Your Goals
Our Mission

Special Tree Employee Wins National Award for Injury Prevention Education

Around Special Tree, Todd Hammons is known as a strong advocate for persons with spinal cord injury (second from right in photo).  As Special Tree's Accessibility Advisor, he orchestrates our annual Mobility Expo as well as a monthly Spinal Cord Injury support group.  Not only is he passionate about showing people what they CAN do after spinal cord injury, he's also dedicated to preventing serious injury in the first place, especially among teens.

Todd was recently honored with a national award for his work with Think First, an injury prevention program for K-12 which strives to prevent brain and spinal cord injuries through education.  For the past two decades, Todd has been a “Voice for Injury Prevention” (VIP) for Think First, sharing his own experience with spinal cord injury with thousands of local students to raise awareness about the serious consequences of risky behavior.  Todd traveled to Chicago in May to accept the “VIP of the Year” award at Think First’s national convention.

Todd was nominated for the award by Joyce Kessler, co-President of Think First’s Washtenaw Chapter, because he exemplified the group’s message and passion for its mission.  “Todd conveys his message in a way that really hits home with kids," she said, adding that students always want to talk to Todd after a presentation and that he has binders full of thank you letters.

“We’re so proud of all the great work that Todd has done for Think First and also for Special Tree.”

 

 

 

What do SLPs do?

May is Better Speech and Hearing Month and the perfect time to learn more about what Speech Language Pathologists do at Special Tree.  Speech-Language Pathologists (SLPs) have a long job title, but they need all those words to reflect the many aspects of their job.  Speech is our ability to make sounds so others hear and understand us.  Language is much broader and involves a system of communication – the underlying rules (sounds, words, grammar) we all use to communicate.  SLPs diagnose and treat communication disorders that interfere with BOTH speech and language.   At Special Tree, SLPs treat clients with communication disorders following brain injuries and other neurological impairments whose injuries have affected skills such as eating, swallowing, verbal and non-verbal communication, memory, sequencing, problem-solving and more.  Speech-Language Pathologists work with the interdisciplinary team to develop appropriate rehabilitation for each client.

Our SLPs diagnose and treat the following communication disorders:

Aphasia
Aphasia is an impairment of language that can mildly, moderately, or severely impact a persons’ ability to express and understand many aspects of language. This language impairment can impair the ability to express oneself through talking, writing, or gesture (e.g., sign language). Aphasia can also impair the ability to understand what one hears or reads, or what is being gestured

Apraxia
Apraxia is a disorder that makes difficult the sequencing and coordination of movements. Many different body structures can be affected by apraxia, and as such, there are many different forms of this disorder including but not limited to oral apraxia, apraxia of speech (verbal apraxia), limb apraxia, and conceptual apraxia.

Cognitive-Communication Disorders
This refers to communication difficulties that stem from underlying impairments in cognition, behavior, and/or emotion

Cognitive Impairment
Cognition can be described as the means by which we acquire knowledge or understanding. The essential processes by which we acquire information include the five primary senses paired with our arousal, attention, speed of processing, visual-spatial ability, memory, language, and executive functioning. These are all neural functions and consequently, neurologic injury can often impair one or many of these processes

Communication and Environmental Access Augmentative and Alternative Communication (AAC)
AAC includes all forms of communication, other than speech.  SLPs provide assessments, recommendations, and training to those with severe speech or language problems who may rely on a system to supplement their existing communication or completely replace speech that may be non-functional. AAC systems (whether low- or high-tech) allow individuals to communicate their thoughts, express their feelings, direct their caregivers regarding their wants/needs, and participate in social interaction

Dysarthria
Dysarthria is a neurogenic speech disorder caused by a weakened, paralyzed, or uncoordinated speech system. The speech of a person with dysarthria may sound sluggish, weak, imprecise, or uncoordinated

Dysphagia
Dysphagia is a term used when a person experiences difficulty swallowing food, liquid or managing secretions.  Special Tree SLPs assess client’s strength and movement of the muscles involved in swallowing, and observe feeding to see a client's posture, behavior, and oral movements during eating and drinking. Speech therapy may involve special tests to evaluate swallowing. Therapists may recommend exercises, positions, or strategies to help clients swallow more effectively. Working closely with the Dietary Manager and Nutritionist, specific food and liquid textures that are easier and safer to swallow may be recommended.

