with special needs. So while you are enjoying your independence you’ll also have confidence that comes from knowing you are safe. Rehab Transportation. We are… GRAND RAPIDS TRI-CITY AREA your license to GO! LANSING

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18 | RainbowVisions RainbowVisions | 19 www.rainbowrehab.com FALL 2014

What's new at Rainbow U is a unique outpatient and day treatment program offering dozens of interesting elective courses in addition to an individual's core therapies.

Therapeutic fishing? Absolutely! For staters, ask any fisherman and they’ll tell you about the stress-relieving benefits of a trip to the lake. At Rainbow U, we also know that casting, tying lures and even remov- ing hooks are excellent activities that encourage the practice of fine and gross motor skills, concentration and attention to safety. Rehab Tech Jeff Brozoski who designed the “Fish On!” course last sum- mer, says that more than a dozen Rainbow clients are enjoying this bonus to traditional therapy with the opportunity to reinforce skills they’ve learned in treatment. “I’ve seen many gains and improvements along the way. I’ve had clients show up extra early just because they are excited to go fishing and enjoy the fresh air. They also enjoy time interacting with fellow clients.” Participants in “Fish On!” also learn about Michigan lakes and rivers, lures and baits, casting techniques, knots and reel stringing, species identification, safety and etiquette. Regular fishing outings are espe- cially anticipated, as is the opportunity to yell, “Fish On!”

Above, Ed Pttman and Rehab Tech Jeff Brozoski cast their lines at Walled Lake in Oakland County, MI. Ed was an avid fisherman before his injury and loves every opportunity to participate in the sport. Left, Autumn Lujan displays the impressive small mouth bass she landed after a 10 minute struggle “The excitement and look on her face was priceless,” said Brozoski. “I walked her through how to handle the fish, remove the hook and properly place the fish back in the water. She talked about it all day!”

18 | RainbowVisions RainbowVisions | 19 Conference & Event Schedule 2014Fall September September 14-17 Contemporary Forums Case Management Conference Las Vegas, NV www.contemporaryforums.com September 16 Michigan ARN Dinner Presentation Rainbow’s Ypsilanti Treatment Center, MI www.miarn.org September 16 CMSA Gr Rapids/Kalamazoo Dinner Conference Bluffs Conference Center, Grand Rapids, MI www.cmsa-westmi.com September 17-20 Contemporary Forums Brain Injuries Conference Grand Hyatt—San Francisco, CA www.contemporaryforums.com September 20-21 International Symposium on Life Care Planning Marriott City Center—Minneapolis, MN www.isicp.com September 29-30 Michigan Assoc. for Justice Auto NoFault Seminar Westin Hotel—Southfield, MI www.michiganjustice.org October October 3 ACMA Great Lakes Chapter Conference Suburban Collection Showplace—Novi, MI www.acmaweb.org October 14 CMSA Detroit Breakfast Conference Farmington Hills Manor—Farmington Hills, MI www.cmsadetroit.org October 18 CPAN Gala Dinner Eagle Eye Banquet Center - E. Lansing, MI www.cpan.us October 24-27 American Association of Nurse Life Care Planners Atlanta, GA www.aanicp.org October 27-30 NASHIA Annual State of the States Meeting Courtyard Downtown—Philadelphia, PA www.nashia.org October 28 MSU Case Management Conference Kellogg Center—East Lansing, MI [email protected] October 29-Nov. 1 ARN Education Conference Disneyland Exhibit Hall—Anaheim, CA www.rehabnurse.org November November 18 CMSA Gr Rapids/Kalamazoo Dinner Conference Borgess Medical Center - Kalamazoo, MI www.cmsa-westmi.com

November 19-20 National Worker’s Comp & Disability Conference Mandalay Bay - Las Vegas, NV www.wcconference.com 2015 Preview January 11-14 Craig Hospital Brain Injury Summit Vail Cascade Resort/Spa—Vail, CO www.braininjurysummit.org March 22 Carnival of Care Suburban Collection Showplace—Novi, MI www.carnivalofcare.com April 31-May 2 NABIS 12th Annual Conference on Brain Injury Westin Riverwalk Hotel—San Antonio, TX www.nabis.org

20 | RainbowVisions www.rainbowrehab.comwww.rainbowrehab.com SUMMERFALL 2014 2014

MBIPC Michigan Brain Injury Provider Council RINC Rehabilitation & Insurance Nursing Council meetings MEMBERS ONLY

Registration at 11:30 a.m. / Lunch at Noon Presentation begins at 12:45 p.m.

