MARCH 2015 • VOLUME 22 • ISSUE 1 Sports and ABI EDUCATION: AWARENESS: SUPPORT: Concussion Guidelines for Parents & Caregivers pg 36 Study of Former NFL Players Reveals Specifics of Concussion Brain Damage pg 10 Survivor Story - Having a Brain Injury Didn’t Break my Funny Bone pg 31 OBIA REVIEW 2 MARCH 2015 BOARD OF DIRECTORS President Barbara Claiman Treasurer Brad Borkwood Corporate Secretary Dr. Debby Vigoda Directors Alice Bellavance Dr. Sheila Bennett Sabrina Chagani Maria Hundeck Nancy Nicholson Veronica Pepper Hazel Wood OAC Representatives Wendy Charbonneau Mary Lou Dalaire Tim Slykhuis Dr. Mary-Ellen Thompson INSIDE THIS ISSUE Awareness: Study of former NFL Players Reveals Specifics of Concussion Brain Damage 10 Education: Concussion Guidelines for Parents & Caregivers 36 Support: Survivor Story Having a Brain Injury Didn’t Break My Funny Bone 31 OBIA STAFF 905-641-8877 1-855-642-8877 Toll-Free Support Line: 1-800-263-5404 Executive Director Ruth Wilcock ...#238 Associate Director Tammy Dumas ...#240 Financial Controller Gail Coupland ...#230 Advocacy Specialist Katie Muirhead ...#229 Support Services Specialist Carla Thoms ...#227 Admin. Services Coordinator Terry (Wilcox) Bartol ...#234 Training & Admin. Assistant Diane Dakiv ...#231 Communications & Program Assistant Kimberly Butcher ...#224 I.T. Consultant Steve Noyes ...#232 Special Projects Assistant/ OBIA Review Editor Jennifer Norquay ...#242 Also Inside Ruth’s Desk .............................................................................4 Public Policy: Ministry of Education Concussion Policy .......................................7 In the News: New Partnership Sets a New Standard for Concussion and Education ...................................................... 13 New at the Bookstore ..............................................................17 Parents Struggle to Keep Their Heads in the Game ....................19 Across the Province ................................................................25 Survivor Stories: Having a Brain Injury Didn’t Break My Funny Bone ....................31 Concussion Guidlines for Parents & Caregivers...........................36 Events Calendar .....................................................................40 Community Associations ..........................................................42 Provincial Associations ............................................................46 OBIA Training: Advanced Brain Injury Rehabilitation (Level Two) .......................48 VISIT www.obia.ca Connect with us! EMAIL obia@obia.on.ca Copyright 2015, PUBLICATIONS MAIL AGREEMENT NO. 40005485 RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: Ontario Brain Injury Association, PO Box 2338 St. Catharines, ON L2R 7R9 Ph: 1-800-263-5404 (support) 1-855-642-8877 or 905-641-8877 Fax: 905-641-0323, E-mail: obia@obia.on.ca Registered as a Canadian Charitable Organization Reg. #10779 7904RR0001 3 OBIA REVIEW AWARENESS The societal attitude particularly in sports needs to continue evolving not only in the understanding of concussions but the treatment as well. RUTH S DESK Concussions - No Laughing Matter For many years, Curly, Larry and Moe (from the smash TV hit The Three Stooges) brought laughter to countless people with their outrageous physical antics. Poor Curly, seemed to be the one always getting a plethora of slaps, punches and bonks on the head. However, on television, bonks on the head were not limited to The Three Stooges. As a child I remember watching cartoons, such as The Bugs Bunny/ Road Runner Hour, the Flintstones and Scooby Doo to mention a few. In all of the cartoons, there was never an absence of hits on the head with the character seeing stars or birds twirling in circles over their heads. This attitude towards being hit on the head was not limited to fictional characters. Until recently, many athletes who sustained concussions, simply referred to them as “a bump on the head,” or laughed it off by saying “I got my bell rung.” What these players sustained was a concussion, which is a brain injury and is no laughing matter. By Ruth Wilcock Executive Director, OBIA 4 The good news is that things are slowly beginning to change. Most noticeably, attention to concussion was brought to the forefront when Sidney Crosby (Canada’s star Olympic hockey player and NHL’s leading scorer) sustained a serious concussion, sidelining him for over 11 months. Sports teams, both professional and minor are beginning to develop and implement concussion protocols. However, the ingrained attitude to play tough and through the pain still permeates the culture of sports. What is so disconcerting is that this attitude is not only prevalent with professional athletes, but also in the sports that our children engage in. This point was driven home to me when I came across the slogan of a young boy’s hockey team. I was out for dinner on a weekend, when a hockey team comprised of about 20 boys, around the ages of 9 and 10 descended upon the restaurant. Each boy was proudly wearing his hockey jersey with the team’s name on the front and its slogan on the back. The slogan which each young boy so proudly sported was “Pain is Weakness Leaving the Body.” I found this slogan to be greatly troubling. These young people are immersed in a sports culture that continues to promote pain as a badge of honour. Furthermore, this attitude may contribute to the player’s unwillingness to be forthright about their injuries. This particularly Politics: runoff election likely a MARCH 2015 applies when it comes to a concussion/ brain injury which many times has no outward physical signs, unlike a broken arm or leg. The societal attitude particularly in sports needs to continue evolving not only in the understanding of concussions but the treatment as well. OBIA was a part of the expert panel of the Ontario Neurotrauma Foundation’s development of Guidelines for Pediatric Concussion and also the Guidelines for Concussion/ mTBI & Persistent Symptoms. These guidelines are essential for understanding the management and treatment of concussions for both adults and children. schools. OBIA also continues to provide support to those who have sustained concussions. Over the past several years we have seen a substantial increase in calls from parents, coaches and teachers regarding concussions. We do attribute the increase in calls to the increased awareness about concussions. As a society and more specifically those of us who work in the field of brain injury or are persons living with brain injury, we must all work together to initiate societal attitude change towards concussions. Concussions are serious. A concussion is a brain injury. Concussions are not a laughing matter. ◊◊◊ Also, in an effort to bring education and awareness to the seriousness of concussions, OBIA has developed two new concussion booklets, one for Adults and one for Children and Youth. Already, the booklets have been proven to be useful in different settings including #SaveYourBrain OBIA’s Online Bookstore A great selection of Books, DVDs, and Manuals for professionals, survivors and family members. Visit www.obia.ca OBIA’s Concussion Booklets Information includes: • • • • • • • • • What is a Concussion? Anatomy of a Concussion. Symptoms. What Should I do? How Long Will it Take to Feel Better? When Can I Go Back to Work, School, Play, Activity? What is Second Impact Syndrome? Where Can I Get Help? Resources. To receive a copy of this brochure, or if you need further information on concussion, contact: 1.800.263.5404 support@obia.on.ca 5 OBIA REVIEW Providing direct therapy, transitional support and community integration to children, youth, adults and seniors recovering from an acquired brain injury and/or serious trauma. www.bartimaeusrehab.com 1-877-542-9990 Setting the standard of excellence in Rehabilitation Support Workers since 1988 Memory Loss When you need support to EHZKR\RXDUH3DWKZD\V can help you to LIVE with an $FTXLUHG%UDLQ,QMXU\ “ I love being a part of this club. I love the shopping, theatre, and all the activities. I’ve met some of my very best friends here ” —“K. B.” Supported Client in Pathways Family Home program “ to Independence Acquired Brain Injury Services Accredited by the Commission for the Accreditation of Rehabilitation Facilities (CARF), Pathways to Independence specializes in providing community based living services and programs to people living with an ABI. Pathways ABI programs and services are tailored to accommodate client needs and provide a continuum of care. Pathways works closely with every client to develop a Depending upon the nature of the brain injury, these supports may include: I like that I have a place to go where I feel safe and comfortable ” — “B. B.” Supported Client at Pathways Club ABI 24 hour Supported Homes Family Homes Respite Services ABI day programs Employment Supports Behaviour Management 5HDFKRXWWRXVWRÀQGRXWPRUHDERXW3DWKZD\V$%,6HUYLFHV : 289 Pinnacle St., Belleville, ON K8N 3B3 T 613.962.2541 F 613.962.6357 356 D Woodroffe Ave., Ottawa, ON K2A 3V6 T 613.233.3322 6 service plan that supports a person’s rehabilitation and reintegration to the community following a brain injury. In addition to assisting with activities of daily living, Pathways employees actively work with the client to access social networks and community partners to develop and support the implementation of a person’s individualized service plan. Psychological & Psychiatric Services Legal Services Medical and Wellness Support such as Physiotherapy, Speech Therapy, Occupational Therapy, Nursing, Dietician www.pathwaysind.com MARCH 2015 AWARENESS PUBLIC POLICY Ministry of Education Concussion Policy By Katie Muirhead, OBIA Support Services Research indicates that a concussion can have a significant impact on a student – cognitively, physically, emotionally and socially. Macpherson et al, 2014 suggest that 754/100,000 boys and 440/100,000 girls sustain a concussion per year in Ontario. More and more students are reporting concussions occurring at school and outside of school time during extra-curricular activities. In some cases these injuries are not being responded to in the best way possible and students and families are left with little support and direction to help them on the road to recovery. With this growing health concern, the Ministry of Education felt that it