#48: Pediatric TBI and OT with Nelson Gonzalez (CE Course)

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Full Course Details: Public course page
Learn more about our guest: Nelson Gonzalez, OTR/L, RFS, CHHC, CCT, CPMT, CORE, CLT

Read the article and discussion upon which this podcast is based.

Released January 16, 2023.

Children are not little adults.

Their brains are actively developing. Because of this neuroplasticity, one might assume they would more quickly and fully recover from a traumatic brain injury (TBI).

This is not the case.

A brain injury can have a more devastating impact on a child than a similar injury in a mature adult. (Brain Injury Association of America)

This is what makes comprehensive, ongoing rehab for pediatric TBI so important. But, unfortunately, as we will see in our primary research, many children who experience TBI have substantial unmet rehab needs.

After reviewing the research, we are thankful to welcome to the podcast, Nelson Gonzalez OTR/L, RFS, CHHC, CCT, CPMT, CORE, CLT to discuss OT and TBI assessment, treatment, and what’s on the horizon in this practice area.

Primary Journal Article Explored

When you log in, be sure to check out the OT Potential Club’s written breakdown of the following research article. Then, share your questions and thoughts with fellow practitioners.

Fuentes, M. M., Wang, J., Haarbauer-Krupa, J., Yeates, K. O., Durbin, D., Zonfrillo, M. R., Jaffe, K. M., Temkin, N., Tulsky, D., Bertisch, H., & Rivara, F. P. (2018). Unmet Rehabilitation Needs After Hospitalization for Traumatic Brain Injury. Pediatrics, 141(5), e20172859.

Mentioned Resources for Pediatric TBI

Assessments for Pediatric TBI:

See all TBI Assessments

Learning about Neuroscience and health:

Supporting Research and Journal Articles

MacWilliam, K. R., Giancola, J. R., Wright, F. V., &; Ryan, J. L. (2021). Use of motor learning strategies in occupational therapy for children and youth with acquired Brain Injury. Physical & Occupational Therapy In Pediatrics, 42(1), 30–45.

Aravich, D., &; Troxell, L. (2021). Clinical practice guidelines for occupational therapists in the evaluation and treatment of oculomotor impairment following traumatic brain injury. Current Physical Medicine and Rehabilitation Reports, 9(3), 93–99.

Learning Objectives

  • You will be able to recognize which pediatric TBI patients tend to have the highest levels of unmet OT service needs post hospitalization.
  • You will be able to identify assessments you can use to ascertain service needs in different functional domains.

Agenda

Intro (5 minutes)

Breakdown and analysis of journal article (5 minutes)

  • Intro to unmet rehab needs following pediatric TBI
  • What was the intent of this paper?
  • Methods
  • Results
  • Discussion
  • Takeaways for OT practitioners

Discussion on practical implications for OTs (with Nelson Gonzalez) (50 minutes)

  • How did you first find OT?
  • How did you become interested in neuro OT?
  • What were your initial impressions of the article? Did it align with what you’ve seen in practice?
  • Did you find the list of the screens helpful? What do you all use?
  • What advice do you have for approaching TBI as a team, and looping in other professionals as needed?
  • The article did not go into specific TBI treatment, how do you approach a pediatric TBI and what are your go-to interventions?
  • What skills/resources do you recommend for OTs looking to improve their TBI care?
  • How can we extend our follow-up period for TBI patients?
  • It feels like overall there are so many unmet neuro needs- how do we as a profession need to change to meet them?
  • You went to ACRM this year, what made you excited about the future of OT for TBI and/or neuro OT?

Contact Hours

1 hour (0.1 AOTA CEUs). Released online from Aurora, NE.

Target Audience/Educational Level

Our target audience is occupational therapy practitioners who are looking to learn about Pediatric TBI and OT. The educational level is introductory.

Instructional Methods/Registration/Special Needs Requests/Cancellation Policy

This course is an independent/self-study course delivered via podcast on iTunes, Spotify and Google Play. Explore your listening options on the OT Potential Podcast page.

If you need accommodations to take this course, please contact us and we will address your needs on an individual basis.

If this course were to be canceled, please see our cancellation policy on our terms page.

Course Completion Requirements

In order to receive a certificate for this course, you must first listen to the podcast in its entirety. Then, you will need to take the test (found at the top of this page) and earn 75% or higher. If you pass, a certificate will be automatically generated and sent to your email.

Financial and Non-financial Disclosures

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

We here at OT Potential have no financial stake in this topic. Our guest, Nelson Gonzalez also has no financial disclosures.