September 19, 2014 Topic: Proposed Changes to No-Fault Law Learn Over Lunch Speaker: James Iafrate, JD, Robert E. Logeman, JD, Adrienne D. Logeman, JD Meeting times are noon – 2:00 p.m. Location: The Townsend Hotel (Registration at 11:30 a.m.) 100 Townsend St., Birmingham, MI 48009 Cost: MBIPC Member $25 / Non-member $60 RSVP to: Kim Newman at 734-709-1602 For information call 810-229-5237 or [email protected] October 17, 2014 October 14, 2014 Topic: Pediatric Traumatic Brain Injury Topic: Health Disparity Within the LGBTQ Community Speaker: Dr. Harmony Sierens and Creating a Welcoming Environment Location: Detroit Golf Club 17911 Hamilton Rd., Detroit, MI 48203 Speaker: Dr. Grace Hoyer; Asst. Prof., Grand Valley State University Location: Prince Conference Center, Grand Rapids, MI RSVP to: Shannon Higdon at 877-214-1541 [email protected] November 11, 2014 Topic: Veterans Administration Topic November 21, 2014 Speaker: TBD Topic: Evaluation and Management of Sexual Dysfunction after TBI Location: Holiday Inn, Livonia, MI Speaker: Lawrence Horn, MD December 9, 2014 Location: Fleming’s Prime Steak House Topic: Promoting Universal Design to Meet Diverse Needs from 17400 Haggerty Rd., Livonia, 481522 the Home Setting to the Community RSVP to: Rabecca Plenchette at 734-732-0212 Speaker: Carrie Pilarski, Ph.D., LP, CBIS; Vicki Helson, AIA, ACHA, B Arch; Michael O’Connor, OTRL, CAPS, CBIST RINC meetings are presented the third Friday of each month. Location: Prince Conference Center, Grand Rapids, MI For more information on meetings and membership contact January 13, 2015 Adrienne Shepperd: 248-953-4079 Topic: Emotional Intelligence in the Rehabilitation Setting Speaker: Mary Newton, Ph.D., LMSW, CBIS, CCM Rainbow Rehabilitation Centers NOTICE: The conferences and events information listed on Location: Holiday Inn, Livonia, MI these pages is dated information. For the most up-to-date information on industry-related conferences and events, please visit: www.rainbowrehab.com

RainbowVisions | 21 News at Rainbow artists display work at brain injury conference Rainbow clients come from all walks of life and several have artistic backgrounds. Some take a new path during their recovery and have discovered a love and talent for art while receiving therapy at Rainbow. Rainbow U offers many classes in various artistic media. Woodshop, pottery, photography, canvas painting and fibre arts are just a few offered in 2014. These talented artists create one-of-a-kind works to be included in a drawing at the Rainbow booth during the Brain Injury Association of Michigan annual conference in September. Jamie Jamie Choate has been taking pictures all his life. “My dad did photography as a hobby, and I got interested in it in junior high school when I participated in yearbook,” he said. Jamie has recently taken photography classes in Rainbow U and finds it to be therapeutic in nature. “To me, it’s about grabbing a scene and passing it along—sharing it with someone. I like to capture the moment. “ Jamie’s favorite subjects are nature photography and portraits. He also paints in acrylics and will sometimes paint the photos that he takes.

Ashley Ashley Dixson’s previous experience with art comes from Rainbow U groups and Rainbow’s vocational program where she created beaded jewelry. Her favorite media are textiles and wood, and she loves to play with color and texture. Ashley is inventive and frequently asks, “What if I combined…?” as she begins planning her next project. When asked if making art helped with her therapy, she replied, “Yes, art makes me believe that I can do more and express myself better. My mood shows in my work. The bright colors indicate that I am happy.” Char Sobieski, a Rainbow U fibre arts instructor, indicates that Ashley has become a more confident person, “She is thoughtful, focused, creative and seeks challenges that help her grow.”

22 | RainbowVisions RainbowVisions | 23 www.rainbowrehab.com FALL 2014

Rainbow artists display work at brain injury conference Sharon Sharon Brown takes every Rainbow U art course that she can. She has participated in pottery, jewelry and woodshop classes, but her favorite is pottery. She is creating a vessel for Rainbow’s booth at the Brain Injury Association of Michigan Conference and really enjoys working with clay because she feels that it helps her hands. In addition to her Rainbow U art classes, Sharon loves to crochet, an activity she has enjoyed for many years. When asked if she has any goals for her work, she says that she’d like to try drawing. “Art makes me happy,” she said.