was important to address this problem and implement a policy on concussion management and supports within school boards across Ontario. On March 19, 2014 the Ministry of Education released Policy/Program Memorandum (PPM) 158. The implementation of a policy on concussion across the 72 school boards is an important step in creating healthier schools in Ontario. It also reinforces the knowledge, skills and attitudes regarding injury prevention that are developed through the various subjects and disciplines in the Ontario curriculum. Ontario is the first province to have implemented such a policy. “The Ministry of Education expects all school boards in Ontario to develop and maintain a policy on concussion. The purpose of this memorandum is to provide direction to school boards on the development and implementation of their policy. This memorandum outlines the ministry’s expectations regarding the components of a board’s policy on concussion. The components include strategies to develop awareness of the seriousness of concussions; strategies for the prevention and identification of concussions; management procedures for diagnosed concussions; and training for board and school staff.” (Ministry of Education, PPM 158) Important features of these policies include the removal of a student immediately from an activity if a concussion is suspected and also the importance of returning to academics (Return to Learn) prior to returning to any sports environment (Return to Play). Recommendations coming from organizations like Parachute Canada, OPHEA and the mTBI/Concussion Pediatric Guidelines from the Ontario Neurotrauma Foundation (ONF) support this approach. It is also important to note that these policies do not place educators in the role of making any diagnosis of concussion, but create 7 OBIA REVIEW systems by which a student would need to be evaluated by a medical expert. It can be challenging to find a doctor with this specific knowledge, but many school boards have partnered with doctors in their area of the province to provide that information and oversight. Full implementation of these policies were expected no later than January 30, 2015. School Boards across Ontario all had different processes for the development and implementation of their policy. OBIA was pleased to be invited to be a part of the Toronto District School Board (TDSB) public consultation process. The TDSB held 4 separate consultations across the GTA. Along with experts in the field, including Dr. Charles Tator, Dr. Paul Comper and Dr. Michael Hutchison, OBIA presented information to help inform the parents, students, teachers and the general public of the facts of concussion including what supports are available for those who have been affected. 8 As OBIA is an organization that believes strongly in awareness and education on acquired brain injury (ABI), it is exciting to note that for many boards this element of school curriculum will also be included. This would provide students and teachers with an opportunity to learn about concussion and brain injury before it happens. Through our toll free support line, we speak to many people who, before their injuries, had no knowledge of what a concussion was, or how much it could potentially affect their lives. This curriculum component will help to arm people with the necessary information before an injury occurs, hopefully helping to identify a concussion and receive treatment and support faster. For more information about the Ministry of Educations PPM 158 go to: http://www. edu.gov.on.ca/extra/eng/ppm/158.pdf. You may also contact your local school board to see the work that they have done to try to manage concussions better in their school system and how they support their students. ◊◊◊ Brain Fast Facts DID YOU KNOW? • 63% of those who incurred a sports-related brain injury were male • 28% of ABI survivors are not satisfied with their ability to participate in activities in the community such as clubs, sports, churches • 5% of respondents indicated that their brain injury was sports related - 2012 OBIA Impact Report OBIA REVIEW AWARENESS Study of former NFL Players Reveals Specifics of Concussion Brain Damage Research results support calls for better player protections Release Date: January 26, 2015 Reprinted with permission from Johns Hopkins University A team of Johns Hopkins specialists, using a battery of imaging and cognitive tests, has gathered evidence of accumulated brain damage that could be linked to specific memory deficits in former National Football League (NFL) players experienced decades after they stopped playing the game. Results of the small study of nine men provide further evidence for potential long-term neurological risk to football players who sustain repeated concussions and support calls for better player protections. “We’re hoping that our findings are going to further inform the game,” says Jennifer Coughlin, M.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “That may mean individuals are able to make more educated decisions about whether they’re susceptible to brain injury, advise how helmets are structured or inform guidelines for the game to better protect players.” Several anecdotal accounts and studies have suggested that athletes, such as collegiate and professional football, hockey, and soccer players, exposed to repeat concussions could suffer 10 permanent brain damage and deficits from these events. However, the mechanism of damage and the source of these deficits have been unclear. To reveal them, Coughlin; Yuchuan Wang, Ph.D., assistant professor of radiology and radiological science at the Johns Hopkins University School of Medicine; and their colleagues used tests to directly detect deficits and to quantify localized molecular differences between the brains of former players and healthy people who didn’t play football. The researchers recruited nine former NFL players who retired decades ago and ranged in age from 57 to 74. The men had played a variety of team positions and had a wide range of self-reported, historical concussions, varying from none for a running back to 40 for a defensive tackle. The researchers also recruited nine age-matched “controls” — healthy individuals who had no reason to suspect they had brain injuries. Each of the volunteers underwent a positron emission tomography (PET) scan, a test in which an injected radioactive chemical binds to a specific biological molecule, allowing researchers to physically see and measure its presence throughout the body. In this case, the research team focused on the translocator protein, which signals the degree of damage and repair in the brain. While healthy individuals have low MARCH 2015 levels of this protein spread throughout the brain, those with brain injuries tend to have concentrated zones with high levels of translocator protein wherever an injury has occurred. The volunteers also underwent MRIs, which allowed the researchers to match up the PET scan findings with anatomical locations in the volunteers’ brains and check for structural abnormalities. In addition, they took a battery of memory tests. While the control volunteers’ tests showed no evidence of brain damage, PET scans showed that on average, the group of former NFL players had evidence of brain injury in several temporal medial lobe regions, including the amygdala, a region that plays a significant role in regulating mood. Imaging also identified injuries in many players’ supramarginal gyrus, an area linked to verbal memory. evidence among just nine former NFL players suggests that there are molecular and structural changes in specific brain regions of athletes who have a history of repetitive hits to the head, even many years after they’ve left active play. The researchers are currently looking for translocator protein hotspots in both active and recently retired players to help determine whether these changes develop close to the time of play or whether they’re a result of a more delayed response to injury with similarities to other degenerative brain disorders. If these findings are seen in studies with larger numbers of participants, they say, use of this molecular brain imaging technique could eventually lead to changes in the way players are treated after experiencing concussion or how contact sports are played. While the hippocampus, an area that plays a role in several aspects of memory, didn’t show evidence of damage in the PET scans, MRIs of the former players’ brains showed atrophy of the right-side hippocampus, suggesting that this region may have shrunk in size due to previous damage. Other Johns Hopkins researchers who contributed to this study include Cynthia A. Munroe, Shuangchao Ma, Chen Yue, Shaojie Chen, Raag Airan, Pearl K. Kim, Ashley V. Adams, Cinthya Garcia, Cecilia Higgs, Haris I. Sair, Akira Sawa, Gwenn Smith, Constantine G. Lyketsos, Brian Caffo and Martin G. Pomper. Additionally, many of the NFL players scored low on memory testing, particularly in tests of verbal learning and memory. This project was funded in part from financial support from the following National Institutes of Health grants and foundations: NIH 5R21MH082277, NIH 5R01MH092443, NIH R01EB012547, NIEHS ES007062, NIH 5T32 EB006351, NIH P50AG005146, the Lupus Foundation of America, NFL Charities and the GE/NFL Head Health Challenge. ◊◊◊ Though the researchers emphasize that this pilot study, published in the February 2015 issue of the journal Neurobiology of Disease, is small in size, they say that the Canada-wide serious injury care with a local “touch” Bayshore HealthCare delivers a wide range of nursing and attendant care to people with serious injuries, helping them regain their daily lives and maintain quality living within their community. Our nurses are specially trained to care for clients who need advanced clinical care, while our personal support workers perform many delegated tasks for individuals with catastrophic and non-catastrophic injures. They are supported by internal clinical experts and our Managed Care Team – a convenient, central contact point for workers’ compensation boards, insurers and government care programs, providing individualized care plans, standardized client reporting and timely service. With 60-plus offices across Canada, we also offer a local “touch” when it comes to professional care for people with