There is a growing body of literature implicating TBI in the development of substance use problems and, in our lab, we have reliably demonstrated that mild head injuries (MHIs) and injury-related disruptions in physiological arousal and affective regulation can be linked to post-injury substance use, including both alcohol and cannabis, at a level much higher than that of their non-injured cohort. Dampened anticipatory and autonomic activation has been shown to negatively impact decision-making, learning, emotional reactivity and mental fatigue. An inability to expect or anticipate negative consequences of substance use, or learn from or react to these consequences, increases the risk for misuse, and vice versa. These issues are explored in this session.

Join Aleks Mladenovic from Thomson Rogers, Kevin Henderson from Oatley Vigmond and Nick Todorovic from McLeish Orlando, the founding firms of PIA, Law for an interactive session for all experts, health care professionals and those who may be called to testify, regardless of level of experience.

This engaging presentation will describe the evidence-based benefits of yoga and meditation for rehabilitation from acquired brain injury (ABI) and guide participants through examples of brain injury-friendly yoga and meditation practices. Yoga has been shown to improve physical, cognitive, and psychosocial outcomes in a range of clinical populations, yet has not been used widely among the ABI population. The LoveYourBrain Foundation is changing this paradigm through an evidence-based yoga with psychoeducation program for people with traumatic brain injury (TBI) and their caregivers. This program includes a free six-week yoga series following a manualized curriculum designed to foster resilience and community reintegration. Each class integrates breathing exercises, gentle yoga, guided meditation, and group discussion. LoveYourBrain has partnered with and trained 60 yoga studios and 20 healthcare facilities across North America to deliver this program. To date, the LoveYourBrain Yoga program has offered 372 programs across North America, reaching 3,171 people with TBI and caregivers. Participants self-reported diverse injury severity (i.e., mild (39%), moderate (27%), and severe (33%)) and symptoms and comorbidities, including light sensitivity (44%), persistent post-concussion symptoms (30%), and PTSD (15%). Research demonstrated that 705 people with TBI in the LoveYourBrain Yoga program experienced statistically significant improvements in quality of life from baseline (M = 44.9 (SD = 17.6) to M = 54.6 (SD = 17.6), p < 0.0000) to post-series (53.1 SD=18.6, p < 0.001),

There are many causes of a mild traumatic brain injury (MTBI) or concussion, including motor vehicle accidents, slip and falls, sport injuries, domestic abuse and assault. Each type of injury brings with it unique bio-psycho-social issues, as well as, possible but different, physical injuries that must be addressed in the process of implementing protocols for concussion management.

The Ontario Neurotrauma Foundation, the Canadian Concussion Centre and Echo Ontario have promoted the importance of integrating research findings and evidence-based guidelines into clinical practice for improved concussion management. Those recommendations emphasize the importance of early diagnosis and treatment. However, many individuals who have sustained an MTBI do not access care until months or even years have passed since their injury. By that time, the health practitioner is faced with a very complicated and confusing clinical picture. They need to separate and delineate many factors, including age and lifestyle, premorbid physical or medical factors, biopsychosocial issues, as well as the possible effect of their patient being involved in medico-legal or disability systems. This situation creates daunting challenges for health practitioners who are responsible for developing a comprehensive rehabilitation program in a community- based setting while also being aware of established guidelines and timelines.

This presentation comes from the perspective of an experienced physiotherapist who will focus on ensuring that the effects of residual physical injuries are being adequately addressed within a person’s concussion care. She will share her very client-centered perspective on developing individualized treatment plans, as well as treatment strategies that enhance patients’ ability to better understand their persistent pain or other unpleasant sensations (e.g., dizziness, nausea) so that they can be become more actively engaged in their treatment and their own self-management. Numerous resources that she has developed which contain practical and patient-friendly advice on living well after injury will also be shared.

Rachel has written several books: "Really, I’m Fine - A Humourous Look at Recovery," "Up - Rebuilding My Life With Humour," and, "Caregiving - Practical Advice From The Trenches" with Mary Solomon, MRSc.

Katie draws from her experiences as a survivor and as a professional to provide insight and wisdom to other survivors, families and caregivers, as well as other professionals. This presentation is not only from Katie’s perspective, but also her family, friends, and coworkers, as the impact of Katie’s brain injury affects all those who know and love her (and even those who don’t)!

In 1981, Rachel moved to a farm near Owen Sound where she published two cartoon books about horse racing, and won awards for her silk painting. Her horse cartoons adorned a line of t-shirts, cards, memo pads and calendars which were sold in 50 stores. Rachel found that a 5km morning jog helped her focus on her creative work. While jogging on May 6, 1997 she was hit by a car and her whole life changed. Airlifted to London, she spent five days in a coma. Metal rods and pins were put in both legs and arms. In June, she was sent to the rehab center at the hospital in Owen Sound to continue her long recovery. Through perseverance, a positive attitude, and many months of therapy, Rachel regained her ability to walk, speak, and conduct her life independently.