Positive Coping Skills

 

 

In honor of Mental Health Awareness Month, here’s a list of positive coping skills from Special Tree Neuropsychology team that may help when you're experiencing strong emotions such as anger, anxiety, or depression. The purpose of these activities is to help you learn to be more resilient and stress tolerant. These activities are not likely to create more stress or problems so give them a try!  Learn more about Special Tree's Neuropsychology services here.

Diversions

  1. Write, draw, paint, photography
  2. Play an instrument, sing, dance, act
  3. Take a shower or a bath
  4. Garden
  5. Take a walk, or go for a drive
  6. Watch television or a movie
  7. Watch cute dog videos on YouTube
  8. Go shopping
  9. Clean or organize your environment
  10. Read
  11. Take a break or vacation

Social/Interpersonal (with others)

  1. Talk to someone you trust
  2. Set boundaries and say "no"
  3. Write a note to someone you care about
  4. Be assertive
  5. Use humor
  6. Spend time with friends and/or family
  7. Serve someone in need
  8. Care for or play with a pet
  9. Role-play challenging situations with others
  10. Encourage others

Cognitive (Of the Mind)

  1. Make a gratitude list
  2. Brainstorm alternative solutions
  3. Keep an inspirational quote with you
  4. Be flexible
  5. Write a list of goals
  6. Act opposite of negative feelings
  7. Write a list of pros and cons for decisions
  8. Reward or pamper yourself when successful
  9. Write a list of strengths

Tension Releasers

  1. Exercise or play sports
  2. Catharsis (yelling into a pillow, punching a punching bag)
  3. Cry
  4. Laugh

Physical

  1. Get enough sleep
  2. Get into a good routine
  3. Eat healthy foods but also eat a little chocolate
  4. Deep/slow breathing

Spiritual

  1. Pray or meditate
  2. Enjoy nature
  3. Get involved in a worthy cause

Limit Setting

  1. Drop some involvement
  2. Prioritize important tasks
  3. Use assertive communication
  4. Schedule time for yourself

Special Tree Wins Healthcare Achievement Award

Special Tree is the recipient of the 2016 Intalere Healthcare Achievement Award which recognizes healthcare providers for their efforts to enhance quality and operations, improve patient satisfaction, and increase community awareness and education.  According to Animesh Anand, Chief Administratife Officer, Special Tree won in the financial and operational improvements category.  “By making adjustments to our supplier/distributor/vendor relationships, we were able to reduce costs and maintain Special Tree’s high quality patient care.”  

 

Mobile Apps for Brain Injury Recovery

Smartphones and tablets are everywhere these days, including at Special Tree, where they've become powerful therapy tools to help people with brain injury.  Special Tree Occupational Therapists, Speech Therapists, and Physical Therapists all utilize a long list of mobile apps to help improve outcomes for clients throughout the entire rehabiliation process.

In honor of Occupational Therapy Month, we're spotlighting the apps that Special Tree OTs use most often to help improve everyday living skills.  Thanks to Special Tree OT Amanda Katt Phillips for compiling the list

Week Cal $1.99 (iOS only)

The most beneficial feature of this app is the ability to color code events.  Since people with TBI brains work differently, having a color coded visual cues can increase attention and memory.  Templates for recurring events can be created, decreasing the chance of entry errors.  Icons can also be added to events for an additional visual cue.  Many people with TBI have problems with their vision.  The native iPhone calendar is bright white and the glare can be disruptive.  Week Cal has a dark theme which reduces eye strain and also makes the color coding more prominent (iPhone only).  There are seven different views from daily to yearly which give people with TBI more flexibility to choose the layout that works best for them.  If the client is already using their native calendar app or Google calendar, once installed all the prior and upcoming events can be synchronized in minutes to Week Cal.  All of the days and tomorrows events also appear on the iPhone’s widget by swiping down from the lock screen.