serious wounds, fractures, amputations and spinal cord/acquired brain injuries. To learn more, please call 1.877.289.3997 www.bayshore.ca ISO 9001 HealthCare Quality Management System Registered Company 11 OBIA REVIEW podemos ayudarle. pwede kaming tumulong. chúng tôi se ~ giúp. As Toronto’s largest ethnic personal injury law firm, speaking 24 languages, we are dedicated to ensuring our clients receive the rehabilitation and fair compensation they deserve, in a language they understand. At Carranza, many of us are first or second generation Canadians who are able to provide expert legal representation in multiple languages. Not only can we help overcome the language barrier, but we can also assist with many of the cultural issues that may arise throughout treatment and recovery. No matter how you say it, “we can help.” 416.633.1065 ƀ 1-877-633-1065 www.carranza.on.ca 12 MARCH 2015 AWARENESS IN THE NEWS New partnership sets a new standard for concussion and education http://communications.uwo.ca/media/releases/2014/August/new_ partnership_sets_a_new_standard_for_concussion_research_and_ education.html A new partnership announced today aims to help understand and mitigate the long-term effects of concussion. The partnership makes Western University’s Schulich School of Medicine & Dentistry the new home for the Canadian chapter of the Sports Legacy Institute (SLI Canada). Combining Western University’s leading expertise in medical research and education, with SLI Canada’s established reputation for concussion awareness, sets a new standard for the quality of education, research and healthcare related to concussions in sport. “No other institution in Canada has such a broad range of experts dedicated to solving the problem of sports-related concussion,” said Tim Fleiszer, Executive Director of SLI Canada. “This partnership with Schulich Medicine & Dentistry will enable us to join together to operate outstanding education and prevention programs and perform cutting-edge research. This is a big step towards solving the concussion crisis in Canada.” Established in 2012, SLI Canada is the first international chapter of the Boston-based Sports Legacy Institute. SLI Canada operates prevention, education and awareness programs across the country, including the SLI Community Educators (SLICE) program which teaches student-athletes about the dangers of head injuries. The Sports Legacy Institute is also world-renowned for its Brain Bank, a resource for researchers to study the donated brains of athletes in order to investigate the long-term effects of head trauma. Working in partnership with the Schulich School of Medicine & Dentistry, SLI Canada aims to advance the study, treatment and prevention of the effects of brain trauma in Canadian athletes and other at-risk groups. “Together with SLI Canada, we will be able to further build on the leading-edge work we are doing in this area,” said Dr. Michael J. Strong, Dean, Schulich School of Medicine & Dentistry. “This collaboration makes us uniquely positioned to lead the way in concussion education and research.” Schulich Medicine & Dentistry and its partners at Robarts Research Institute, Lawson Health Research Institute, its affiliated hospitals and the Fowler Kennedy Sport Medicine Clinic, are home to a dedicated group of individuals who are investigating a range of concussion-related questions. These initiatives include the development of therapeutic strategies to better understand the short- and long-term effects of concussion, and how we might better establish clinical indicators to determine when an injured athlete can safely return to play. This new partnership was announced today as part of See the Line. See the Line is a one-of-a-kind education, awareness and fundraising initiative that combines the cumulative experience of world-class acute sport concussion clinical care and research leaders in London, with the aim of reducing the incidence of concussion, improving care through research, and educating athletes, coaches and parents about the serious impact of concussions. The initiative includes a continuing medical education component, public symposium and a fundraising gala, which this year celebrates Fowler Kennedy Sport Medicine Clinic’s 40 years of leadership and pioneering excellence in the field of sport medicine. See the Line is a collaborative initiative between Western University’s Schulich School of Medicine & Dentistry including Robarts Research Institute and the Faculties of Health Sciences and Engineering, Fowler Kennedy Sport Medicine Clinic, London Health Sciences Centre (LHSC), St. Joseph’s Health Care London (SJHC), Lawson Health Research Institute (Lawson), and Children’s Health Research Institute. www.seetheline.ca MEDIA CONTACT: Crystal Mackay, Media Relations Officer, Schulich School of Medicine & Dentistry, Western University , 519.661.2111 ext. 80387, c. 519.777.1573, crystal. mackay@schulich.uwo.ca ◊◊◊ 13 OBIA REVIEW 14 MARCH 2015 VS. YOUR ADVANTAGE, in and out of the courtroom. www.thomsonrogers.com 15 OBIA REVIEW Online Concussion/mTBI Support Group Do you have a Concussion or Mild Traumatic Brain Injury (mTBI)? OBIA is pleased to announce the launch of our ONLINE SUPPORT GROUP FOR ADULTS (18 and over) living with Concussion or mTBI: • • • Providing support and sharing information about brain injury and concussion Delivered online and available throughout Ontario Free and confidential For more information or to register for the group, contact: 1.800.263.5404 or support@obia.on.ca. 16 MARCH 2015 AWARENESS New at the OBIA Bookstore $56 Sports Neuropsychology: Head Games: $20 Assessment and Management of Traumatic Brain Injury Football’s Concussion Crisis Edited by: Ruben Echemendia, Ph.D. Author: Christopher Nowinski This book is a comprehensive text on scientific knowledge about sports-related concussion. It provides practical guidelines for evaluating mild head injury and making crucial return-to-play decisions for athletes at all levels, from school children through high school, college and professional players. Every parent, coach, athletic trainer and school athlete should read this book to understand the full impact of concussion in sports. A former Harvard football player and professional wrestler, Nowinski’s career was ended by multiple concussions that left him struggling to get through the day. His compelling writing style intertwines his personal experience with interviews and research findings from national experts on the treatment of post concussion syndrome. Chapters by national and international clinicians and researchers give essential information on the nature and prevalence of mild traumatic brain injury as well as pre and post-concussion assessment. It describes the effects of age and gender on athletic activity. The complex process of return-to-play decision making is examined in depth. Contents cover the spectrum from the most sophisticated evidencebased neurocognitive techniques to guidelines for counseling athletes. While grounded in research, this book is practical and readable. He debunks the common myths and misunderstandings about the effects and extent of concussion in our youth, high school, college and even professional sports. He clearly explains the inherent risks of cerebral concussions in contact sports and the measures that would improve their identification and prevent complications. While he presents the most recent studies and medical advances in identifying and treating the symptoms of concussion, he also exposes the attitudes among athletes and coaches that contribute to endangering our athletes. For a list of available resources, visit OBIA’s Online Bookstore: www.obia.ca/bookstore/ 17 OBIA REVIEW 18 MARCH 2015 AWARENESS Parents struggle to keep their heads in the game Allan Maki, The Globe and Mail, With files from Sarah MacWhirter Reprinted with permission - License #3.8425-21125 It remains Canada’s national sport, a way to forge our identity, feed our passion. But for parents worried about the health of their children, hockey is no longer the game of choice. Faced with a near daily stream of new research about the alarming and often long-term effects of concussions on youth, more and more parents are balking at hockey’s dangers, which includes a significantly higher risk of attempting suicide; links to anxiety and depression; and such emotional and cognitive symptoms as disturbed sleep, difficulty concentrating, frustration and forgetfulness. Confronted with all that, parents are enrolling their children in seemingly safer sports. While the high cost of outfitting a player and the time commitment involved are contributing factors in hockey’s declining numbers, concern about head injury is eating away at hockey’s core: One survey, conducted by Charlton Strategic Research, noted that 70 per cent of parents with kids playing at the midget age group (15 to 17) were worried about injuries. Three in 10 parents said they have a player who had suffered a concussion. In Ontario alone, researchers now believe as many as 36,000 players suffer concussions yearly. Hockey Canada has just tallied its registration numbers and discovered it is lighter by more than 5,600 players in the 2013-14 season. Though girls’ hockey has grown, the same can’t be said for boy’s hockey, which has been on the slide for three consecutive seasons. Hockey executives are taking notice. Don Fehr, executive director of the National Hockey League Players’ Association, gave the keynote address at a University of Toronto symposium focused on better understanding the effects of concussion on athletes. Society as a whole, he said, allows and often applauds people for partaking in hyper-dangerous activities. “The question becomes what do we permit and under what regulations, and that’s what I think we’re now beginning to really re-examine,” he said. “What we are engaged in I think, is the beginning – at least in connection with a couple of sports – of a fairly thorough re-evaluation of how things are going to be done.” The ultimate question, Fehr said, is who decides. 