Easterseals Crossroads recently transitioned the Brain Injury Rehabilitation Services program from Rehabilitation Hospital of Indiana (RHI). This statewide service is no longer available through RHI, but Hoosiers can count on the same level of service delivery in helping individuals with brain injuries navigate the resources they need to live, learn and work in our community from Easterseals Crossroads.

The new Resource Facilitation program at Easterseals Crossroads employs staff to identify specific resources such as therapy, support groups, education options, transportation assistance, social services and more so that adults with brain injuries can live as independently as possible. A resource facilitation team is assigned to individuals with brain injuries so that they can benefit fully from available resources.

Adult services at Easterseals Crossroads have long been positioned to serve individuals with brain injuries through day service options, employment services and assistive technology solutions. Brain injury services perfectly align with our existing array of service delivery within the agency. This new to Easterseals Crossroads service will create opportunities to more fully meet the needs of individuals living with disabilities in our community and our state.

Our experienced team is ready to identify specific resources such as therapy, support groups, education options, transportation assistance, social services and more so that adults with brain injuries can live as independently as possible. A resource facilitation team is assigned to individuals with brain injuries so that they can benefit fully from available resources.

A person living with a brain injury is capable and valuable to the community. Sometimes a person just needs supports and accommodations. More often than not, a person with a brain injury is able to live independently and contribute positively to their community.

Amy E. Miller is the director of Brain Injury Resource Facilitation Services at Easterseals Crossroads; she has answered some questions below to more fully explain the program.

What are resource facilitation services ?

Resource facilitation is a robust community-based public health model that has been proven to improve outcomes in both acute and chronic brain injury. The services are funded through Vocational Rehabilitation and offered free to qualified participants, giving them the opportunity to work with a team of brain injury professionals to achieve return to work or return to school goals.

In addition to returning to work or school, the services are also focused on one’s quality of life. Benefits include revised or acquired self-management and independent living skills, along with the ability to identify personal needs to improve relationships and advocate for needs. Additionally, it is common to see improvement with self-efficacy and life satisfaction in general. The things that make a person successful in returning to work or school can also contribute to happiness and success in other key areas of life.

Functions of resource facilitation include:

• Providing brain injury specific education to individuals with brain injury and their families/caregivers
• Proactively helping individuals identify, obtain and navigate needed services and supports
• Promoting brain injury informed care with other providers
• Ensuring collaboration, integration and coordination between providers and community-based resources.

Resource facilitation services at Easterseals Crossroads are available to individuals who qualify for vocational rehabilitation services for adults in central Indiana and throughout the entire state.

How are these services important for individuals with brain injuries?

Resource facilitation offers hope, a collaborative pathway to reach goals and the opportunity to find resources to take control of life for people with brain injuries.

The majority of people with whom we work are 5-10 years post injury and many never knew they had a history of brain injury.

What makes our ability to provide these services unique in our state?

There are so many reasons why Easterseals Crossroads is a great fit for this program. The organization has been a critical community resource for over 85 years providing community-based services. Many existing programs dovetail with the need for resource facilitation, and the brain injury services team is particularly excited about learning from the other Easterseals Crossroads program areas. The existing relationship with Vocational Rehabilitation will ease service delivery for individuals who will benefit from brain injury services.

What is our goal in proving these services?

We strive to serve each individual in the most effective, comprehensive way possible, guided by individual strengths, potential for change and perceived needs.

How can services help people with brain injuries reach their maximum potential?

A care plan is carefully crafted for each individual seeking service, which breaks down long term goals into achievable steps that are monitored carefully and adjusted to allow the person to stay on course to achieve desired goals.

In addition to acquiring and maintaining employment, resource facilitators help secure other supports including financial resources to prepare them to navigate systems independently once they have completed services.

No two brain injuries are the same. To understand the consequences of a brain injury you have to know the person, how their brain functions and how they have reacted to the injury. Severity of injury is often not correlated with level of disability. A “mild TBI” does not automatically mean a mild injury or mild consequences.

What are some challenges/obstacles for people with brain injuries?

Invisibility of a brain injury is often a barrier. A person with a brain injury can seemingly be functioning effectively in certain areas of their life, which can hinder overall ability. When someone is experiencing issues with initiation, a specific action may not occur to them; once prompted, the person can be fully motivated to act.