 

Medisafe Medication Reminder, Prescription and Pill Organizer Free (iOS and Android

Taking all prescribed medications accurately is an extremely important part of living with a TBI.  Remembering what was taken and when can be a major difficulty due to memory and attention deficits.  Medisafe is a great app to help clients remember to take their medications and tracks compliance.  The other benefit of this app is that it is visual based and not only a written list.  When entering a new medication, the shape and color of the pill can be set.  There are also symbols for injections, inhalers, liquid and powder.  The pill box view gives a simple visual reminder of the number of pills to take in a 6 hour period.  Refill reminders can be set based on the custom number of pills before running out, eliminating the need to count months, weeks and days.  The report shows the daily number of medications taken and missed.  Health measurements can also be tracked within the app including but not limited to: cholesterol, weight, glucose and blood pressure.  Users can add a family member or friend that will be notified 30 minutes after a missed dose.  No more taking a bag of pill bottles to doctor appointments.  All the current medication information will be stored on your phone.

 

1Password Free (iOS and Android

1Password stores all of your usernames, passwords, credit card numbers, addresses and even has a notepad. This app is not just for people with TBI, anyone can benefit from it.  You don’t even have to remember the one master password.  The app can be unlocked using the fingerprint scanner on iPhone or Android.  If the user enters the log in website, there’s a built in browser that can fill in the usernames and passwords with just the touch of a button.  Credit card numbers can be copied and pasted within the app or another browser so there’s no more searching for your wallet.  1Password can also create passwords for you from 4 to 50 characters for increase security along with its AES 256-bit encryption.  There are more features such as creating multiple vaults to categorize information in the paid version.

 

Celebrating Occupational Therapy Month

April is Occupational Therapy Month and at Special Tree we’re celebrating the many ways our Occupational Therapists (OTs) and Occupational Therapy Assistants (COTA) help our clients to become as independent as possible in their daily life.

Occupational therapy is an integral part of the rehabilitation process because it focuses on the activities and tasks we do on a daily basis for our self-care, work, and leisure.  Special Tree's OTs and COTAs provide the therapeutic interventions to help our clients perform these daily activities in a more functional, successful, and independent way.   The OT team is involved in every phase of recovery from helping clients and/or their caregivers learn basic tasks like dressing, bathing, and eating, all the way through returning to work, home management, and driving.   In addition to helping clients regain meaningful everyday living skills, OTs and COTAs also specialize in vision therapy and sensory integration therapy to address visual perception and sensory issues that are common after a TBI.

We asked Special Tree's Ursula Kotzabassi to share her thoughts on being an Occupational Therapist.

Why did you decide to become an OT?

I was a college student at Eastern Michigan University and I hadn't chosen a major yet, but knew I wanted to do something to help people. I started investigating different types of therapy professions and found that occupational therapy fit best with my personality and the way I wanted to help people. I talked to a friend whose mother had had a stroke when we were in elementary school and learned about her experience receiving occupational therapy. She had to relearn how to care for herself and her family and went on to live an independent and fulfilling life. After that I decided that I wanted to help other people do the same.

What is the most rewarding part of your job?

When people realize they are still capable of doing things for themselves and for others in the face of losing nearly everything. I am excited about my job and the possibilities that exist to help people achieve independence to do the things that they want to and need to do.

What is the most important thing you’ve learned from clients?

Try not to take things for granted, life can change in a matter of seconds. Be open, flexible, stay positive and learn to adapt to situations as they change. Growth can come from adversity, but it takes time and the right mindset.

What do you like to do outside of work?

I love spending time with my family and friends: sharing a meal, watching a movie, playing board games or just talking. My second job is co-parenting a loving and rambunctious 3 year old boy, a geriatric great dane, two ridiculously playful kittens and a handful of well-behaved saltwater fish. I'd love to try some new hobbies so if you have a suggestion come find me in therapy!

Introducing Synchrony: Break Through Technology for Speech and Swallowing

 

After a brain injury, a person may have to learn to do many things all over again, including eating, drinking, and talking. At Special Tree we’re excited to announce our use of a revolutionary new device called Synchrony, which helps with speech and swallowing.Guided by Special Tree's experienced Speech Language Pathologists specially trained to use Synchrony, the device uses evidence-based protocols, a revolutionary new sEMG Biofeedback system, and ACP’s proven “PENS” e-stim technology to help clients with dysphagia. Common after brain injury, dysphagia is difficulty or discomfort when swalling; when it takes a person more time or effort to move food or liquid from the mouth to the stomach. Swallowing is critical to eating and drinking as well as talking. While we may not be conscious of it, we frequently swallow as a routine part of speaking.

