Researchers to examine traumatic brain injury for underserved people, pediatric concussions

Two faculty members of the Department of Occupational Science and Occupational Therapy will be doing research in expanding understanding of traumatic brain injuries and pediatric concussions, after receiving Canada Research Chairs.

On December 16, the 2020 Canada Research Chairs were announced. Professor Angela Colantonio was awarded a Tier 1 Canada Research Chair in Traumatic Brain Injury in Underserved Populations. Professor Nick Reed was awarded a Tier 2 Canada Research Chair in Pediatric Concussion.

Reed is an Associate Professor in the Department of OS&OT and the Rehabilitation Sciences Institute and an Adjunct Scientist at Holland Bloorview Kids Rehabilitation Hospital.

We asked Professors Colantonio and Reed to share with us how their research will impact society and occupational therapy practice.

We have to address the lack of awareness, understanding and support for people with brain injury, particularly among the most underserved populations. Some of these communities are women who experience intimate partner violence, people who experience housing instability or who interact with the justice system.

My work aims to create more capacity inside and outside the health care system to address the unique needs of  Canadians who have a traumatic brain injury.

I hope to enable greater access to rehabilitation professionals, such as occupational therapists, who can support people experiencing cognitive and other health outcomes resulting from brain injury.

I also plan to address larger societal and environmental conditions that historically lead to discrepancies in health services available to underserved people, for example, by creating educational and training tools for health professionals and other front line workers who interact with members of these communities. My research considers sex and gender, ethnicity, age and other determinants of health that affect provision of and access to services.

My goal over the next five years is to create and share new treatments for concussion, positively change concussion knowledge, attitudes, and health behaviours, and improve social support for children and youth with concussion.

Concussion, which is a mild traumatic brain injury, isn’t only a sports injury and can happen from many different causes. Because of this, I hope to engage a broader population beyond athletes to provide necessary supports to children and youth impacted by concussion.  This research will have a particular emphasis on populations and communities that have largely been left out of concussion research, education and care initiatives to date.

However, occupational therapy and rehabilitation in general have not yet been substantially included in the care of people with traumatic brain injury in underserved populations. This program of research will highlight the important role of occupational therapists and rehabilitation to improve health outcomes and reduce social injustice, and ultimately, advance occupational therapy practice with, and the profession’s contribution to, this area.

My research program embodies the values of the occupational therapy profession and I couldn’t think of a better place to conduct this research. This program will provide extraordinary research and clinical training opportunities and will open the door for new areas of practice for occupational therapy students. I feel extremely fortunate to be advancing our research in this environment.

Often after a concussion, a lot of emphasis is put on the symptoms that a child feels or reports (e.g., headaches, nausea, decreased attention etc.). However, we really need to focus on how these symptoms impact function, or what a child can or cannot do in their lives, for instance  go to school, play sports, or spend time with friends or family.

Occupational therapists focus on function, on getting people back to life after injury, and can provide such an important perspective during concussion care and rehabilitation.

Occupational therapy practice will benefit by putting the findings of this research into action, informing new approaches to education and care, and creating a role for occupational therapy when caring for children and youth after a concussion.

“As international leaders in their fields, Professors Angela Colantonio and Nick Reed are committed to enabling meaningful participation and improving the quality lives of people with traumatic brain injury,” states Heather Colquhoun, Interim Chair, Department of Occupational Science and Occupational Therapy.  “The investment by the Canada Research Chair program will allow them to further advance their work and train the next generation of promising researchers in the field. I am thrilled to have their expertise in our Department and look forward to the contributions they will make to health and well-being in the groups they serve.”

The Canada Research Chair program was created by the Government of Canada in 2000 to help Canadian universities attract and retain world-renowned researchers, develop Canadian research expertise and achieve excellence in training. Tier 1 awards provide researchers $200,000 annually for seven years and Tier 2 awards provide researchers $100,000 for five years.

Authors: Dayna Frydman and Sandra Sokoloff

Jasmine: I first learned about occupational therapy (OT) through my own family’s experience of caregiving for my beloved Great Aunt. An occupational therapist enabled my Aunt to age in place, which gave her the key to living her life to the fullest. Through this experience, I learned that engaging in meaningful daily activities adds quality to people’s lives…COVID-19 has highlighted to me how important daily occupations are; our daily routines and roles have been completely turned upside down due to the pandemic. I believe occupational therapists are needed now more than ever.

Claudia: I have witnessed first-hand the impacts of disability and injuries on my family members’ quality of life and engagement in daily activities. By pursuing occupational therapy, I hope to help people participate and engage in occupations that are meaningful to them, while understanding how various factors may impact their functioning… The COVID-19 pandemic has refocused my attention to the importance of maintaining occupations during life transitions. This pandemic has impacted all of us to some extent, whether it be how we interact with our social circles, our employment status, and even how we engage in our leisure occupations.

Andrea Duncan, PhD (cand.),

Ms. Duncan is completing doctoral studies at the Institute of Health Policy, Management and Evaluation in the Dalla Lana School of Public Health, University of Toronto.  Her research is focused on community mental health service delivery, educational scholarship and education as an intervention for vulnerable populations.  View faculty web page.

Emily S. Ho, PhD, MEd, BScOT, OT Reg. (Ont.),  Assistant Professor, Tenure Stream. Dr. Emily S. Ho received her PhD in Rehabilitation Sciences at the University of Toronto in 2019. She is the Research Director and a Clinician Investigator in the Division of Plastic and Reconstructive Surgery at The Hospital for Sick Children. Dr. Ho’s  scholarship focuses on understanding, fostering, measuring, and evaluating occupational engagement and functioning in young people with musculoskeletal conditions, specifically brachial plexus birth injuries and congenital limb differences. She strives to place the voice of youth with upper limb disabilities at the centre of her research, partnering with them through research initiatives that focus on physical and mental wellbeing to empower independent living.

Dr. Ho has established an international and national reputation for her research and professional activities around musculoskeletal conditions. Early in her career, she developed the Brachial Plexus Outcome Measure, which has been adopted as a national standard for measuring activity function in children with brachial plexus birth injuries. This measure has been used internationally and is undergoing cross-cultural translation in several countries.

Dr. Ho has been involved in the Dept. of OS&OT as a status only lecturer and research project supervisor for many years, and is the recipient of the Department’s 2020 Award for Excellence in Research Supervision. View faculty web page.

Behdin Nowrouzi-Kia, PhD, MPH, MScOT, OT Reg. (Ont.), Assistant Professor, Tenure Stream and Emily Geldsaler Grant Early Career Professor in Workplace Mental Health. Dr. Behdin Nowrouzi-Kia received his PhD in Interdisciplinary Health from the School of Rural and Northern Health, Laurentian University in 2013 with a focus on occupational health. Dr. Nowrouzi-Kia’s research program addresses workplace mental health focusing on prevention and occupational performance, return to work and workplace psychological injury, and occupational therapy interventions in mental health management and prevention. His research is motivated by efforts in the field of work disability prevention that extends beyond the efforts to prevent or cure diseases from a purely physical perspective towards more holistic approaches. The major tenets of his work take a biopsychosocial perspective to understand work disability and extend towards incorporating personal characteristics (e.g., psychosocial) and environmental (e.g., healthcare system, workplace, workers’ compensation system) factors in improving health outcomes.

Dr. Nowrouzi-Kia has held appointments in the Department since 2016 and is cross-appointed to the Rehabilitation Sciences Institute. He is also CEO and founder of a private OT practice in Northern Ontario focusing on return to work, mental and physical health, and work disability prevention, and CEO and founder of a consulting group specializing in work disability management, prevention and population health.  View faculty web page.