One person with whom we worked had impaired initiation that was very debilitating for him. For example, he could feel the physical sensation that indicated a need to use the restroom, but he could not automatically think of how to relieve the sensation; nothing was triggered by the sensation. When asked if he needed to use the restroom he could answer yes and obligingly proceed with this process.

Another very dramatic situation occurred when a husband experienced a brain injury and was unable to work or leave the house on his own. His wife was his sole caregiver and was managing everything. The stress of it all was starting to affect their marriage in very negative ways. She would leave for work in the morning and he would agree to do dishes, clean and perform other household chores. When she arrived home from work, nothing was done and they would fight it out with him not having a good explanation for why he hadn’t done what she asked and vowing to better the next day.

The cycle just continued. After learning that he had considerable deficits in the area of initiation, she left written notes with lists of what he should get done during the day and they set up alarms on his phone reminding him to look at his list. After implementing these very simple strategies, he got everything done and without exaggeration, their marriage was literally saved.

Impairment in executive functioning such as organization, time management and decision making; difficultly with abstract reasoning; difficulty concentrating and problem solving; lack of self-awareness (which often translates into poor understanding of what their limitations are and what they need); meta-cognition or thinking about thinking; slowed processing speed are all areas that are frequently affected by a brain injury.

Other obstacles or challenges include:

• Slowed or delayed processing speed often times to the point of not being able to effectively keep up with a conversation, which can make group treatments and classroom lectures very difficult
• Physical disabilities often as a result of the same incident that caused the brain injury can be visible, but can also include debilitating headaches and neurological issues
• Lack of available community resources
• Limits on insurance or therapies
• Loss of independence often causing transportation difficulties

Appropriate intervention depends on eliminating any other issues that can resemble consequences of brain injury, like incompatible medication, sleep disturbance and mental health concerns. For example, if someone is not getting enough sleep they can have trouble with concentration and memory. Sleep disturbance is a very common concern after brain injury.

What can success look like for someone who has used this service?

Effective resource facilitation services can include success in work, community engagement and family relationships. People can benefit from the security in knowing there is a team of professionals, advocates and partners to help move them forward in life.

One person with whom we worked was living out of his car and did not have a job when he started resource facilitation services. During those services he obtained an apartment, got a job in a medical field (where he is still employed), completed cognitive therapy and participated in a community program with university students in social work studies, medical studies and speech studies.

He was so pleased with having a team after feeling he’d been alone for so long. When he first started the program, he revealed that he was suicidal; our professionals were able to get him into an inpatient mental health program. By the time services ended, he reported being equipped and confident and ready to manage knowing that he had resources if he found he needed more help.

What should a potential employer know about an employee with a brain injury?

When individuals are motivated to work – with the right approach incorporating the right tools – success happens. An employee with a brain injury can be a great asset. Through resource facilitation services, they work with a team that helps to ensure the position is a good fit and everyone involved knows what accommodations the employee needs to succeed. We have found that many employees with a brain injury stay in their position long-term when their employer understands their needs and makes sure they have what they need to succeed.

Who does our resource facilitation team include?

Medically speaking, we do not yet have imaging sophisticated enough to show changes within cells, so many brain injuries can only be diagnosed with neuropsychological assessment.

We employee six resource facilitators, one psychotherapist and one BICS sppecialist who are available around the state. In addition to our team, we also offer:

• Brain Injury Coping Skills (BICS), which is a 15-week psychoeducational group intervention that helps clients and family members better understand their injury, gain self-management tools for alleviating the consequences of brain injury and learn the best ways to advocate for themselves and the accommodations they need.
• Brain injury informed psychotherapy, which is individualized to meet individual needs as they arise and change over time. This can be offered as a short- or long-term intervention – whatever is therapeutically prescribed to meet a person’s goals. Often used as a bridge to appropriate community services, this therapy engages therapists to consult with local providers to ensure continuum of care.

Contact us to learn more about referrals for brain injury services.

hosted by Jane Harper, an information security and risk expert

About Jane
Jane is a Senior Director of Information, Security Risk Management and Business Engagement, Eli Lilly and Company, as well as a member of our Easterseals Crossroads Board of Directors and a published author. Additionally, Jane serves on the board of the National Cyber Security Alliance, and she works actively with them to help everyone stay safe online.