19 OBIA REVIEW “Who gets to decide what activities that kid engages in and under what conditions? Some group, some organization, the government, or mom and dad? I don’t think there’s any clear answer and I think it changes with time, it changes with perception and it changes with circumstances.” In Marshall, Tex., best known for its appearance in the legendary football movie Friday Night Lights, the school board decided in February to replace entry-level tackle football for Grade 7 students with flag football. That call drew interest around the continent. “Canadians are as passionate about hockey as Americans are passionate about football,” says Dr. Paul Comper, a clinical neuropsychologist at Toronto’s University Health Network who also works as a consultant for the NHLPA. And though Canadian boys dream of playing in the NHL, “at the lower level, the reality is these kids are not going to be professional hockey players,” Comper added. “They should not have to worry about head injuries. … We want kids to be active, but at what point does the needle move to where the risks outweigh the benefits?” Hockey Canada insists safety is a top concern. “When we talk to parents, we want to make sure they know that making the game safe is a top priority for us,” says Todd Jackson, a senior manager at Hockey Canada. “If we want to build up registration numbers, we’ve got to continue to work on safety.” Last year, the game’s governing body implemented a controversial nationwide ban on bodychecking for players 13 and under to reduce the incidence of concussion. Later in June, the Greater Toronto Hockey League – the world’s biggest minor hockey league – will vote on taking that measure a step further: A motion before the board will, if approved, extend the no-bodychecking rule to all A-level players (not AA or AAA), regardless of age. A survey of thousands of parents, players, team and club officials found that more than 64 per cent favour removing bodychecking in A-level hockey. (That percentage slipped to just over 57 per cent when respondents considered that these teams may not then be eligible to play in tournaments and championships involving other Ontario Hockey Federation leagues that still allow bodychecking.) It’s a monumental shift in how kids play the game. With his association struggling to attract new players (despite population growth, registration has flat-lined), the GTHL’s executive director hopes this extended emphasis on safety will help. “The game is changing now, but people saw [Chicago Blackhawk] Brent Seabrook’s hit on [St. Louis Blues] David Backes and think that’s what happens in the minor hockey,” Scott Oakman says. “We’re trying to make our game safer, but 20 image issues take time to change.” Even with heightened awareness, it is still difficult to determine the exact incidence of concussion. Parents have to fill out an injury report for a player who is hurt during team activities, a copy is kept by the league, and if a player has a concussion, he can’t return to the ice until cleared by a doctor. It’s a well-intended system, but not foolproof. “Concussions are, as you can imagine, tough to track as many occur at the local levels and do not necessarily get reported to us,” says Jackson of Hockey Canada. “This makes it difficult to get a true picture of the number occurring.” Some teams are now conducting preseason baseline tests via questionnaires. The results are used as a comparison when a player suffers a head injury. Hockey Canada approves of baseline testing, but does not make it mandatory. Paul Carson, the organization’s vicepresident of development, notes the decision to test belongs to the individual minor hockey associations. “If an association thinks that is a healthy choice for kids, then good for them,” Carson says. “I just don’t want it to be another expense when parents have said that [financial cost] is a concern for them.” As for the GTHL, member clubs will vote on extending the bodychecking ban on June 14 – the GTHL board is recommending that if the rule change is accepted, it be MARCH 2015 deferred to the 2015-16 season. For parents tired of watching players helped off the ice after being hit in the head, that might not be good enough. “Parents are tired of it,” says Robert Deutschmann, a father of three minor hockey players in Toronto. “I think it is commendable for the GTHL to be doing this, but we should go forward and do it this year.” Soccer years behind hockey in understanding head injury It’s fun, it’s inexpensive and it continues to grow in popularity. In 2013-2014 alone, 20,000 new players registered for soccer, pushing the total number in Canada to almost 866,000. The way parents see it, soccer is a safe haven for their kids, a game without serious risk. But scientists and doctors are picking a hole in that argument, specifically when it comes to heading the ball. Though the exact risk isn’t known, researchers suggest it may contribute to cognitive decline or impairment, with studies on long-term effects pointing to greater memory, planning and perceptual deficits. Increasingly, they’re calling for more comprehensive research on soccer players, and more awareness from kids, their parents and professional players as they re-examine the risk of the beautiful game. “The goal is to come up with a far better understanding of concussions so it can turn into clinical practice,” said Dr. Paul van Donkelaar, director of the School of Health and Exercise Sciences at the University of British Columbia’s Okanagan campus. “I’d say soccer information is four to five years behind hockey.” Toronto researchers raised red flags in February with a study that concluded that concussions accounted for 5.8 per cent to 8.6 per cent of the total number of injuries that occurred during soccer games. The study, co-authored by Monica Maher, a neuroscience master’s student, pointed to the long-term effects – verbal and visual memory loss – for soccer players who suffered more than one concussion or had “sub-concussive” head injuries. Those involve repeated blows to the head without the athlete presenting concussive symptoms such as headaches, dizziness and nausea. Also in February, Boston University made a discovery that stunned the soccer world. Doctors found chronic traumatic encephalopathy (CTE) in a 29-year-old soccer player who had died in 2012 from amyotrophic lateral sclerosis (ALS). Researchers admitted they need more information before they could say conclusively that heading a soccer ball results in CTE, and that CTE contributed to development of ALS. Van Donkelaar says soccer could take a page from the playbook of other sports to lower concussion risk for kids. “In baseball, if you’re under a certain age, you’re only allowed to pitch a certain number of throws or innings. That stops them and it saves the arms of young kids so they’re not used up by 15,” he said. “In soccer, there is an inkling to limit the number of times a player heads the ball. It would only be allowed at a certain age, like hitting in hockey.” 21 OBIA REVIEW The cost of concussion is high. “A developing brain with a major injury is far reaching,” he added. The undeveloped brain: Why treat kids like adults? When adults suffer a concussion, they’re told to rest at least seven days. When kids suffer a concussion they’re told the same thing. Dr. Michelle Keightley disagrees with that identical treatment plan. The clinical neuropsychologist at the Holland Bloorview Kids Rehabilitation Hospital in Toronto is convinced the current concussion protocol designed for adults is inappropriate for children. “Before, it was all about the adults. They were told it was a seven to 10-day recovery so kids were told that, too,” Keightley said. “[But] we found their brains take longer to recover because they are still developing.” The Greater Toronto Hockey League has been working with Holland Bloorview. After suffering a head injury, players may require weeks to months of rest, along with an MRI so that doctors have a better understanding of the neural impact. Dr. Blaine Hoshizaki, a professor at the University of Ottawa’s Faculty of Health Sciences, says there’s still much to learn. “I think there are more concussions involving children than reported, likely much higher than in adults,” he said. “I would agree with Dr. Keightley that we should be treating children more conservatively until we have more research involving children.” 22 At Mind Matters, a University of Toronto symposium on concussion and sport, researchers noted that younger athletes report longer recovery times: about 10 days for professional athletes, 20 days for university athletes and 45 days for high-school students. But that doesn’t necessarily mean that recovery time would be longer for even younger athletes. Dr. Doug Richards, chief medical officer of the Canadian Sport Institute Ontario, said younger athletes may be telling the truth about ongoing symptoms, where professional athletes may lie to get back into play sooner. The Canadian Paediatric Society recommends “conservative, cautious and individualized” return-to-play decisions for athletes. Researchers simply don’t know if a younger brain takes longer to recover. “There may be issues that we don’t understand,” Richards said. But, he noted, when it comes to getting accurate information from young athletes, a real challenge is “hovering parents” – kids simply aren’t comfortable answering questions about sexual activity and substance use in front of mom and dad. New research points to the importance of understanding emotional changes during the recovery stage as well. Tension, depression, anger, fatigue and confusion levels rise postconcussion – and not simply because athletes aren’t able to play the games they love. Athletes, concludes Dr. Lynda Mainwaring, professor at the University of Toronto, often don’t report emotional disturbance because they don’t realize it’s a symptom related to their injury. “Assessment of post-injury emotional functioning could help to inform return-to-play decisions so that athletes do not return to play with emotional disturbance, which might create a risk for further injuries,” she writes. ◊◊◊ MARCH 2015 23 OBIA REVIEW Tax-free, guaranteed structured settlements are all we do, and we pledge to do it right. OUR PLEDGE Henderson Structured Settlements is licensed with all major federallylicensed life insurance companies underwriting structured settlements in Canada. A structured settlement produced by Henderson Structured Settlements will always be brokered without regard to the commissions payable to Henderson for its brokerage services and with the intent of producing