Nikki Nikki Markham creates artwork in many media but particularly enjoys textile art and beaded jewelry. Whether in a Rainbow U course or working on pieces at home, she loves to embellish her work with color. She is a joyful class participant and is quick to offer encouragement to her fellow artists. Nikki’s goal for her work is to become more creative and do her best to make it even better. She loves to visit museums, particularly the Chicago Institute of Art, and is intrigued by artwork that is created by animals. “Art helps create who you want to be, you can express yourself through art,” she said.

Tom Tom Sparschu was born with the ability to draw. He is a serious artist who puts a great deal of thought into his work and is very focused while he is creating. Tom regularly visits art galleries and museums. In addition to his Rainbow U art classes, he currently enjoys throwing pottery at a local art studio. An accomplished artist in 2-D and 3-D media, Tom says he never stops learning and is always seeking a new challenge for his own personal growth. Tom’s goal is to eventually sell his artwork to the public. While art is his first love, Tom also enjoys gardening, maintaining an aquarium and volunteering at a local animal shelter and conservatory.

22 | RainbowVisions RainbowVisions | 23 News at New Professionals

Coryanna Ku, MA, LPC, NCC Mental Health Counselor Coryanna works with Rainbow’s pediatric population at the Oakland Treatment Center in Farmington, MI. She earned a bachelor’s degree and Master of Arts in Professional Counseling from Eastern Michigan University. Coryanna has experience working with children at CALM Child Abuse Listening Mediation in Santa Barbara County, CA as well as Penny Lane Centers where she was a residential therapist for adolescent clients released from juvenile detention centers.

Andrea Mason, PT, DPT Physical Therapist Andrea earned a Doctor of Physical Therapy degree from Central Michigan University and a bachelor’s degree in kinesiology from Michigan State University. She is a recent graduate and performed clinical rotations at Sparrow Hospital in Lansing, MI and at Origami Brain Injury Rehabilitation Center. Andrea works with clients at several Rainbow treatment centers in Washtenaw and Oakland counties.

Kaitlin O’Hara, PT, DPT Physical Therapist Kaitlin is a recent graduate with a Doctor of Physical Therapy degree from Washington University in St. Louis. Her clinical experience includes work at TIRR Memorial Hermann Healthcare System in Houston, TX, Barnes-Jewish Hospital in St. Louis and the Rehab Institute of Michigan. Kaitlin treats clients at Rainbow’s NeuroRehab Campus® and the Farmington Hills Treatment Center, both in Oakland County.

Julie Ferry Nursing Secretary Julie joins the team at our NeuroRehab Campus® in Oakland County. She has exten- sive experience in the health care field as an office manager for Dwight Orthopedic Rehabilitation and ATI Physical Therapy. Julie completed a certificate program in medical billing from Ross Medical Education Center.

Work with Us Interested in a career with Rainbow? We welcome applications from qualified candidates for a variety of positions. To learn more, just visit: www.rainbowrehab.com/workwithus

24 | |Rainbow RainbowVisionsVisions RainbowVisions | 25 www.rainbowrehab.com FALL 2014 Rainbow Employees of the Season

Rehabilitation Assistants Spring 2014 Ann Arbor Apts: Christian Smith, Labor Pool: Diane Lee Stoney Creek: Justin Wargo, Kayci Drake Ashanda King Maple: Riad Alhakim Talladay: Mykyla Whitehurst Arbor: Ryan Miller NRC: Mercedes Mitchell, Salina Brown, Carol Textile: Andrea Martin, Debora Farrrow, Belleville: Pamela Joseph D’Angelo, Amber Watson, Antonia Starks Tanille Scott, Brianna Minor, Falisha Matthews Bemis: Janifer Eddins Page: Kristen Johnson Westmoreland: Darlene Townsend Briarhill: Glen Kurz RIPROC: Anise Chappell Woodsides: Danielle Scott, Mesha McCloud, Elwell: Janae Taylor Shady Lanes: Jacqueline Dunne, Bridgette Michael Rangel Garden City Apts: Emonda Burroughs Fox, Chenoa Mays, Christine Cervantes Ypsilanti Treatment Center: Raymond Trabulsy, Christina Dulaney, Genesee Treatment Center: Brittany Hepburn Southbrook: Kelly Goodman Jessica Lupone Spring Valley: Felicia Woods