“In rehabilitation, we’re trying to help the brain “remember” how to do things," explains therapist Lauren Garrisi, SLP. "We want to remap the wiring so the body does what it’s supposed to and in the right order." Garrisi goes on to explain that "for the first time with swallowing, we can base therapy on real time data.”  Synchrony helps therapists 'see' what’s happening in the body. In the past, therapists relied on what they could view from the outside, or on what clients were able to communicate to them. With Synchrony, they get real time information about exactly when the client is swallowing, or making certain movements with their mouth which impact speech.

The Syncrhony receives information via electrodes attached to the throught or cheeks which communicate with the device through blue tooth. Each time the patient swallows, it is shown on the screen through therapeutic exercises and games that are fun and engaging. Whether it is a bar graph going up and down or a kangaroo hopping up to capture treats each time the person swallows, Synchrony provides a very effective visual to actually see the swallow. For clients, seeing the swallow helps their brain make the connection and better understand what they need to do. Therapists can then reinforce the correct movements when they are shown on screen, rather than trying to explain verbally what to do.

Being able to swallow properly and speak properly can have a big impact on a person’s recovery and overall quality of life. “The Synchrony is helping us achieve better outcomes more quickly, and could even help some clients avoid more costly treatment," explains Garrisi. "We are excited to see the impact it will have as we begin using Synchrony in treatment with more and more people.”

Special Tree demonstrated the Synchrony on WDIV local 4 Live in the D with Chuck Gaidica and Tati Amare as part of Brain Injury Awareness Month. 

 

March is National Nutrition Month

by Brahmlin Sethi, RD, CBIS, Special Tree Rehabilitation System

March is National Nutrition Month and this year’s theme is “Savor the flavor of eating right.”  Consequently, loss of smell is a common symptom after traumatic brain injury (TBI), as well as taste. These two factors make a huge impact on what we eat and how we want our foods flavored.

Therefore many TBI clients want salty and spicy items. The 2015 Dietary Guidelines of Advisory Committee (DGAC) states that the average American should not get more than 2300 mg of salt a day. This can be difficult for most individuals since salt is hidden in many sweets, processed foods, and recipes. Ways we can try to reduce salts is by naturally increasing flavors with spices, herbs, and natural flavor enhancers such as ginger, garlic, lemon, jalapenos, and vinaigrettes.

To learn more about National Nutrition Month visit http://www.eatright.org/resources/national-nutrition-month

 

 

ReWalk Opens Whole New World of Mobility for Client

Justin had been in a wheelchair almost five years from a spinal cord injury he sustained in a car accident when he came across an article that would change his life.  The article was about the ReWalk Exoskeleton, a robotic suit with motorized legs that’s helping people who are paralyzed to stand up-right and walk again.   Justin, the father of two young sons, never lost hope that he would walk again, but the discovery of the ReWalk turned hope into a fiery determination to get back on his feet.

Justin’s quest to get a ReWalk would bring him and his mother, Shelly, to Special Tree Rehabilitation System, one of only three rehabilitation providers in Michigan certified for ReWalk training.  Special Tree’s Physical Therapists began screening potential ReWalk candidates last summer and Justin was the first to meet all of the physical and medical requirements, including getting approval from his insurance company to fund the costly device and the required 30-40 therapy training sessions.

Justin’s ReWalk™ Personal System represents the next generation of exoskeleton technology that was first introduced in 2010 by Israeli engineer Dr. Amit Goffer.  Designed for everyday use, the ReWalk enables Justin to sit, stand, and turn, and can be used at home and in the community on different surfaces and terrains with a companion.  Developing the strength and balance to use the 50-pound exoskeleton in a variety of environments is why so many training sessions with Physical Therapists are necessary.

“It’s not so simple to use in the beginning,” said Special Tree Physical Therapist Jennifer Ratermann, who helped Justin take his first steps in the ReWalk back in September.  “Mastering the ReWalk takes hard work before being able to take one home.” 

Justin was up for the challenge.  For the next five months, Justin and his mom drove 80 miles to and from Special Tree three days a week for ReWalk “boot camp,” where he worked on everything from standing and sitting to opening doors and walking up and down ramps. 

