OBIA Review 22-1 final.indd - Ontario Brain Injury Association

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
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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
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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
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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”
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Our nurses are specially trained to care for clients who need advanced
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providing individualized care plans, standardized client reporting and
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With 60-plus offices across Canada, we also offer a local “touch” when
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OBIA REVIEW
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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
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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
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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.
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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
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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
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visit: www.ob
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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?
AD SPACE
starting from
$900
for one full year!
Call OBIA
905-641-8877
50
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MARCH 2015
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We see the lives behind our laws.
With over 40 years of litigation experience, Oatley Vigmond knows
personal injury law. We’ve argued hundreds of cases, secured record
settlements and have helped shape Canadian law. Yet for all our
success in the courtroom, we have never lost sight of the fact that
people come first. We are dedicated to serving clients across Ontario.
Contact us at 1.888.662.2481 or oatleyvigmond.com.
Proud Member