the best structured settlement income/cost attainable in the marketplace at the time of final brokerage. Ceteris paribus (other things being equal), Henderson Structured Settlements will always be able to match or better any structured settlement income/cost attainable in the structured settlement marketplace at the time of final brokerage. Henderson Structured Settlements will, with every structured settlement annuity contract, produce a written guarantee of tax law compliance and ongoing service and responsibility. HENDERSON STRUCTURED SETTLEMENTS LP Your Partners In Service® Since 1981 www.henderson.ca 1.800.263.8537 24 MARCH 2015 AWARENESS Across the Province OBIA Advisory Council (OAC) Community Programs & Events At the January 17th meeting of the OBIA Advisory Council Barbara Baptiste, President of Rehabilitation Management Inc. and former Board President of OBIA shared her presentation “Life Care Planning: The Value of Provincial ABI Data.” Following this presentation, Tammy Dumas talked about the Provincial Research Questionnaire review and future dissemination. Both of these presentations demonstrated the importance of data collection in order to provide meaningful statistics to researchers working in the field of ABI. As always, we are delighted to be able to showcase many of the wonderful programs and events happening around Ontario. The afternoon portion of the meeting gave representatives from across the province an opportunity to share with their colleagues the activities of their respective associations. The next meeting will be held on March 14, 2015. Seizure & Brain Injury Centre (Timmins) A most successful Christmas gift wrapping fundraiser was held at our local mall the Timmins Square. Over $1,400 was raised along with sales of our prints and raffle tickets. Fundraisers like this help with our day programing “New Beginners” in which there are now over 30 participants. In January clients enjoyed a wonderful spaghetti supper to ward off the long cold winter days here in northern Ontario. We have seen an increase interest in Peer Mentoring so working hard to ensure that matches happen. Clients are assisting with preparing for our annual “Colour It Up” Run/Walk June 13th to bring awareness of Brain Injury and celebrate Brain Injury Awareness Month. BIA Sudbury and District Enhancing lives... On December 5 2014, the Brain Injury Association Sudbury and District and the March of Dimes Canada hosted its Annual Holiday Dinner and Dance for members, caregivers and guests. Pictures were taken in front of the Christmas tree as a memory of this special event. It was a festive night featuring a gourmet turkey dinner catered by the United Steel Workers Hall and generously funded by Oatley, Vigmond Personal Injury Lawyers. The night was filled with Christmas spirit as a lovely slide presentation of this year’s events was created by the March of Dimes. The presentation also showed participants singing and reenacting the Twelve Days of Christmas. Once the food was gobbled up gifts were distributed to survivors and caregivers. There was a variety of prizes given out that were generously donated and once all gifts were distributed the dance floor opened up and there were more prizes for best dancers. Overall the night was a fun filled event with festive decor, amazing music, an array of gifts and prizes and most importantly filled with wonderful guests and volunteers. A special thank you to Oatley Vigmond for sponsoring the dinner and gifts, Source Rehabilitation, for the large donation towards the gifts and prizes, United Steel Workers for donating the hall, Walmart and Subway and the March of Dimes Canada for their generous donations and a big thank you to all the volunteers (including Santa). Without such generous sponsors and volunteers the Holiday Dinner and Dance would not have been such a big success (see photo below). Have questions? Call our toll free number: 1-800-263-5404 Visit us online at www.obia.ca 25 OBIA REVIEW BIA London and Region As one of the three founding partners, Donna Thomson and the Brain Injury Association of London and Region, along with Brain Tumour Foundation of Canada and Dale Brain Injury Services, have officially launched the Year of the Brain 2015 in London & surrounding region. The focus of Year of the Brain 2015 is to provide a platform for all neurological and mental health based organizations in the area to come together to support people living with brain-related conditions. A networking group from various organizations has been formed, called the Brain Health Network of Southwestern Ontario. One of the largest benefits to the London community will be the data analysis of the services that currently exist and the identification of gaps in services, as well as providing education and creating awareness throughout the area. The official Kick-Off at Parkwood Institute on January 28th was a huge success, with members from all seventeen community The above photo is (from left to right) Sue Hillis - Executive Director of Dale Brain Injury Services, Carl Cadogan - CEO of Brain Tumour Foundation of Canada, Donna Thomson - Executive Director of Brain Injury Association of London and Region, and far right is Mayor Matt Brown of London. partnered neurological and mental health organizations, Mayor Matt Brown, Ward 14 Counsellor Jared Zaifman and numerous initiative supporters were present. Social media including a Twitter account, Facebook page, and official website have been launched. In addition, the initiative was thrilled to accept a donation of $20,000 from The Sifton Family Foundation. With a monthly webinar series, Brain Fair at the London Children’s Museum on April 1st, and various partnered-organization events promoted throughout the duration of the Year of the Brain 2015 – it’s bound to be an exciting and busy year ahead! Above is BIA London and Region’s Executive Director Donna Thomson with London’s Mayor Matt Brown. 26 MARCH 2015 BIA Ottawa Valley The Brain Injury Association of the Ottawa Valley will be hosting the Brain Basics Course in Ottawa on March 12th and 13th at the RA Centre, 2451 Riverside Drive. This course is excellent for all frontline workers as well as family members. If you are interested in registering for this course please contact ddakiv@obia.ca or if you would like further information please contact Wendy Charbonneau at (613) 233-8303. A limited number of subsidies are available for survivors or family members. Arrangements are already in place for the 2nd Annual Fleming Fitness Golf Tournament to be held on June 18th at the Loch March Golf Course. For more information please contact Patrick Fleming, R.Kin, CSCS at (613) 8828434 or patrick@flemingfitness.ca The members of the Artistic Expressions Workshop are busy working hard in the JUNE 18 woodworking classes held on Tuesday and Thursday afternoons. Some of the projects they have completed are wooden clocks, gift boxes, coasters. Some of the participants are learning how to use a wood burning tool safely to embellish their work. Our newest program, the Concussion Peer Support Group, meets bi-weekly on Mondays. The group is co-facilitated by a Nursing student from the University of Ottawa. For information about any of the programs offered by the association, please contact Wendy at (613) 2338303 or braininjuryottawavalley@bellnet.ca. Hamilton BIA The HBIA is running an injury prevention program from April to June 2015. The Bikes, Blades & Boards is an inschool injury prevention and helmet safety presentation for grade 2 students. Curriculum includes: • Interactive discussion regarding parts of the brain, their function and difficulties when damaged. • Demonstrations regarding safe helmet use. • A short video on bicycle safety, helmet features and proper use. • A thorough helmet inspection, adjustment and education session. • Stickers, pamphlets and various other colourful and informative handouts. • A take home individualized “report card” providing information to parents on their children’s helmet wearing habits. HBIA is also busy with our support groups, workshops and seminars along with a varied activities program, including the 10th Annual HBIA 5K by the Bay (see page 28). To become involved or get more information, contact us at info@hbia.ca. SAVE THE DATE… For the 2nd annual… Golf Tournament All proceeds benefiting the Brain Injury Association of the Ottawa Valley …at Loch March Golf & Country Club FEATURING DR. DONALD CHOW AS HONORARY GUEST & SPEAKER, AND DERICK FAGE, DAYTIME HOST OF ROGERS TV, AS THE M.C. CONTACT PAT FLEMING FOR SPONSORSHIP OPPORTUNITIES (2 PLATINUM, 1 GOLD, 1 SILVER, 1 BRONZE) Patrick Fleming, R.Kin, CSCS Fleming Fitness 613-882-8434 patrick@flemingfitness.ca 27 OBIA REVIEW New Beginnings ABI & Stroke Recovery Association (Chatham/Sarnia) During the month of November, the New Beginnings ABI & Stroke Recovery Association in Chatham Kent, implemented a fundraiser for the Movember Foundation of Canada. The Movember Foundation challenges men to grow moustaches during the month of November, to spark conversation and raise awareness and funds for men’s health. New Beginnings altered their fundraiser to include some interesting and fun elements throughout the month. Firstly, the name of the fundraiser was titled “Growvember”. Participants, who included both staff and members, were encouraged to grow their hair – face, legs, head, etc. On the first day of November they hosted a “clean shaven day”. Staff and members shaved their faces, legs, and even their head! It was an exhilarating experience full of laughter, and surprises. One of the members who has had his beard his whole life, shaved it completely off. His wife, while reluctant, had a hand with the razor. “Baby face” became his new nick name and what a transformation! In addition, Bob Rawlinson, the Executive Director, dyed his hair purple. Another member, whose hair was at least 14 inches long, had the staff cut her hair and donated it to Locks of Love, a not for profit organization that provides hairpieces to financially disadvantaged children. On the last day of November, they hosted a “shave off”. It was finally time to get rid of the unwanted hair. Surprisingly, a few of the participants kept their face growth, just tidied it up a little. Two members, volunteered to have their body hair waxed for a nominal fee which was