Professional/ Therapy Residential Administrative Vickie Bey-Walker Program Manager Julie Mooring Karen Violette Ron Williams Celine DeMeyer Tomeka Beaty Rehab Techs Bonnie Tatterton Sandra Yarbrough Michelle Trojniak Christine Boujoulian Megan Fryer Sabrina Miles-Bentley Lisa Hildebrandt Kevin Michels Kelly Jarzynski Joe Wurmlinger Jenny Auty Susan Arney Amy Hocken Rehab Transportation Danyell Solomon Nicole Jeanguenat Joy Sharp Jennifer Griewahn Kate Sobbry Victoria Buggs Demetrius Kirk Cheryl Helber Vanessa Queen Heather Garavaglia

Please join us in congratulating these outstanding team members!

24 | RainbowVisions RainbowRainbowVisionsVisions || 2525 One Thousand Words

Ah, Summer Fun! It’s hard to see it go, but we still have the memories of new experiences and the benefits of therapeutic goals met. Our pediatric clients enjoyed at least one outing to area attractions each week this year. They went camping, visited the state capitol building, rooted for the Detroit Tigers and recorded their own music in a real recording studio. On this warm July day, the Oakland County group cooled off at Red Oaks Water Park in nearby Madison Heights, MI. In spite of a little trepidation, client Kevin made a big splash on the water slide. Find out more about the vast offerings of Rainbow’s Pediatric Program by calling 800.968.6644.

Toll free: 800.968.6644 E-mail: [email protected] Locations Visit: www.rainbowrehab.com GENESEE COUNTY NeuroRehab Campus® THROUGHOUT MICHIGAN Genesee Treatment Center 25911 Middlebelt Rd., Farmington Hills, MI 48336 Home Care 5402 Gateway Centre Dr., Suite B, Flint, MI 48507 T: 248.471.9580 F: 248.471.9540 T: 800.968.6644 T: 810.603.0040 F: 810.603.0044 WASHTENAW COUNTY Functional Recovery / Home and OAKLAND COUNTY Ypsilanti Treatment Center Community -Based Rehabilitation Farmington Hills Treatment Center Now Open! 5570 Whittaker Rd., Ypsilanti, MI 48197 T: 810.603.0040 F: 810.603.0044 28511 Orchard Lake Rd., Suite A T: 734.482.1200 F: 734.482.5212 Rehab Transportation® Farmington Hills, MI 48334 WAYNE COUNTY A wholly-owned subsidiary of T: 734.482.1200 F: 248.306.3197 Rainbow Corporate Headquarters Rainbow Rehabilitation Centers Oakland Treatment Center 38777 Six Mile Rd., Suite 101, Livonia, MI 48152 T: 800.306.6406 32715 Grand River Ave., Farmington, MI 48336 T: 734.482.1200 F: 734.482.3202 T: 248.427.1310 F: 248.427.1309 Two vocational treatment centers and 37 residential facilities 26 | RainbowVisions RainbowVisions | 27 www.rainbowrehab.com FALL 2014 no finerpromise of achievement… The Farmington Hills Treatment Center A full Continuum of Care including active therapy, Rainbow U day treatment, and vocational rehabilitation

FEATURING OT/PT gym Fitness facility Individual treatment space Computer lab Therapeutic kitchen and laundry Group treatment rooms Spacious activity center

to schedule a tour. Conveniently accessed by major freeways, ion or rmat info the Farmington Hills Treatment Center for m co serves residential and outpatient adults b. ha with brain injuries and spinal cord injuries. re w o b in ra @ s n o i s s i

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26 | RainbowVisions RainbowVisions | 27 Presorted Standard U.S. Postage PAID 38777 Six Mile Road, Suite 101 Permit 991 Livonia, Michigan 48152 Ypsilanti, MI

INSIDE: Post-traumatic Amnesia—Learn about this period of confusion that often follows a traumatic brain injury.

Tell us what you think about RainbowVisions! Do you have a story idea or comment? Email: [email protected]

Therapeutic

After School & Saturday Programs

Take steps to boost academic and social success Rainbow’s After School and Saturday Programs provide education and structure for children pre-school age through adolescence who have experienced a traumatic brain injury. Discover the program developed by pediatric rehabilitation specialists to be therapeutic, safe and fun.

Now offered in Oakland and Genesee Counties 800.968.6644