Nebraska Pilot of the
BRAIN BOOK^® System

Background
Since April 1997, the Kearney office of Nebraska Vocational Rehabilitation Services has been conducting a pilot project using the BRAIN BOOK^® Life Management System to retrain cognitive skills to eight consumers affected by Traumatic Brain Injury. Our rationale for the pilot was based on a mutual frustration of both our consumers with brain injury and vocational rehabilitation personnel providing employment services to them.

Few people who experience brain injury in the state receive any inpatient or outpatient cognitive rehabilitation or retraining, and traditional vocational training services have met with limited success. Our rationale was supported by the results of a November 1995 statewide survey conducted by Hanna Keelan Associates, P.C., which indicated persons with brain injury and their family members across the state believed short-term memory difficulties and other cognitive impairments were their greatest barriers to employment. It is apparent that, generally speaking, the people with brain injuries who come to us for employment services are not equipped with the compensatory strategies or tools to benefit from our vocational services, however effective they may be.

We purchased materials for the eight participants and two trainers in January 1997. By April, Kathy Moeller completed the first three “Skills in Action” assessments and trained Keri Bennett to complete the remaining five assessments. We added participants until the last person began the program in February 1998.

Profiles of Participants
Participants varied in terms of the severity of cognitive impairment, from mild to severe. Shortly after we began the pilot, Internet-based skills training became available from the BRAIN BOOK^® System office in Medford, Oregon, and four of the eight participants completed or are completing training through that medium. The type and length of training for each participant is:

Consumer #1 received 109 hours of individualized training over 7 months

Consumer #2 received 28 hours of individualized training over 3 months.

Consumer #3 received 26 hours of individualized training over 5 months.

Consumer #4 received Internet-based training only, with telephone support, as needed

Consumer #5 received Internet-based training with 3-5 hours of individualized support

Consumer #6 received Internet-based training initially, but is now receiving individualized training, approximately 15 hours to date

Consumer #7 received 30 hours of individualized training, including training at the worksite

Consumer #8 received Internet-based training only,

At this time, Consumers #2, 3, 4 and 8 are completing academic training programs and Consumer #2 has been using the BRAIN BOOK^® System successfully at her part-time worksite since beginning the program in April, 1997. Consumer #7 is self-employed. Consumers #5 and 6 are full-time homemakers with plans to re-enter competitive employment. Consumer #1 is considered severely injured and has not completed a vocational training program, but she is living in her own home more independently.

Benefits
Observable benefits of the BRAIN BOOK^® System include (1) increased independence at home and in training situations, (2) improved punctuality and follow-through (appointment attendance), (3) improved cooperation with services, such as vocational evaluation, independent living training and academic training (as perceived by staff).

Recognized advantages of the System include increased flexibility in training options and easy access to support via the Internet. The BRAIN BOOK^® System does not require expensive maintenance or technical support and has proven to be accessible in both urban and rural communities.

Funding limitations and availability of appropriate trainers have been barriers to statewide implementation of the system beyond the pilot. The pilot has been deemed a success and we are currently developing grant-based and other funding options to make the BRAIN BOOK^® available to our consumers.

Keri Bennett
Vocational Counselor, Kearney, Nebraska
Coordinator, BRAIN BOOK^® System Pilot Program
Telephone: 308/865-5012 E-mail: keri.bennett@vr.ne.gov