donated to their fundraiser as well. This display of confidence quickly turned into thoughts of “what was I thinking” after the first swipe of wax was pulled. Nevertheless, they gained a 28 MARCH 2015 considerable audience and noted some bravery amongst the young members. Overall, the experience brought togetherness, courage, and laughter to the members, caregivers and staff at the Club and all for a worthwhile cause. BIA Windsor-Essex BIAWE’s Social Committee hosted an old fashioned Christmas in December at the Chrysalis Day Club. It was a wonderful evening for everyone with fabulous food, merriment and friendship. We are delighted to once again offer our popular new goal-setting support group “Seeds of Hope” support group. The “Seeds of Hope” support group is about bringing people together in an environment that fosters relationship building, safety and trust. The group is simultaneously shaped as a group and individualized; everyone that participates in the group sets and works on goals and importantly, each member chooses and works on their own goal. Our pilot session was an astounding success and we are very happy to be able to offer this program once again. We have been busy at BIAWE preparing for our 2nd annual Sports & Sparkle Gala that will be held on April 11th. The committee has been busy planning this extraordinary gala that supports our growing needs. On May 30th BIAWE will be hosting a conference on the “Assessment & Treatment of Concussion and Mild Traumatic Brain Injury”. An extraordinary panel of speakers has been put together and we are looking forward to this event. For more information about BIAWE and the programs that we offer, please visit www.biawe.com. Share your expertise... BIAWE Social Committee group members enjoying a Chrysalis Country Christmas at the Chrysalis Day Club. Be an OBIA Review Guest Author Upcoming themes: June 2015 Brain Injury Awareness Month September 2015 Education December 2015 Relationships March 2016 Innovation Contact the Editor: editor@obia.on.ca 29 OBIA REVIEW 30 MARCH 2015 SUPPORT Survivor Stories Having a Brain Injury Didn’t Break my Funny Bone By Sandeep Chahal, Brain Injury Survivor Brace yourself for one of the best stories in the world—better than Russell Peters’. (Warning, the following contains humour: listener discretion is advised.) I was an aspiring young man that any parent would be proud of. I enrolled in honours English at York University and worked as an assistant supervisor at Canada’s Wonderland. Before that, I had graduated with honours from high school and from Humber College (Dean’s List). One of my essays was even published in one of my professor’s books. Clearly York did not capitalize on this talented writer… the two weeks I was there that is! I had a good circle of friends. I was also a role model for my younger cousins who I hoped I would pass on a lot of useful knowledge. Good thing that children are so gullible! I was a child any parent would be proud of (except for those with astrological biochemical alchemy practising neurological Big Bang physicist children). My mother and father are immigrants who walked to Canada from India many years ago (from the airplane that is). I am their only child, which is fortunate because I didn’t have to share my Lego with anyone (actually, I played with Mighty Blocks, we couldn’t afford Lego). I was the first generation in my family to be born outside of India; so thankfully, I got to set the standard (high at some points, low when I wanted to). Life was difficult growing up. I had to work harder than most for many things; whether it was growing up in a neighbourhood where I was the only Indian child or being the first in my family to learn English as my primary language. I learned the value of a good work ethic from my parents, such as making sure that you are irreplaceable! My parents worked multiple difficult factory jobs during odd hours just to ensure that I would grow up better than they did. My father must have worked 10-15 low paying, physically demanding jobs, saving money so I could get a good education and job. Too bad the internet did not exist. So take pain and don’t quit because pain makes you stronger in many ways. My parents valued my life and future very much, for some unknown reason, so anyone could guess that they were worried and devastated when I was involved in a car accident. One evening after I had finished a miserable day at York my father was kind enough to drive me home. Unfortunately, we were involved in a serious accident involving a tractor trailer. I was knocked out and do not remember the details of what happened. Two days later I awoke in a hospital bed. I suffered multiple serious physical injuries, but worst of all was that I had an acquired brain injury. Although life has been pretty difficult after my injury, there have also been a number of positives. I met a lot of really great and helpful people including my entire rehabilitation team. Also, I am presently working on writing my own book. It is a hilarious tale about four young minorities who form a club called the Kool Kids Klub but are too young and naive to realize the implications of the initials of their club. This leads to wild and wacky adventures and is a guaranteed laugh. Look forward to my upcoming book (cheap plug huh?). Another area I am involved in is called Elder Technology Assistance Group (ETAG) which helps adults aged 55 and over (last time I checked 67 years was considered elderly) develop technological skills that we young people grew up with. Although sometimes I feel like I have no idea what I am doing, they apparently like me and think I am doing amazingly. This actually describes the story of my life perfectly in a nutshell. Another positive is that my accident actually brought my family closer together. Before 2008, I was completely independent. Afterwards, I was unable to perform many of my daily tasks. Thankfully, I was fortunate enough to have an amazing, supportive family. Now we are closer than ever. 31 OBIA REVIEW 32 MARCH 2015 My grandfather, who has many medical conditions, would likely have had more health issues if I were not injured. He is approximately 89 years old but likely older (back in India, tracking age was not important) Because of my situation, I have been able to help with his care more. I do not wish my situation upon anyone. The amount of pain, suffering, turmoil, and relationship issues can never be compensated for. However, if someone is in this situation, there is nothing that can be done to rewrite the past. We must all see the opportunities that have opened up rather than closed down. If we do not see these opened doors and instead focus on the closed doors, the number of opened doors will greatly diminish. Maybe someone in a situation like mine is in a lot of pain, has memory problems, and cannot work or study. That person has more time to discover this mysterious world. This time can also be used to learn compensatory strategies like carrying a notebook. Consider this: if the average Canadian sees a person with a notebook, I am positive that person would be seen as organized rather than forgetful. I also highly recommend that once you have a task that needs to be completed, you should try to complete it immediately. If you procrastinate, you may forget about it. Face your challenges immediately or else they may never be completed. Another tip I can share is to try to accomplish what you can without relying on others to understand you. It is an unfortunate truth, but some people in this world do not have the time or interest in appreciating a disability. Try to see yourself as anyone else and live the best way you can. And remember, there are those who do understand us. My most crucial tip I can share is that the challenges we face, although we may have help, are our own challenges. Others may guide you and give you help, but ultimately we must conquer the challenges ourselves. This is not easy and will take work. As I conclude my story, I trust a very intelligent reader such as you has come to realize I have a quirky sense of humour. If I have offended you, I apologize and hope you got something out of this article, because I sure as heck didn’t (that’s a joke). So in conclusion, some days will feel harder than others, so you should work through them and don’t isolate yourself. Do things and hobbies that make you happy, and help your family understand your situation. I leave you with something that my high school geography teacher told me the first day of class. He said something to the effect of “If you live in a western country, you have won the only lottery that matters.” Your situation may not be pleasant, mine sure was not, but there are millions of people out there worse off than us, so please be happy and laugh, then thank and love the people around you. ◊◊◊ Support Services for Brain Injury Helping individuals living with the effects of brain injury achieve a better quality of life Serving East Central Ontario MindWorks Group 312 Rubidge Street Peterborough, Ontario K9J 3P4 Phone: 705-741-3412 Fax: 705-741-4098 Toll Free: 1-800-559-8323 OUR SERVICES s s s s s Rehabilitation Assistants Community Support Staff School Support Staff Recreational Programming Vocational Planning, Programming and Coaching www.mindworksgroup.ca 33 CANA D I LAWYER M A INE AZ G AN MARCH 2015 Sponsorship Opportunities • • • • Platinum Sponsor $6,000.00 You will receive 15 tickets to the Mix and Mingle, table for promotional material at event, verbal acknowledgement at event, your company logo on: all email marketing, on a banner and the next OBIA Review and BIST Website/Blog; in addition to a full page ad in the event program and a full page digital ad on the AV screen. Gold Sponsor $4,000.00 You will receive 10 tickets to the Mix and Mingle, your company logo on: a banner, the program and the OBIA Review and BIST Website/Blog. Food Station Sponsor $2,500.00 You will receive 5 tickets to the Mix and Mingle, signage on food stations, your logo on banner, program and acknowledged in OBIA Review and BIST Website/Blog. Silver Sponsor $1,500.00 You will receive 5 tickets to the Mix and Mingle and your company name on a banner, in the program and the OBIA Review and BIST Website/Blog. Tickets $125.00 each Register online: www.obia.ca 35 OBIA REVIEW EDUCATION Concussion Guidelines for PARENTS & CAREGIVERS WHAT IS A CONCUSSION? A concussion is a brain injury that cannot be seen on routine x-rays, CT scans, or MRIs. It affects the way a child may think and remember things, and can cause a variety of symptoms. WHAT ARE THE SYMPTOMS AND SIGNS OF CONCUSSION? A CHILD DOES NOT NEED TO BE KNOCKED OUT (LOSE CONSCIOUSNESS) TO HAVE HAD A CONCUSSION. THINKING PROBLEMS CHILD’S COMPLAINTS OTHER PROBLEMS • Does not know time, date, place, period of game, opposing team, score of game • Headache • Poor coordination or balance • Dizziness • Blank stare/glassy eyed • Feels dazed • Vomiting • General confusion • Feels “dinged” or stunned; “having my bell rung” • Slurred speech • Cannot remember things that happened before and after the injury • Knocked out • Sees stars, flashing lights • Slow to answer questions or follow directions • Ringing in the ears • Easily distracted • Sleepiness • Poor concentration • Loss of vision • Strange or inappropriate emotions (ie. laughing, crying, getting mad easily) • Sees double or blurry • Stomachache, stomach pain, nausea • Not playing as well WHAT CAUSES A CONCUSSION? WHAT SHOULD YOU DO IF YOUR CHILD GETS A CONCUSSION? Any blow to the head, face or neck, or a blow to the body which causes a sudden jarring of the head may cause a concussion (ie. a ball to the head, being checked into the boards in hockey). Your child should stop playing the sport right away. They should not be left alone and should be seen by a doctor as soon as possible that day. If your child is knocked out, call an ambulance to take him/her to the hospital immediately. Do not move your child or remove any equipment such as helmet, in case of a cervical spine injury. Wait for paramedics to arrive. Our aim is an injury-free Canada. Parachute is bringing attention to the issue of preventable injury and to help Canadians reduce their risks of injury and enjoy long lives lived to the fullest. 36 MARCH 2015 CONCUSSION GUIDELINES FOR PARENTS & CAREGIVERS HOW LONG WILL IT TAKE FOR MY CHILD TO GET BETTER? The signs and symptoms of a concussion often last for 7-10 days but may last much longer. In some cases, children may take many weeks or months to heal. Having had previous concussions may increase the chance that a person may take longer to heal. HOW IS A CONCUSSION TREATED? THE MOST IMPORTANT TREATMENT FOR A CONCUSSION IS REST. The child should not exercise, go to school or do any activities that may make them worse, like riding a bike, play wrestling, reading, working on the computer or playing video games. If your child goes back to activities before they are completely better, they are more likely to get worse, and to have symptoms longer. Even though it is very hard for an active child to rest, this is the most important step. Once your child is completely better at rest (all symptoms have resolved), they can start a step-wise increase in activities. It is important that your child is seen by a doctor before he/she begins the steps needed to return to activity, to make sure he/she is completely better. If possible, your child should be seen by a doctor with experience in treating concussions. WHEN CAN MY CHILD RETURN TO SCHOOL? Sometimes children who have a concussion may find it hard to concentrate in school and may get a worse headache or feel sick to their stomach if they are in school. Children should stay home from school if their symptoms get worse while they are in class. Once they feel better, they can try going back to school part time to start (eg. for half days initially) and if they are okay with that, then they can go back full time. WHEN CAN MY CHILD RETURN TO SPORT? It is very important that your child not go back to sports if he/she has any concussion symptoms or signs. Return to sport and activity must follow a step-wise approach: www.parachutecanada.org STEP 1) No activity, complete rest. Once back to normal and cleared by a doctor, go to step 2. STEP 2) Light exercise such as walking or stationary cycling, for 10-15 minutes. STEP 3) Sport specific aerobic activity (ie. skating in hockey, running in soccer), for 20-30 minutes. NO CONTACT. STEP 4) “On field” practice such as ball drills, shooting drills, and other activities with NO CONTACT (ie. no checking, no heading the ball, etc.). STEP 5) “On field” practice with body contact, once cleared by a doctor. STEP 6) Game play. Note: Each step must take a minimum of one day. If your child has any symptoms of a concussion (e.g. headache, feeling sick to his/her stomach) that come back at any step, STOP activity, wait 24-48 hours, and resume activity at previous step. When should I take my child to the doctor? Every child who gets a head injury should be seen by a doctor as soon as possible. Your child should go back to the doctor IMMEDIATELY if, after being told he/she has a concussion, he/she has worsening of symptoms such as: 1. being more confused 2. headache that is getting worse 3. vomiting more than twice 4. strange behaviour 5. not waking up 6. having any trouble walking 7. having a seizure Problems caused by a head injury can get worse later that day or night. The child should not be left alone and should be checked throughout the night. If you have any concerns about the child’s breathing or how they are sleeping, wake them up. Otherwise, let them sleep. If they seem to be getting worse, you should see your doctor immediately. NO CHILD SHOULD GO BACK TO SPORT UNTIL THEY HAVE BEEN CLEARED TO DO SO BY A DOCTOR. Copyright Parachute 2013 37 OBIA REVIEW SUPPORT % 82 % 90 Get Connected with Peer Support of Mentors say that being a Mentor improved their quality of life! of Partners recommend the Peer Support Program. OBIA s Provincial Peer Support Program connects persons with lived experience (the Mentor) with an individual who is living with the effects of acquired brain injury and who requires support (the Partner). This program is available to survivors, family members and/or unpaid caregivers. For more information contact: Ontario Brain Injury Association 1-800-263-5404 peersupport@obia.on.ca Funding provided by: Development Sponsors: 38 MARCH 2015 Restoring Hope. Building Futures. Comprehensive rehabilitation services from providers you can trust. physiotherapy | case management | discharge planning | occupational therapy speech-language pathology | rehabilitation therapy | home assessments vocational counselling | personal counselling | life care planning/future costs medical & psychological assessments | employer services | insurer services www.rehabfirst.ca 1-888-REHAB-90 | info@rehabfirst.ca 39 OBIA REVIEW EDUCATION Events Calendar March 9-11, 2015 ROTMAN Research Institute presents: 25th Annual ROTMAN Research Institue Conference: 25 Years of Brain and Aging Location: Metro Toronto Convention Centre, 255 Front Street West, Toronto, ON Contact: Paula Ferreira Phone: 416-785-2500 ext. 2363 E-mail: pferreira@baycrest.org April 15-16, 2015 Brain Injury Canada presents: 2015 Annual Conference Location: Halifax, NS Contact: Barb Butler, Conference Committee Chair Phone: 306-530-8703 Fax: 306-584-9419 Email: barbbutler@biac-aclc.ca Website: www.braininjurycanada.ca May 14-15, 2015 Hamilton Health Sciences presents: 22nd Annual ABI Conference Inter-system Collaboration: Building Innovative Networks that Support Individuals with ABI Location: Hamilton Convention Centre, Hamilton, ON Contact: Joyce Lambert, ABI Conference Coordinator Phone: 905-521-2100 ext. 40833 Fax: 905-577-8233 Email: jlambert@hhsc.ca Website: www.hamiltonhealthsciences.ca/body.cfm?id=2127 May 27-29, 2015 OBIA and Brock University present: Advanced Brain Injury Rehabilitation (Prerequisite: Neurobehavioural Rehabilitation: Assisting Recovery & Function in Everyday Life Following Brain Injury) 40 Location: Brock University, St. Catharines, ON Contact: Diane Dakiv Phone: 905-641-8877 ext. 231 Email: training@obia.on.ca Website: www.obia.ca/brock-university-certificate-courses (See page 52 for details.) June 10, 2015 BIST/OBIA presents: 11th Annual Mix and Mingle Location: Steamwhistle Brewery, Toronto, ON Contact: Terry (Wilcox) Bartol Phone: 905-641-8877 ext. 234 Fax: 905-641-0323 Email: events@obia.on.ca October 23-24, 2015 OBIA and Brock University present: Children and Youth with Acquired Brain Injury Location: Holiday Inn & Suites Conference Centre, St. Catharines, ON Contact: Diane Dakiv Phone: 905-641-8877 ext. 231 Email: training@obia.on.ca Website: www.obia.ca/brock-university-certificate-courses November 11-13 2015 OBIA and participating Community Associations present: 2015 ABI Provincial Conference - Innovate Integrate Motivate Location: Sheraton on the Falls Hotel, Niagara Falls, ON Contact: Terry (Wilcox) Bartol Phone: 905-641-8877 ext. 234 Fax: 905-641-0323 Email: conference@obia.on.ca Website: www.ontarioabiconference.ca ◊◊◊ MARCH 2015 Save the Date! Brain Injury Diagnostics Half Day Conference Location and Speakers TBA - Oshawa, ON Tuesday, June 2, 2015 • 8 a.m. - 12 noon All proceeds to be donated to OBIA and BIA Durham: For information, contact either: Jean-Marie Fiala Deborah Crowe Telephone: 1-866-899-4674 Telephone: 1-519-878-5839 Email: jmf@mriappointments.com Email: deb@mriappointments.com 2015AP rcoqvuiinr ceida lBCr aoinnf eI nr ej unrcye PRESENTED BY INNOVATE INTEGRATE MOTIVATE and PARTICIPATING COMMUNITY ASSOCIATIONS Call for Abstracts For more information www.ontarioabiconference.ca/call-for-abstracts/ November 11 -13, 2015 Sheraton on the Falls Hotel Niagara Falls, Ontario 41 OBIA REVIEW SUPPORT Community Associations All recent changes to information marked in orange. Call OBIA 1-855-642-8877 Toll Free Support Line 1-800-263-5404 (HELPLINE) Ontario Brain Injury Association Dufferin County (Mail) PO Box 2338, St. Catharines, ON L2R 7R9 (Courier) 3550 Schmon Parkway, 2nd Floor, Thorold, ON L2V 4Y6 Phone: 905-641-8877 or 1-855-642-8877 Toll-free support 1-800-263-5404 Fax: 905-641-0323 Email: obia@obia.on.ca Web Site: www.obia.ca Headwaters ABI Group (HABI) Belleville BIA of Quinte District 223 Pinnacle Street Belleville, ON K8N 3A7 Phone: 613-967-2756 or toll free: 1-866-894-8884 Fax: 613-967-1108 Email: biaqd@bellnet.ca Website: www.biaqd.ca Chatham-Kent New Beginnings ABI & Stroke Recovery Association (2 Locations - Chatham and Sarnia) 9 Maple Leaf Drive Chatham, ON N7M 6H2 Phone: 519-351-0297 Fax: 519-351-7600 Email: info@newbeginnings-cksl.com