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The mission of Brain Injury Services of SWVA is to help children and adults living with brain injury improve the quality of their lives and reintegrate into family and community.
Frequently Asked Questions About Child and Adolescent Case Management  

1. What Are The Common Symptoms of Persons Who Have Survived Brain Injuries?
It is important to remember that each person who sustains a brain injury will experience a unique set of symptoms. Some symptoms may last for a few weeks while others may last for a lifetime. The following is a list of common physical, cognitive and emotional symptoms of persons who have survived brain injuries. The following information has been gathered from the Brain Injury Association of America, Inc.

Cognitive Impairments Involve:

  • Communication and language
  • Memory, especially for learning new information
  • Perception, sensory integration
  • Attention and concentration
  • Judgment, planning, and decision making
  • Ability to adjust to change (flexibility)
  • Organizational skills
  • Initiation

Social and Behavioral Impairments Involve:

  • Mood swings
  • Denial
  • Depression and/or anxiety
  • Lowered self esteem
  • Sexual dysfunction
  • Restlessness and /or impatience
  • Inability to self-monitor
  • Inappropriate social responses
  • Difficulty with emotional control and anger management. Abrupt unexpected acts of violence
  • Inability to cope
  • Excessive laughing or crying
  • Agitation
  • Delusions, paranoia, mania
  • Non-Age appropriate behavior

Neuromotor-Physical Impairments Involve:

  • Vision, hearing, speech and other sensory impairments
  • Headaches
  • Lack of coordination and speed of movement
  • Muscle spasticity (a condition that causes stiff, tight muscles, especially in the arms and legs, making movements stiff jerky or uncontrollable)
  • Paralysis
  • Seizure disorders
  • Sleep disorders
  • Dysphagia (a disorder of swallowing)
  • Dysarthria (a disorder of articulation and the muscular/motor control of speech)
  • Balance, strength, and equilibrium
  • Motor function

2. Is Brain Injury In Children Different From Adults?
Brain injury is the most frequent cause of disability and death among children and adolescents in the United States. The most frequent causes of traumatic brain injury in children and adolescents are: falls, motor vehicle crashes, pedestrian injuries, shaken baby syndrome, firearm injuries and near drowning. It is important to recognize that children are not a younger version of adults. The brain develops through stages during childhood before it fully develops into adulthood. We acknowledge the importance of developmental milestones in the treatment of children with brain injury and their need for services provided in a continuum of care. Therefore, our program is designed to provide long term community-based case management, and takes into consideration that each child's recovery process is unique. The family and support system play an essential role in this process.

3. Will Brain Injury Services Of SWVA Pay for Services Such As Transportation, Therapies, Medication, Etc.?
Each family works with a Case Manager, who is trained in the special needs of children and adolescents, to develop a case management plan specific to the child's/adolescent's needs. Brain Injury Services of SWVA may pay for a limited amount (if resources are available) of needed services related to the case management plan once all other options are exhausted (the child/adolescent, family, other service providers, etc.). The family will be asked to complete a Financial Eligibility Form, which determines how much financial assistance Brain Injury Services of SWVA will provide.

4. Is There A Cost for Services?
There is no cost for case management services directly provided by a Case Manager. If a person receives Life Skills Training Services from our trained staff, or a service that is contracted by the Case Manager, then a Financial Eligibility Form is completed with the Case Manager. This will determine whether the individual will be required to contribute towards the particular services (for example: speech therapy).

5. Will Brain Injury Services of SWVA Help Us With School Re-Entry, or The Individualized Education Plan (IEP) Process?
Children and adolescents face numerous challenges as they make a transition from the medical and rehabilitation settings back to home, school and community. In the school situation, teachers are especially challenged by the learning and behavioral difficulties children often demonstrate after brain injury. The Case Management Program specializes in key strategies to help school personnel and families manage this difficult transition. The strategies include: building collaborative teams, providing training and information about pediatric brain injury, and facilitating the establishment of a common philosophy in teaching students with brain injury. Academic goals are established through an IEP (Individualized Education Plan), which provides alternative options for learning and adapts the school curriculum to meet the student's unique needs. The child’s Case Manager will assist in developing the IEP.

6. Who Has Access to My Files?
You always have the right to look at anything in your file that was created by Brain Injury Services of SWVA. Some information received from outside sources may not be released. Your Case Manager, the Program Director, the Director of Administration, and the Executive Director will have access to your file but it will be inaccessible to any other Brain Injury Services of SWVA staff, volunteers, or clients without your prior consent.