“Justin is super motivated.  When he sets his mind to something for sure he’s going to accomplish it,” said Jackie Cunningham, another ReWalk certified Physical Therapist at Special Tree.  “It’s one of his best attributes and why he’s been so successful in using the ReWalk.”

But the ReWalk is giving Justin more than the ability to walk.  “It’s changed his whole outlook on life,” said his mom.  “It’s also been life changing for my grandsons.  They don’t remember when he could walk.  They can’t wait to walk around town with their Dad.  We’re all so proud of him.”

There’s also many physical benefits of using the ReWalk.  Based on data collected by ReWalk, the system helps cardiovascular health, loss of fat tissue, building of lean muscle mass, and improved bowel function.  These improvements can result in better pain management, fewer medications, and potentially reduced hospitalizations.

On March 3rd, Justin graduated from boot camp with flying colors -- demonstrating his mastery of a long checklist of skills before taking the ReWalk home. 

“The ReWalk has changed my life,” said Justin.  “I can regain my independence and walk with my kids again.”

 

 

Healthy Bites from Special Tree's Registered Dietitian

by Brahmlin Sethi, RD, CBIS, Special Tree Rehabilitation System

Since 1990 National Nutrition Monitoring and Related Research Act stated that every 5 years Dietary Guidelines for general public would be required to be published jointly by U.S. Departments of Health and Human Services (HHS) and of Agriculture (USDA). The guidelines focused on encouraging healthy eating patterns, on healthy eating habits over time, a variety of nutrient dense foods in moderation, limiting salt, sugar, and saturated fat calories, and low calorie beverages, and working in community to support healthy eating habits for all.

The top 8 takeaways from the 2015 Dietary Guidelines Advisory Committee (DGAC)

Same ol’ story – Intake of fruits and vegetables remains low while salt is still over consumed.  Dietary sodium recommendations stayed at 2300 mg per day while saturated fats increased to less than 10 percent of total calories per day from the previous recommendation of less than 7 percent.  Encourage fruits, vegetables, whole grains, legumes, seafood, and low fat dairy products.

Don’t hold back- 2015 DGAC used subtle but direct language regarding the state of health for average Americans. The frightening statics painted a picture of one or more preventable chronic diseases that could be changed drastically with individual behaviors regarding nutrition and physical activity.

New bad boy on the play ground – DGAC recommends no more than 10 percent of total calories from added dietary sugars in the form of sweetened beverages, refined grains, sweets and desserts. Low calorie sweeteners should be reduced while sugar sweetened drinks to be substituted by water. Food labels to include “added sugars” label to the Nutrition Facts Panel. The committee wants to place taxes on these items but already getting some resistance to this suggestion. 

The ugly truth – First time a complete chapter dedicated to sustainability. Three diets were recommended; Healthy U.S. style plan, Healthy Mediterranean style plan, and Healthy vegetarian plan since these have the lowest amount of effects on the environment and beneficial health outcomes.  Moderate amount of fish consumption is recommended since health benefits outweigh mercury and pollutants.  Coffee consumption in moderation (3-5 cups per day) is not shown to have long term health risks but the added calories in milk, sugar, and cream could minimize the effects of coffee.  Energy drinks and alcohol should not be consumed together and children should limit or avoid caffeine consumption.

Hello/goodbye- Removed the 300mg/day cholesterol recommendation and instead advising Americans to continue to monitor dietary cholesterol intake but not adding limits to the amounts. This is a controversial topic since other health organizations believe this is still an issue.

Grab the reigns- Placed the responsibility on consumers by encouraging home cooked meals, reduce screen time, reduce frequency of eating out, and educate on healthy lifestyle interventions.

Sip don’t chug- Moderate levels of alcohol (1 serving for women and 2 servings for men a day) are recommended). Disclaimer: some health benefits associated with drinking the recommended amount but if you do not drink then do NOT start drinking.  Higher alcohol consumption has increased associated risk of violence, drowning, injuries from falls and motor vehicle crashes.

Paradigm shifts - Pushing programs and policies for health care - federal nutrition assistance programs, including Food Stamps (the Supplemental Nutrition Assistance Program), should be aligned with the Dietary Guidelines

Pages