Website: www.newbeginnings-cksl.com Contact: Bob Rawlinson 42 Orangeville, ON Phone: 519-215-1519 Contact: Volunteer Intake Coordinator Durham BIA of Durham 24 - 850 King Street West Oshawa, ON L1J 8N5 Phone: 905-723-2732 or toll free: 1-866-354-4464 Fax: 905-723-4936 Email: information@biad.ca Website: www.biad.ca Contact: Frank Murphy, Exec. Director Fort Erie HIA of Fort Erie and District 649 Niagara Boulevard Fort Erie, ON L2A 3H7 Phone: 905-871-7789 Fax: 905-871-7832 Email: hiafeevents@bellnet.ca Contact: Donna Summerville Hamilton-Wentworth Hamilton BIA 822 Main Street E. Hamilton, ON L8M 1L6 Phone: 905-538-5251 Fax: 905-390-3649 Email: info@hbia.ca Website: www.hbia.ca Contact: Adria Repp MARCH 2015 London and Region Peterborough Area BIA of London and Region Brain Injury Association Peterborough Region 560 Wellington St., Lower Level London, ON N6A 3R4 Phone: 519-642-4539 Fax: 519-642-4124 Email: info@braininjurylondon.on.ca Website: www.braininjurylondon.on.ca Contact: Donna Thomson 158 Charlotte St. Peterborough, ON K9J 2T8 Phone: 705-741-1172 or 1-800-854-9738 Fax: 705-741-5129 Email: biapr@nexicom.net Website: www.biapr.ca Contact: Cheryl Ann Hassan Niagara Area BIA of Niagara Office: 10 - 261 Martindale Road, St. Catharines, ON Mail: PO Box 20019 Thorold, ON L2V 5B3 Phone: 905-984-5058 Fax: 905-984-5354 Email: pat@bianiagara.org Website: www.bianiagara.org Contact: Pat Dracup North Bay Area BIA of North Bay and Area c/o PHARA 280 Oakwood Ave. North Bay, ON P1B 9G2 Phone: 705-840-8882 Fax: n/a Email: contact@bianba.ca Website: www.bianba.ca Sarnia-Lambton BIA of Sarnia-Lambton 1032 - 1705 London Line, Sarnia, ON N7W 1B2 Phone: 519-337-5657 Fax: 519-337-1024 Email: info@sarniabiasl.ca Website: www.sarniabiasl.ca New Beginnings ABI & Stroke Recovery Association Lochiel Centre 180 College Avenue North, 2nd Floor Sarnia, ON N7T 7X2 Phone: 519-491-2668 Fax: 519-491-2632 Email: info@newbeginnings-cksl.com Website: www.newbeginnings-cksl.com Contact: Bob Rawlinson Sault Ste. Marie BIA of Sault Ste. Marie & District Ottawa Area BIA of Ottawa Valley 211 Bronson Avenue, 3rd Floor Ottawa, ON K1R 6H5 Phone: 613-233-8303 Fax: 613-233-8422 Email: BrainInjuryOttawaValley@bellnet.ca Website: www.biaov.org Contact: Wendy Charbonneau PO Box 272 Richards Landing, ON P0R 1J0 Phone: 705-943-0424 Fax: n/a Email: braininjuryssmd@gmail.com Website: www.braininjuryssm.ca Contact: Elizabeth Eddy Sudbury and District BIA of Sudbury & District Branch Peel-Halton BIA of Peel & Halton PO Box 47038 Sheridan Mall PO Mississauga, ON L5K 2R2 Phone: 905-823-2221 or 1-800-565-8594 Fax: 905-823-9960 Email: biaph@biaph.com Website: www.biaph.com Contact: Jorun Rucels 2750 Bancroft Drive Sudbury, ON P3B 1T9 Phone: 705-670-0200 Fax: 705-222-2427 Email: info@biasd.ca Website: www.biasd.ca Contact: Sean Parsons 43 OBIA REVIEW Thunder Bay BIA Thunder Bay & Area BIA of Waterloo-Wellington 217 - 1100 Memorial Ave. Thunder Bay, ON P7B 4A3 Phone: 807-621-4164 Email: biatba@yahoo.ca Website: www.bisno.org/brain-injury-association-of-thunder-bay 871 Victoria Street North, Unit 1 Kitchener, ON N2B 3S4 Phone: 519-579-5300 Fax: 519-579-0118 Email: patti@biaww.com Website: www.biaww.com Contact: Patti Lehman, Exec. Director Timmins 44 Waterloo-Wellington Seizure & Brain Injury Centre Windsor-Essex 733 Ross Ave. E. Timmins, ON P4N 8S8 Phone: 705-264-2933 Fax: 705-264-0350 Email: sabicrl@eastlink.ca Website: www.seizurebraininjurycentre.com Contact: Rhonda Latendresse BIA of Windsor and Essex County Toronto (GTA) York Region Brain Injury Society of Toronto Brain Injury Association of York Region #205-40 St. Clair Ave. East Toronto, ON M4T 1M9 Phone: 416-830-1485 Email: info@bist.ca Website: www.bist.ca Contact: Michelle McDonald 11181 Yonge St., 3rd Floor Richmond Hill, ON L4S 1L2 Office Voicemail: 905-780-1236 Fax: 905-780-1524 Email: baebristow@rogers.com Website: www.biayr.org Contact: Bev Bristow 201 - 200 West Grand Blvd. Windsor, ON N9E 3W7 Phone: 519-981-1329 Email: info@biawe.com Website: www.biawe.com Contact: Mary-Ann Fuduric MARCH 2015 ), - ./#0 ,#1)2 #3 4 . ,) 15 6 !" # $ #$ %$&%'!& %(#)*%'+* !" " !" # !"# # !" 45 OBIA REVIEW SUPPORT Provincial Associations Brain Injury Canada/Lésion Cérébrale Canada 200 - 440 Laurier Ave. West Ottawa, ON K1R 7X6 Phone: 613-762-1222, Toll Free Line: 1-866-977-2492 Fax: 613-782-2228 Website: www.braininjurycanada.ca Email: info@braininjurycanada.ca British Columbia Brain Injury Association Newfoundland and Labrador Brain Injury Association 102 – 211 Columbia Street Vancouver, BC V6A 2R5 Phone: 604-601-5102 Fax: 604-681-4545 Website: www.brainstreams.ca Email: info@bcbraininjuryassociation.com PO Box 21063 St. John’s, NF A1A 5B8 Phone: 709-579-3070 Fax: n/a Website: www.nlbia.ca/index.php Email: nlbia2011@gmail.com Central Alberta Brain Injury Society (CABIS) Regroupement des associations de personnes traumatisées cranio-cérébrales du Québec #202, 4805 - 48 Street Red Deer, AB T4N 1S6 Phone: 403-341-3463 Fax: 403-346-1035 Website: www.cabis.info Email: cabis@telus.net 220, avenue de Parc Laval, QC H7N 3X4 Phone: 514-274-7447 (poste 223) Fax: 514-274-1717 Website: www.raptccq.com Email: info@raptcca.com Saskatchewan Brain Injury Association Mail: P.O. Box 3843 Regina, SK S4P 3Y3 Office: #322 - 310 Main St. N. Moose Jaw, SK S6H 3K1 Phone: 306-373-1555 or Toll Free (in Sask) 866-373-1555 Fax: 306-373-5655 Website: www.sbia.ca Email: info_sbia@sasktel.net Manitoba Brain Injury Association 204 - 825 Sherbrook St. Winnipeg, MB R3A 1M5 Phone: 204-975-3280 or Toll Free: 866-327-1998 Fax: 204-975-3027 Website: www.mbia.ca Email: info@mbia.ca Brain Injury Association of Nova Scotia PO Box 8804 Halifax, NS B3K 5M4 Phone: 902-473-7301 Fax: 902-473-7302 Website: http://braininjuryns.com/ Email: info@braininjuryns.com Brain Injury Association of Canada (New Brunswick) Phone: 506-721-8003 Website: www.biacnb.org/# Email: biacnb@icloud.com Brain Injury Association of PEI #5 - 81 Prince Street Charlottetown, PE C1A 4R3 Phone: 902-314-4228 or 902-367-3216 Website: www.biapei.com Email: info@biapei.com Ontario Brain Injury Association PO Box 2338 St. Catharines, ON L2R 7R9 Phone: 905-641-8877 or 800-263-5404 (support) 855-642-8877 (admin) Fax: 905-641-0323 Website: www.obia.ca Email: obia@obia.on.ca 46 Alberta Brain Injury Association Website: www.biaa.ca MARCH 2015 47 OBIA REVIEW EDUCATION OBIA Training The Ontario Brain Injury Association in conjunction with Brock University has developed a Certificate Training Program to provide professionals with the tools and knowledge to assist clients with recovery and function in everyday life following acquired brain injury. Brock Certificate Training Programs: The program is currently composed of two separate levels and feature guest faculty. Both levels are directed primarily at personnel working in community and home based rehabilitation programs that serve individuals with acquired brain injury. Featured course Advanced Brain Injury Rehabilitation Prerequisite: Neurobehavioural Rehabilitation: Assisting Recovery & Function in Everyday Life Following Brain Injury Approved by VRA Canada for 24.5 Continuing Education Hours This Certificatte Training Prrogram m is design ned to o inccreasse your knowled dge of brain in njury acrosss the lifesp pan and to appreciate factors which make brain injuryy rehabilittatio on more challeng ging. The e training pro ogram m will prov vide in nsigh ht into importan nt aspeccts of advan nced Neurrorehabilittatio on including: 1. Brain Injurry and th he Life ecycle in nclud ding the Ag ging Brain n 2. Brain Injurry and Em motion nal Dysrregula ation,, Dual Diag gnossis and Suicid dal Beha aviour 3. Issues and d Interventionss for Mild to Mode erate Brain Injury Dettailss Loca ation n: Date e & Time e: Hote els: Proffesso ors: This program is an exttension n of OB BIA s Neuro oreha abilitation n: Assisting Reco overy & Functtion in Everryday y Life Follo owin ng Brain Injury program.. 48 Bro ock Univ verssity 50 00 Gle enriidge e Av ve. St.. Cath hariiness, ON N Ma ay 27 7 to Ma ay 29 9, 2015 Fo our Po ointts Shera aton - 905.984.8484 Ho oliday y Inn & Suittes - 905.688.2324 Sh herrie e Bie ema an-C Copland Ph.D, C.Psych Da awn Goo od, Ph.D D, C.Psych Fo or more infformatio on abou ut this and/or other Ce erttifi ficate Traiining g Programs visit: www.ob bia.ca 905..641 1.88 877 1..855.642.8877 train ning g@obia a.on.ca MARCH 2015 We want to hear from you. Do you have a story of survival? Are you a caregiver to someone with ABI? Have you dedicated your life to helping those with brain injuries? To help spread the awareness of how brain injury impacts our lives, OBIA is pleased to share stories from our readership. The goal is simple: Share • Inspire • Support To share your stories with our readers, email us at stories@obia.on.ca DISCLAIMER: Articles may be reproduced from the OBIA Review provided credit is given to the authors wherever possible. Note: the opinions expressed herein are those of the respective authors and advertisers and not necessarily those of the Ontario Brain Injury Association (OBIA). OBIA will not be liable for any damages or losses howsoever sustained, as a result of the reliance on or use by a reader or any other person of the information, opinion, or products expressed, advertised or otherwise contained herein. Where appropriate, professional advice should be sought. 49 OBIA REVIEW Advertiser Index Bartimaeus Rehabilitation Services - 6 Bayshore - 11 Bergeron Clifford LLP - 16 Brainworks Rehabilitation - 50 Carranza Barristers & Solicitors - 12 Champaigne Klassen - 32 Community Solutions - 26 Dale Brain Injury Services - 49 Gluckstein & Associates LLP - 51 Henderson Structured Settlements - 24 Hill Program - 29 Himelfarb Proszanski LLP - 47 Inter-Action Rehabilitation Inc. - 50 Judith Hull & Associates - 8 Lawlor Therapy Support Services Inc. - 23 Mazin Associates - 18 McKellar Structured Settlements - 2 McLeish Orlando - 9 Mindworks - 33 NHI Health Care - 32 NRIO - 23 Oately, Vigmond LLP - back cover Osgoode Professional Development - 50 Pathways to Independence - 6 Rehab First - 39 ResCare Premier - 14 Shekter, Dychtenberg - 35 Singer, Kwinter - 34 Step Up! Brain Injury Services - 45 Thomson Rogers Lawyers - 15 Wallbridge Wallbridge - 30 INTERESTED in advertising in the OBIA REVIEW? 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