She is passionate about information security for all and she is excited to share some tips to help keep us safe online, compliments of NCSA. Every other month, Jane will share some key facts, stories and tips regarding online security.

As tax season is coming up, we want to help you be prepared to work with your tax preparers. The volume and types of scams increase during this season, so stay alert, ask good questions and make it clear that protecting your information is key. Lastly compliments of the National Cybersecurity Alliance, here are some tips you can use.

Working with Tax Preparers

Do your Research
Vet your tax preparer before handing over sensitive information and ask what steps they take to protect your information. Businesses of all sizes are susceptible to cyberthieves, so it is critical to choose a preparer who takes security seriously.

Choose the Right Tax Preparer
Be selective about who you choose to file your taxes. Consider asking them the following questions:
• How will we exchange files and sensitive information?
• Who at your firm has access to my data?
• Are our communications end-to-end encrypted?
• What types of network security have you implemented?
• How do you back up client data?

Securely Send Documents
The most secure way of transferring documents is physically, either handing them to your tax preparer in person or sending them through the mail. However, if you must transfer them electronically, be sure to do it as securely as possible: Encrypt your files before sending them via email. Encryption protect the content from being read by entities other than the intended recipients. Encryption features are available on most major email platforms. Use a secure portal to upload documents. Portals encrypt documents during transfer and storage and limit access to only approved individuals.

Back it Up
Protect your valuable documents by making an electronic copy and storing it safely. If you have a copy of your data and your device falls victim to ransomware, you will be able to restore the data from a backup.

Use the 3-2-1 rule as a guide to backing up your data:
Keep at least three (3) copies of your data: Store two (2) backup copies on different storage media, With one (1) of them located offsite.

Additional Resources

• IRS: Tax Security 2.0 – A “Taxes-Security-Together”
  Checklist: https://www.irs.gov/newsroom/tax-security-2-0-a-taxes-security-together-checklist
• IRS: Tax Scams and Consumer Alerts – https://www.irs.gov/newsroom/tax-scams-consumer-alerts
• Federal Trade Commission: Tax Identity Theft Awareness – https://www.consumer.ftc.gov/features/tax-identity-theft-awareness
• Identity Theft Resource Center: Tax Identity Theft – https://www.idtheftcenter.org/tax-identity-theft/

Have you bought your Bingo Bonanza tickets yet? They are selling quickly!

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This event – presented by Century 21 Scheetz with grand sponsor HSA Home Warranty to benefit Easterseals Crossroads – takes place at Northside Events & Social Club. Along with seven games of bingo, dinner and two drink tickets are included with your ticket purchase. We will play one bonus game for the chance to win $1,000; bonus game cards will be available for purchase at Bingo Bonanza. In addition to the bingo games, there will be many other fun contests and opportunities for prizes.

Thank you to our Bingo Bonanza sponsors:

Grand
Century 21 Scheetz
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Silver
360 Tour Designs
Arbor Homes
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Nova Home Inspection
PJP Construction
Security Home Inspection

Bronze
Tish Flooring

In-Kind Donors
Centerpoint Brewing
Northside Events and Social Club

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You must be 21+ to attend Bingo Bonanza.

In 2014, 4-year-old Audrey was featured on the cover of the annual engagement report for Easterseals Crossroads. When Audrey’s parents realized that she was not meeting certain age-related milestones, such as sitting up and crawling during her first year, they engaged early intervention services through First Steps and Easterseals Crossroads at 9 months. In 2014, Audrey used a communication board along with signs to express herself and was learning to eat with adapted utensils and dress herself. As a happy 4-year-old, she was always excited to visit Easterseals Crossroads, greet staff members and point out her favorite wall art.

Speech-Language Goals

According to Audrey’s mom Julie, Audrey’s speech has changed tremendously since 2014. Audrey is now fully verbal with no need for sign language or a communication board. Julie notes that Audrey can still be somewhat hard to understand, but the family has found that people who know Audrey can understand her. Those who do not know her can understand the majority of what is said.

I can’t imagine what life would be like if I couldn’t have a conversation with my daughter; I’m so thankful that I can! It’s not easy (for her or us) coming to multiple therapy sessions each week for virtually her entire life, but the payoff has already been huge, and I believe it will continue, said Julie.