7. What Will Be The Family's Role In The Program?
The Case Management Program uses a family-directed approach, which means that goals are owned and directed by the family. Parents or legal guardians are expected to commit to participate actively in the program. The process of identifying, planning, coordinating, and monitoring services and resources to meet the child's/adolescent's needs are facilitated by the assigned Case Manager. The Case Manager will provide family support and education to the client, the family, and the community whenever needed. The Case Manager will also assist the family through all transition processes: from rehab to home and school re-entry.

8. How Do I Make A Referral?
Anyone can make a referral. The process is simple. You may call Brain Injury Services of SWVA and state that you would like to make a referral. The receptionist will take your name and phone number and a member of the Case Management Staff, who specializes in children and adolescents, will call you back. The Case Management Staff will take basic information and history to present to the Intake Review Board. That Board will determine whether the person referred is eligible for services.

9. How Often Do I See My Case Manager?
This varies from client to client. Each individual is seen as often as needed to continue to make progress toward the goals in their Case Management Plan. A minimum of one contact every three (3) months is required to keep your case active.

10. How Long Can Services Be Received?
The family and Case Manager develop a Case Management Plan together. The plan becomes the guiding document for delivery of case management services. The Case Management Plan is revised on an as needed basis. Goals may be developed in the following areas: housing, medical, educational/school re-entry, transportation, social, recreational, financial, etc. Goals are specific, achievable, and measurable. Family tasks are identified with specific time frames for completion. As long as tasks and goals are identified and the family is participating in tasks, services can continue.

11. When Is A Case Closed?
A case will be closed from the Case Management Program if a client (child/adolescent) and/or family:

  • Moves out of the Brain Injury Services of SWVA service area;
  • Does not participate for more than 3 months;
  • Has met all goals in the case management plan;
  • When the client reaches 18 years of age, a case manager specializing in adults may be assigned to the client

12. What Programs Does Brain Injury Services Of SWVA Provide?
In support of our person/ family-centered philosophy, our services are individualized and developed in response to family needs. Family goals and client's needs are evaluated by the family and the assigned Case Manager, and services are set up using community/school resources that can empower the family to reach the goals. The Case Manager will facilitate family support groups and play activity groups. Your Case Manager will advise you about these programs and how they might help you reach your goals. We also provide Life Skills Training Services specific to the needs of children and adolescents, at a rate that takes into consideration the family’s financial status as determined by a completed financial statement.

13. Why Do I Need A Case Management Plan?
A Case Management Plan is a written document that not only summarizes the client’s and family's goals and how they can be accomplished, but also constitutes an agreement between the family and the Case Manager of mutual responsibilities as you work together. This plan can be revised as the family moves through the process of attaining the goals, if deemed appropriate by the family and the assigned Case Manager.

14. What Is Case Management?
It is the process of assessing, planning, coordinating, and monitoring services to achieve specific family goals. The Case Manager looks at each component of the family life in relation to the child with special health care needs: family dynamics and support system, financial, housing, transportation, health, legal, educational and school re-entry, social/recreational. A Case Manager helps you define your goals in each component; then the Case Manager works together with you to achieve them, by helping you connect with resources, by advocating for you, and by creating community and school teams (IEP and CST meetings).

15. Who Is Eligible for Services?
Any child from birth up to 18 years of age who has sustained a brain injury, not as a result of birth or a genetic defect, and needs coordinated services in order to achieve family goals in relation to the child/adolescent with the traumatic/acquired brain injury. The family and client must reside in the Brain Injury Services of SWVA service area.

16. What Is Acquired Brain Injury?
In 1997, the Brain Injury Association of America, Inc. adopted the following definition: an acquired brain injury is an injury to the brain that has occurred after birth. The injury commonly results in a change in neuronal activities that effects the physical integrity, the metabolic activity, or the functional ability of the cell. Causes of acquired brain injury include external forces applied to the head and/or neck (e.g., traumatic brain injury with or without skull fracture), anoxic/hypoxic injury (e.g., cardiopulmonary arrest, carbon monoxide poisoning, airway obstruction, hemorrhage), intracranial surgery, vascular disruption (e.g.,arteriovenous malformation (AVM), thromboembolic events, fat emboli), infectious diseases, intracranial neoplasms, metabolic disorders (e.g., hypo/ hyperglycemia, hepatic encephalopathy, uremic encephalopathy), seizure disorders and toxic exposure (e.g., substance abuse, ingestion of lead and inhalation of volatile agents). The term does not refer to brain injuries that are congenital or brain injuries induced by birth trauma.
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“Brain Injury Services of SWVA is funded in part by state general funds appropriated by the Virginia General Assembly and administered by the
Department for Aging and Rehabilitative Services”