This document summarizes a training for direct care staff in West Virginia's TBI Waiver Program. The training provides one hour of annual training required by the program. It defines TBI, describes brain anatomy, and identifies common impairments from TBI. Successful completion requires passing a test and evaluation. The training aims to help direct care staff better understand and assist those with traumatic brain injuries.

1. Successful completion of this training meets one hour of the four hour annual training requirement
for Personal Attendant Services direct care staff as provided through the TBI Waiver Program

2. •
•
2013
Information included in this presentation was
current at the time it was developed.
Presentation materials are reviewed on an
annual basis.
West Virginia TBI Waiver Program direct care staff annual training
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3. Christopher J George, MSW, LGSW, CBIS
Kaylynn Shepherd, LICSW, CBIS
Jeanette Motsch, MS, CBIS
Amanda M Wilson, M.A.
Ashley Young, CBIS
Traumatic Brain Injury Services at the Center for Excellence in
Disabilities
Contact information:
www.cedwvu.org/programs/tbi
Toll Free: 1-877-724-8244
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West Virginia TBI Waiver Program direct care staff annual training
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4. Upon completion of this training participants
will be able to:
•
Define Traumatic Brain Injury (TBI)
•
Describe the basic anatomy of the brain
•
Identify three impairments as a result of Traumatic Brain
Injury (TBI)
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West Virginia TBI Waiver Program direct care staff annual training
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5. Traumatic Brain Injury (TBI) is
an insult to the brain not of a degenerative or
congenital nature caused by an external physical
force, that may produce a diminished or altered state of
consciousness resulting in an impairment of cognitive
abilities or physical functioning. It can also result in the
disturbance of behavioral or emotional functioning, may
be temporary or permanent and cause partial or total
functional disability or psychosocial maladjustment
National Head Injury Foundation
(now the Brain Injury Association of America)
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West Virginia TBI Waiver Program direct care staff annual training
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6. A non-degenerative, non-congenital insult to the
brain caused by an external physical force resulting
in total or partial functional disability and/or
psychosocial impairment
WV TBI Waiver Manual 512.7.2.C. page 19
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7. •
•
Every 23 seconds, one person in the United
States sustains a traumatic brain injury
Each year, an estimated 1.7 million people
sustain a TBI
Centers for Disease Control and Prevention
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West Virginia TBI Waiver Program direct care staff annual training
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8. Centers for Disease Control and Prevention
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West Virginia TBI Waiver Program direct care staff annual training
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9. The following estimated averages are based annually for the
United States from 2002-2006:
•
1.7 million people will sustain a TBI
•
52,000 people will die resulting from a TBI
•
80,000 people annually experience the onset of long-term
disabilities following TBI
•
1.365 million (80%) are treated and released from emergency
departments
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West Virginia TBI Waiver Program direct care staff annual training
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10. •
TBI by Age
• Adults aged 75 years and older have the highest rates of
TBI-related hospitalization and death
•
TBI by Gender
• In every age group, TBI rates are higher for males than for
females
• Males aged 0 to 4 years have the highest rates of TBIrelated emergency department visits, hospitalizations, and
deaths
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West Virginia TBI Waiver Program direct care staff annual training
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11. Traumatic Brain Injury (TBI) is often referred to as
some of the following:
• The “Silent Epidemic”
• The “Signature Wound” of returning veterans
• Having your bell rung
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West Virginia TBI Waiver Program direct care staff annual training
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12. Watch the following video
“Relearning Everything”
http://www.youtube.com/watch?v=-DXKS9uCIc0
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West Virginia TBI Waiver Program direct care staff annual training
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13. The following are some injuries that may occur at the
time of traumatic injury:
•
Axonal Shearing (diffuse axonal injury): damage to individual
nerve cells (neurons)
o
•
Contusion: bruising of the brain tissue
o
•
Often caused by small blood vessel leaks as a result from a
fall or car accident
Coup-Contrecoup: shaking of the brain back and forth within the
confines of the skull
o
•
Often seen in car accidents as a result from the brain
bouncing against the wall of the skull
Often caused when the head slams into a dashboard then
jerked back hitting the headrest during a car accident
Skull Fracture: break in one or more of the bones that make up
the skull
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West Virginia TBI Waiver Program direct care staff annual training
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17. The following are some injuries that may occur after
the trauma:
•
Hematomas: Accumulation of blood or a collection of blood
trapped in the tissue of the brain.
•
Increased Intracranial Pressure: Pressure inside the skull that
builds as the brain swells.
•
Seizure Disorder: Disorderly discharge or electrical activity in
the nerve cells of the brain.