Occupational Therapy Goals

During her time with occupational therapists, Audrey has worked to learn to eat independently with utensils, drink from an open cup, dress herself, type on her chrome book, turn faucets on/off, brush her teeth, buckle/unbuckle her own seat belt, open various packages on her own for meals and so many other fine motor skills. “All of these things make our lives as parents so much easier and are great for Audrey’s feelings of independence,” said Julie.

“I remember one night a few years ago, when I heard Audrey turn the bathroom faucet on and off. This was a huge moment for us – this seemingly simple moment that so many parents take for granted. For us, it was a moment of independence – Audrey no longer needed to ask for help getting a drink of water,” said Julie.

Audrey is working very hard with handwriting. It appears as though handwriting may never be Audrey’s best form of communication, but her family feels that being able to write her name is incredibly important. Audrey is progressing with this, yet it is still very difficult for her. Aside from writing her name, other current goals include expressing her emotions properly, alternating arm movement, building strength in her hands/arms, coloring, cutting and performing fine motor tasks such as stringing beads. Therapy is hard work and Audrey attends multiple appointments weekly. Her therapists plan activities that are engaging because the hard work can affect Audrey’s focus on tasks.

Audrey Today

Audrey is now in 7^th grade where she enjoys singing in the choir, music and dancing. She enjoys swimming lessons, watching shows, supporting the Indianapolis Indians team and especially mascot Rowdie. As a huge baseball fan, she has memorized how to sing the national anthem at baseball games; she loves joining in with Take me out to the Ballgame after the 7^th inning stretch; and she knows the announcements at the end of the game.

In addition to therapy appointments twice each week, Audrey has attended camps offered by Easterseals Crossroads. She began with CampAbility when she was 4 years old. According to her parents, Audrey would have not benefited from traditional day camp. “Audrey absolutely loves attending camps every summer and enjoys the photo book that the camp counselors have made for her after camp. This past year, Audrey attended Camp FUEL, which we called the big kids camp. We were worried that she would be among the youngest, but the counselors were great and Audrey loved it. It’s wonderful to know that we can always count on Easterseals camps to provide a fun summer experience for her,” said Julie.

“Easterseals has been a resource for Audrey and services have grown with her adjusting therapies to her specific needs and to our desires for her. The therapists care about what is important to our family, and these are the skills they will work on,” said Julie.

“Easterseals has been a huge blessing in our lives. Her therapists over the years have done things to show their care for Audrey as a person, not just a client. Things like taking photos of their pets to show Audrey when she asked; showing her their pets via zoom when we did therapy virtually during Covid; gifting her a weighted stuffed animal because she liked one at therapy. We love how everyone here knows her and us. It isn’t uncommon for the maintenance staff to greet us and comment on how far Audrey has progressed over the years,” said Julie.

And you know – as a mom, I love seeing the different abilities of the staff at Easterseals Crossroads. Seeing adults at work who may have ability levels similar to Audrey gives me hope and confidence for her future as a working adult, said Julie.

Harrison’s family knows him as a kind, loving child who is very social; they never know what he is going to say or do next. Harrison’s mom Amy describes her pregnancy with Harrison as typical, but once he arrived, a heart murmur was detected. This lead to open heart surgery along with some other medical issues; eventually Harrison was diagnosed with Williams syndrome, a genetic condition that is present at birth and characterized by medical problems, including cardiovascular disease, developmental delays and learning challenges.

At around 6 months, the family knew that early intervention services were critical for his development and started with physical therapy and occupational therapy. Speech-language services began later.

Williams syndrome is rare and we learned to take it all one day at a time because the range of ability with Williams kids is so broad. We realized we couldn’t control outcomes, but we could provide Harrison resources to advance, said mom Amy.

When Harrison aged out of early intervention services at 3, his family wanted to continue his therapy appointments at Easterseals Crossroads. Now 8 years old, he is working on occupational therapy skills that include buttoning, zipping, tying and holding a pencil to write. He continues to work on conversation, chewing and swallowing with his speech-language pathologist.

“It was a game changer for me when I could see that Williams syndrome did not have to define Harrison; he is Harrison first and everything else comes second to that. He can still do what he wants to do; it just may be a little harder. This does not have to define who he is for his life,” said Amy.

Learn more about Harrison’s early intervention services by watching the video below.