Katie received her Bachelor of Therapeutic Recreation and minor in Psychology from Brock University in 2012. While working on her degree, Katie was struck by a car as a pedestrian, sustaining a traumatic brain injury. Through her recovery she used herself as a case study to learn about brain injury and recovery, in order to understand other survivors’ needs. Katie has since worked and volunteered in various capacities in the ABI community for 15 years. She is now Coordinator for the Personal Effectiveness Training Program for Brain Injury Community Re-Entry in Niagara, and truly enjoys helping others live their best life. Passionate about advocacy, brain injury awareness, and education, Katie has spoken on several occasions including awareness events, webinars, ABI training, and a co-presentation with her clinical psychologist.

A re-emergence of creativity through Meditation, Yoga and Painting has elevated my response to various rehab treatments, taking me to the next level in my ABI recovery. These creative modalities stimulated a new flow of growth and opportunity; they have been powerful clinical tools, not hobbies. In tandem with my therapists, those creative explorations continue to expand my horizons, replenish my repertoire of tools and elevate me to the next level of recovery, which I am eager to share!

The purpose of this presentation is to provide a framework for the development of positive, personal, and meaningful supports for individuals with complex needs. Included in this framework are methods for developing supports that focus on meaningful engagement in chosen life activities, creating positive personal identities, and the development of scripts for positive interaction. Moreover, the reality of any successful intervention requires those who provide supports to be flexible when developing supports and to include each individual in determining what helps and what doesn’t help and then to be planful in making whatever adjustments might be needed to increase the success of any supports.

Sleep is an often ignored and undertreated area of functioning after ABI. Quality sleep helps you think clearly, feel alert, and function at your best in all areas: cognitively, physically, and emotionally. Most, if not all persons who sustain an ABI, complain of disrupted sleep, often for many years post-injury. Cognitive Behaviour Therapy for Insomnia (CBT-I) could lead to significant improvements in sleep efficiency and overall quality of life and is proven to be more effective than sleep hygiene alone. Using the protocol with persons with ABI requires special considerations, especially if co-occurring conditions of mood disturbance or pain are present. Obtaining quality sleep should form the basis of any rehabilitation program and the strategies can be implemented in a relatively short-term intervention. Learn the basics about how to apply this evidence-based protocol to the ABI population in this practical workshop and rest easy at night knowing your clients are too!

Tim Feeney is the Chief Knowledge Officer for Belvedere Health Services in Albany, NY and the Founder and Director of the Mill School in Winooski, Vermont. Tim has assisted numerous agencies around the world in the development of system-wide changes in order to provide sustainable, high quality, and cost-effective educational and rehabilitation services. He has authored over 75 journal articles and book chapters, is co-author, with the late great Mark Ylvisaker, of the book Collaborative Brain Injury Intervention: Positive Everyday Routines, and happily talks to anyone who’s interested about collaborative services designed to support individuals with complex needs. All of Tim’s degrees are in psychology and he hopes that you don’t hold this against him.

The discussion will focus on the definition of Concussion/MTBI in 2021. It will include information on post-concussion syndrome and in particular the physiology and management of PCS. We will also review in detail the new diagnostic tools in concussion, such as Quantitative Electroencephalogram (qEEG) and Single Photon Emission Computed Tomography (SPECT their medico-legal implications.

This presentation will highlight two consecutive projects that aim to assist justice-involved persons with ABI throughout Ontario. The first is an educational awareness toolkit and the second is a practical, functional ABI support program. We will share this model, the tools and the training materials we created in an effort to continually expand this work. The Legal Education Awareness Project (LEAP) is an initiative funded by the Law Foundation of Ontario that has created increased awareness, education, and online tools to improve the barriers and service gaps for individuals with brain injury involved in the criminal justice system. This project has been rolled out across Ontario and has received acclaim for its ability to provide an easily accessible tool that meets this need. This project was created in collaboration with legal professionals, experts in brain injury and individuals with lived experience. The ABI Justice, a Functional Support Initiative funded by the Ontario Neurotrauma Foundation, was co-created by the Brain Injury Associations of Toronto and North Bay. It provides support to persons with ABI to increase equitable justice when navigating the judicial system. This results in a reduction of missed appointments/court dates, an increase in supporting documentation, and a clearer understanding of the judicial process. This program also increases education to legal professionals on the challenges and barriers faced by this population. This project serves to provide functional support, increased advocacy, and awareness to provide individuals with ABI equitable and accessible support within the broader community and a criminal justice context. Results and learnings of this initiative will be shared.