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West Virginia TBI Waiver Program direct care staff annual training
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18. •
The Brain is comprised of nerve cells
o
Consistency similar to spaghetti
•
The Brain fits tightly within the skull
o
Surrounded by fluid called cerebrospinal
•
The Brain is divided into four lobes
o
Frontal
o
Occipital
o
Parietal
o
Temporal
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West Virginia TBI Waiver Program direct care staff annual training
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19. The following link will explain the four lobes of the
brain and their functions
Please take a minute and review each lobe provided on
the link below
Brain Basics - 3D Model of Brain Injury | BrainLine.org
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West Virginia TBI Waiver Program direct care staff annual training
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20. •
Frontal
o
o
o
o
o
•
Impaired social behavior
Decrease in problem solving abilities
Difficulty controlling emotions
Decision making: Often can not see long-term
consequences of actions
Memory
Occipital
o
o
Double Vision
Vision field cut
-Part of what a person may see might be cut off
Example: When looking at a flower a person may only see the bottom
half of the flower
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West Virginia TBI Waiver Program direct care staff annual training
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21. •
Parietal
o
o
o
o
•
Impaired body sensation on affected body parts
Decreased awareness of a person’s own body parts
Problems judging distances and depth
Trouble controlling eye movements
Temporal
o
o
o
Impaired sensory information
-Hearing
Can cause problems with communication, comprehension, and memory
Difficulty with speech
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West Virginia TBI Waiver Program direct care staff annual training
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22. The Brain Stem is located deep inside the brain and
leads to the Spinal Cord
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West Virginia TBI Waiver Program direct care staff annual training
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23. The Brain Stem controls many arousal and
basic life functions like the following:
•
Respiratory and Cardiac Centers
o
o
o
•
Breathing
Heart Rate
Swallowing
Autonomic Nervous System
o
o
o
o
Sweating
Blood Pressure
Digestion
Body Temperature
•
Reflexes to Seeing and Hearing
•
Ability to Sleep
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West Virginia TBI Waiver Program direct care staff annual training
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24. When someone has experienced damage to the
brain stem they may experience
some of the following:
•
Dizziness and Nausea
o
May also be known as Vertigo
•
Insomnia
•
Difficulty swallowing
o
•
May also be known as Dysphagia
Difficulty with organization/perception of the
environment
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West Virginia TBI Waiver Program direct care staff annual training
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25. Located towards the back of the
brain, underneath the occipital and temporal
lobes
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West Virginia TBI Waiver Program direct care staff annual training
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26. The Cerebellum is also known as “little brain”
because it controls many of the following:
•
Movement
o
o
o
o
Direction
Rate
Force
Steadiness
•
Muscle Tone
•
Posture
•
Hand/Eye Movement
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West Virginia TBI Waiver Program direct care staff annual training
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27. When someone has experienced damage to the
cerebellum they may experience trouble with some
of the following:
•
Walking
o May appear “drunk” when walking
•
Balance
•
Fine Motor Movement
•
Coordination
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West Virginia TBI Waiver Program direct care staff annual training
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28. •
Learning to work with those who have a
Traumatic Brain Injury (TBI) takes time
•
Recovery time will vary from person to person
•
Change and improvement can continue for
many years
•
Continued communication and consistency will
assist with the recovery process
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West Virginia TBI Waiver Program direct care staff annual training
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29. U.S. Department of Health and Human Services
Centers for Disease Control and Prevention,
http://www.cdc.gov/TraumaticBrainInjury/
Brain Injury Association of America: The Essential Brain Injury
Guide 4.0. Academy of Certified Brain Injury Specialist (2009)
BrainLine
http://www.brainline.org
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30. Here are some additional resources that you may want to explore:
•
•
•
TBI Survivors View
Centers for Disease Control and Prevention: TBI
Center for Excellence in Disabilities at West Virginia University
CDC Injury and Violence Prevention and Control
http://www.cdc.gov/injury/index.html
Shepherd Center Learning Connections
http://myvitalconnections.org/webmanuals.nsf/3478d43e5c5c8dcb
85256ae60061f897/1B910B089562F1EB85257164006D34A7
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31. •
•
•
To receive your certificate of successful completion
you must first pass the test and complete an online
evaluation
A score of 80% or higher is required
Once you have successfully completed this training
module you will receive an email with your
certificate of completion
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West Virginia TBI Waiver Program direct care staff annual training
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32. •
Please scroll down and take the test below.
•
Your thoughts and comments are very important to
us. You may submit by clicking the survey link
below.
Thank You!
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West Virginia TBI Waiver Program direct care staff annual training
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