Speakers

Nelson Gonzalez, OTR/L, RFS, CHHC, CCT, CPMT, CORE, CLT

Nelson Gonzalez, OTR/L, RFS, CHHC, CCT, CPMT, CORE, CLT

Nelson been an occupational therapy practitioner for over 18 years with an array of certifications and specialties including Rehabilitation Fitness Specialist, Certified Holistic Health Coach, Certified Cupping Therapist, Certified Pediatric Massage Therapist, Certified Oncology Rehabilitation Expert, and Certified Lymphedema Therapist. Nelson is the Executive Director / Administrator of Rehab Without Walls® NeuroSolutions (Florida division). Nelson is the Co-Chair of the Administration and Management Special Interest Section for the Florida Occupational Therapy Association and serves on the Sabrina Cohen Foundation Advisory Board and Campaign Leadership Team.

Nelson has presented at several national and international conferences and symposiums including ACRM on topics including Chronic Stress, Intensive Therapy for the Neuro Population, Timing & Rhythm in the Brain and Body, and Autism Spectrum Disorder. As a clinician and therapy leader, he has restored function for clients and decreased disabilities following disease or profound injury including congenital dysfunctions, developmental disorders, spinal cord injuries (SCI), traumatic brain injury (TBI), acquired brain injury (ABI), cerebral palsy, paralysis, Anxiety Disorders, Autism Spectrum Disorder (ASD), Chronic Stress, etc. Nelson has written several articles for various publications and co-authored a medical book that focused on topics that highlight the importance of taking not only an holistic approach to treatment but a whole-person and environmental approach as well.

Sarah Lyon, OTR/L:

Sarah Lyon, OTR/L headshot

Sarah’s passion is helping fellow OT practitioners translate evidence into daily practice. Sarah earned her BA in religion from St. Olaf College, then earned her master’s degree in occupational therapy from New York University in 2011. Since then, she’s worked in numerous facilities, including a critical access hospital, an acute trauma hospital, and a state inpatient psychiatric hospital.

Sarah is the founder/owner of OT Potential. Read more about OT Potential here.

Ep48-AOTA-Badge

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Please share any other feedback below! Including, ideas for future programming, and most importantly, how you feel this podcast will impact your practice!

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This was fantastic listening and learning; thank you! I found the holistic picture of OT in practice Nelson’s company offered a refreshing reminder of what drew me into OT in the first place, and energizing to learn that that model exists right now in practice - in my home state to boot!

I was really struck by the comments regarding the lack of education given (or remembered) in the acute care setting, to help prepare families and patients for next steps out of the hospital/acute rehab. That’s my current setting, and is an immediate take away I can put into practice - upping my pt/family education game in a way that is more concrete and can be remembered. I was also really struck by the discussion around food / the brain-gut connection and can be applied in any setting of practice.

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I agree, @melissa26! I absolutely agree. I HAVE BEEN that acute care therapist that could have done a much better job at providing education to these patients.

I could tell right away in talking with Nelson that we are taking in some of the same content on neuroscience. It is incredible the advances happening in this field. Here is a primer on the gut brain axis that I think everyone should listen to:

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Awesome podcast! I loved Nelson’s enthusiasm for wholistic care! The brain/gut discussion and resources shared are so interesting and make me want to read more about this relationship. My big concern is the high percentage of children on my caseload who have such narrow diets due to the limited variety of foods that they will eat- often the processed foods (chicken nuggets etc) and carbs (fries, bread, crackers etc). They are a super tough group to accept nutritious foods! Ugh!!

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I agree with @melissa26, this reminded me of the larger picture of OT which is what I’ve hoped to capture/provide to all of my families. I’ve been in OP peds for 5 years and struggle to get families and other disciplines to see we can go deeper than just the physical skills we are targeting and make a longer lasting improvement with our patients.

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This was interesting to me as it is an area that I have not worked in in a very long time.i do like listening to these podcasts aboutdifferent areas of OT to keep current in areas i dont see every day. Thanks.

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Seriously great episode!!! Neuroplasticity is everything and I’m so encouraged to hear our profession getting on board with how important it is really for all of our settings and populations! Thanks to you both!

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I thought this was a great podcast about a vast and complicated topic. I plan to look at some of the assessments to see how they could overlay into general pediatric practice. I really enjoyed and was intrigued by the additional discussion of reactions in other body systems to a TBI as well as use of tx of those systems to assist with TBI recovery.

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This was a really good listen! I learned a lot and so impressed with the way that this clinic operates- the whole body approach- it’s what I got into OT for.

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My first clinical rotation was a facility specializing in SCI/TBI that followed a patient from acute to home & it was AMAZING! During my fieldwork, managed care was taking over & we were bought out by HealthSouth. All of a sudden, patient stays were shorter & quality of care wasn’t a priority. What a learning experience it was! So instead I changed my career path.
Thank you Nelson for advocating & continuing the quality of care!
Listening to you was so encouraging!

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Good for you for changing your career path!!

I’m personally so interested in what happens to our healthe care systems when they are controlled by private equity firms. (What you experienced is all too common.) But, there ARE other ways of doing things, and I’m so thankful when OTs are able to opt out of settings that do not prioritize client care!