A review of the research on menstrual cycle changes post all severities of TBI will be reviewed. This existing research inspired further work into the relationship between TBI and the influence on menopausal timing, best assessed using anti-Müllerian Hormone (AMH) serum samples The results from a preliminary case series exploring AMH levels in community-dwelling women following TBI will be reviewed. In addition, the relation of AMH to the menstrual cycle, cognition, distress, symptoms of menopause and the need for more research will be discussed.

To support family caregivers and help them mitigate the steep learning curve required to understand ABI, the Ontario Brain Injury Association (OBIA) secured funding through a Ministry of Health grant to co-create a caregiver educational support program. In this presentation, we will introduce Support, Hope & Resiliency: An Education and Training Program for Caregivers of Acquired Brain Injury Survivors. We will: 1) describe the partnership approach that OBIA employed with caregivers, clinicians and researchers to co-design a caregiver education workshop, 2) propose a model of caregiver engagement and co-design from the perspective of a Parent Caregiver, a Caregiver Education Specialist, and a Clinician/Researcher, 3) describe the content and interactive nature of the educational workshop, and, 4) share the creation of the “Caregiving After Brain Injury,” an online platform that is sustaining the work of OBIA and its partners in this project.

Based on more than a decade of research, my lab founded the Telerehabilitation Centre for Acquired Brain Injury in 2017, which integrates clinical care with research for patients across Ontario. Through participation in research to refine existing treatments and develop novel cognitive and mood interventions, we remotely treat underserviced patients in their own homes. Patients/participants include people living with traumatic brain injury (moderate/severe; post-concussion syndrome; multiple concussions), non-traumatic brain injuries (e.g., stroke, hypoxia), and multiple sclerosis. This talk will provide an overview of the Centre's research, clinical care and vision for the future.

Dr. Robin Green is a Clinical Neuropsychologist and senior scientist in cognitive neurosciences at University Health Network - Toronto Rehab, and the Saunderson Chair in Acquired Brain Injury. Dr. Green's program of research addresses brain and behavioural mechanisms of recovery from TBI. Her lab has focused on neural, cognitive and mood functioning in the chronic stages of mild to severe brain injury, in order to develop evidence-based treatments. The lab has identified novel, modifiable (i.e., treatable) targets, and has developed mechanism-based treatments to prevent declines in chronic brain injury and improve cognitive, mood and emotional functioning. Her lab has focused more recently on the development of novel interventions for concussion, and for long-COVID. Dr. Green completed her PhD at Cambridge University and her clinical neuropsychology training at UHN in Toronto.

This presentation will explore the importance of anti-Black racism when providing services and treatment to individuals who have experienced an ABI. Drawing on our lived experiences as Black clinicians working in ABI rehabilitation and founding members of the Ontario Rehabilitation Alliance Black Network (ORABN), we will explore how anti-Black racism is manifested in professional practice and the delivery of rehabilitation treatment and services. In so doing, offer insights and actions that all ABI clinicians and service providers can take in their daily practice to address anti-Black racism, promote cultural competency, and advocate for equality and inclusion.

Prior to the pandemic, Parkwood Institute's ABI Outpatient Program ran six BrainEx 90 OT/PT treatment groups of seven individuals with persistent symptoms after mTBI each per week. BrainEx 90 is designed as a 16-week group where patients move through a circuit of different stations addressing balance, vision, vestibular, cognition, self-management and education. When safety measures due to COVID-19 led to the cancellation of BrainEx 90, it significantly restricted the number of patients we could offer services to. When the restrictions showed no signs of lifting, the team decided to figure out a way to provide a modified version of this intervention in a virtual format. This talk will discuss the decisions and rationale in developing the virtual group and share the challenges and barriers we found and how we navigated them. We will outline how we structure and run the virtual group from intake to evaluation and demonstrate some of our virtual treatment stations and highlight the benefits of this new model.

Based on more than a decade of research my lab founded the Telerehabilitation Centre for Acquired Brain Injury in 2017, which integrates clinical care with research for patients across Ontario. Through participation in research to refine existing treatments and develop novel cognitive and mood interventions, we remotely treat underserviced patients in their own homes. Patients/participants include people living with traumatic brain injury (moderate/severe; post-concussion syndrome; multiple concussions), non-traumatic brain injuries (e.g., stroke, hypoxia), and multiple sclerosis. This talk will provide an overview of the Centre's research, clinical care and vision for the future.

