Photo of Emily Nalder

Enabling resiliency after an acquired brain injury

New research with community impact conducted through Paul J.J. Martin Early Career Professorship

Five years after its endowment establishment, the March of Dimes Canada Paul J.J. Martin Early Career Professorship has made an important contribution to  improving community integration for individuals with acquired brain injury. Driving this progress has been Dr. Emily Nalder, Assistant Professor, Department of Occupational Science and Occupational Therapy, and the inaugural researcher to hold the professorship. From the start, Dr. Nalder’s vision has been to use the best available evidence to optimize service delivery and ultimately ensure that experiencing a brain injury is not a barrier to successful community participation.

In delivery of her research program, Dr. Nalder has worked in collaboration with March of Dimes Canada and their clients, families and partners. She has examined how to optimize the participation of individuals living with brain injury, by understanding and targeting resiliency, breaking down silos in service delivery and through innovations in housing services and supports.

March of Dimes Canada is one of the country’s largest organizations serving and supporting people with disabilities, and recognizes that acquired brain injury is a leading cause of disability worldwide, and that there is an urgent need for community services and supports that would maximise community participation. Their funding of the career professorship supports emerging researchers and provides evidence-based knowledge to better develop best practices in service areas and program priorities.

“We are excited to see the results of Dr. Nalder’s research,” said Dr. Michelle Nelson, Chief Knowledge and Innovation Officer, March of Dimes Canada. “We are committed to continuing our support of this professorship and research that can improve the lives of people affected by a disability and provide opportunities to translate evidence to  practice.”

Dr. Nalder has facilitated educational and training opportunities for staff at March of Dimes Canada and students from the University of Toronto with the aim to contribute to a culture of evidence-based practice, developing research capacity within a national service organization, and supporting professionals working in community services so that they can be change agents and responsive to community needs.

The importance of resiliency

It will require a shift in thinking, but my dream is to see resiliency become an explicit part of rehabilitation.

Dr. Nalder’s work explores how to enable resiliency, that is, the ways in which individuals and communities negotiate life challenges. Resiliency is important to services optimizing participation, as it prepares people to negotiate the challenges they may face in their lives.

“It will require a shift in thinking,” said Dr. Nalder, “but my dream is to see resiliency become an explicit part of rehabilitation.”

Together with March of Dimes Canada, she has developed and begun validating a conceptual model of resiliency specific to the context of living with traumatic brain injury. She has determined that resiliency must involve engaging in meaningful and productive activities, feeling a sense of belonging, making sense of difficult experiences and having hope. The next stage is to examine how service providers foster resiliency, and using arts-based research, to uncover stories of resiliency from individuals with brain injury.

Breaking down silos

Imagine someone living with a brain injury that develops dementia later in life. Will they continue receiving services from the disability organization that may have been providing them with housing and personal care support for many years, or a care facility with specialized knowledge of dementia?

March of Dimes Canada has been a strong advocate for the need to break down silos that exist between aging and disability services and policies. Dr. Nalder and March of Dimes Canada have developed a framework that describes initiatives intended to integrate aging and disability services.

“The framework outlines actions that can be taken in research to facilitate collaboration and exchange of knowledge on disability and aging to address common challenges and in policy and service delivery,” said Dr. Nalder. “These steps address barriers to individuals accessing the right care at the right time.”

A place to live

Housing is recognized as a core building block shaping how individuals live their life. Individuals with traumatic brain are at high risk of homelessness, with two-thirds of vulnerably housed individuals in Canada reporting a lifetime history of brain injury.

Dr. Nalder and her colleagues, in collaboration with March of Dimes Canada − which provides housing services as well as attendant care in supportive housing settings − are examining the critical characteristics of housing and support services for individuals with brain injury. Preliminary findings suggest that housing services extend well beyond provision of a dwelling and include case management, crisis support, and supports for community participation. For example: life skills training, and employment services and opportunities.

Support through technology

Dr. Nalder is also working with researchers in Quebec to develop technological innovations such as smart home or wearable technologies, that can support individuals with brain injury and their caregivers in the home. The goal: harnessing emerging technologies that can be used to support the person and their families to remain living in their home, engaged in activities they need or want to do, for as long as possible.

The March of Dimes Canada, Paul J.J. Martin Early Career Professorship has been a significant investment in research to enhance community services and optimize participation for individuals with brain injury. It is also building capacity in junior scholars like Dr. Nalder, and by supporting over 50 University of Toronto learners who have collaborated with March of Dimes Canada in research, program evaluation or clinical fieldwork placements.

The early career professorship and partnership between the University of Toronto and March of Dimes Canada is unique and an excellent model for bringing community and academic organizations together to address areas of community need.

With Dr. Nalder’s term ending, applications are being sought to fill the second five-year term for the professorship.

“The early career professorship and partnership between the University of Toronto and March of Dimes Canada is unique and an excellent model for bringing community and academic organizations together to address areas of community need”, said Dr. Heather Colquhoun, associate professor and interim chair. “We are excited to see what the next person appointed to this role will bring to this body of research.”

Find out more and how to apply at the University of Toronto Careers Website.