Dr. Robin Green is a Clinical Neuropsychologist and senior scientist in cognitive neurosciences at University Health Network - Toronto Rehab, and the Saunderson Chair in Acquired Brain Injury. Dr. Green's program of research addresses brain and behavioural mechanisms of recovery from TBI. Her lab has focused on neural, cognitive and mood functioning in the chronic stages of mild to severe brain injury, in order to develop evidence-based treatments. The lab has identified novel, modifiable (i.e., treatable) targets, and has developed mechanism-based treatments to prevent declines in chronic brain injury and improve cognitive, mood and emotional functioning. Her lab has focused more recently on the development of novel interventions for concussion, and for long-COVID. Dr. Green completed her PhD at Cambridge University and her clinical neuropsychology training at UHN in Toronto.

Rachel has written several books: "Really, I’m Fine - A Humourous Look at Recovery," "Up - Rebuilding My Life With Humour," and, "Caregiving - Practical Advice From The Trenches" with Mary Solomon, MRSc.

In 1981, Rachel moved to a farm near Owen Sound where she published two cartoon books about horse racing, and won awards for her silk painting. Her horse cartoons adorned a line of t-shirts, cards, memo pads and calendars which were sold in 50 stores. Rachel found that a 5km morning jog helped her focus on her creative work. While jogging on May 6, 1997 she was hit by a car and her whole life changed. Airlifted to London, she spent five days in a coma. Metal rods and pins were put in both legs and arms. In June, she was sent to the rehab center at the hospital in Owen Sound to continue her long recovery. Through perseverance, a positive attitude, and many months of therapy, Rachel regained her ability to walk, speak, and conduct her life independently.

Sexual issues are common after a traumatic brain injury (TBI). However, in Central Canada, rehabilitation teams rarely include sex therapists. Without a specific professional obligation, addressing post-TBI sexual concerns lies on the shoulders of both everyone and no one. This presentation will highlight potential solutions to implement a discussion on the subject during rehabilitation and to promote positive sexual health outcomes. I will also share the lessons I have learned from collaborating with individuals with moderate to severe TBI in creating information tools on sexuality.

Sexual issues are common after a traumatic brain injury (TBI). However, in Central Canada, rehabilitation teams rarely include sex therapists. Without a specific professional obligation, addressing post-TBI sexual concerns lies on the shoulders of both everyone and no one. This presentation will highlight potential solutions to implement a discussion on the subject during rehabilitation and to promote positive sexual health outcomes. I will also share the lessons I have learned from collaborating with individuals with moderate to severe TBI in creating information tools on sexuality.

Pascale first studied in social work at the Université de Montréal. By acquiring field experience as a social worker, she gained perspective on the possibilities for alliances between research and clinic to improve the quality of interventions and care. She started working as a research coordinator in 2009 and she collaborated on various projects, first on strategies to support families raising children with disabilities, and then on the development of a clinical practice guideline and the creation of implementation tools. As her interest in knowledge translation grew stronger, she completed a Master’s degree in clinical and biomedical sciences at Laval University. She now pursues her doctoral studies in the same field.

Pascale first studied in social work at the Université de Montréal. By acquiring field experience as a social worker, she gained perspective on the possibilities for alliances between research and clinic to improve the quality of interventions and care. She started working as a research coordinator in 2009 and she collaborated on various projects, first on strategies to support families raising children with disabilities, and then on the development of a clinical practice guideline and the creation of implementation tools. As her interest in knowledge translation grew stronger, she completed a Master’s degree in clinical and biomedical sciences at Laval University. She now pursues her doctoral studies in the same field.

Tim Feeney is the Chief Knowledge Officer for Belvedere Health Services in Albany, NY and the Founder and Director of the Mill School in Winooski, Vermont. Tim has assisted numerous agencies around the world in the development of system-wide changes in order to provide sustainable, high quality, and cost-effective educational and rehabilitation services. He has authored over 75 journal articles and book chapters, is co-author, with the late great Mark Ylvisaker, of the book Collaborative Brain Injury Intervention: Positive Everyday Routines, and happily talks to anyone who’s interested about collaborative services designed to support individuals with complex needs. All of Tim’s degrees are in psychology and he hopes that you don’t hold this against him.

The purpose of this presentation is to provide a framework for the development of positive, personal, and meaningful supports for individuals with complex needs. Included in this framework are methods for developing supports that focus on meaningful engagement in chosen life activities, creating positive personal identities, and the development of scripts for positive interaction. Moreover, the reality of any successful intervention requires those who provide supports to be flexible when developing supports and to include each individual in determining what helps and what doesn’t help and then to be planful in making whatever adjustments might be needed to increase the success of any supports.