Therapy Helps Reorganize Client’s Life after Traumatic Brain Injury

Every morning, Lauren Patterson-Davis consults her color-coded, three ring binder before starting her day. Get dressed, brush your teeth, take your medication and pack a water bottle are some of her tasks listed for each day. If she needs to go to the grocery store in the morning, it requires meticulous planning. She tends to get lost and overwhelmed in large stores. Many times, she will come home with a variety of groceries that do not equal a complete meal. These typically unconscious activities now require conscious effort every day.

A year ago, Patterson-Davis was a successful, working mom of three. She was the principal at Springfield Township Middle School and working on her dissertation to complete her doctorate in School Leadership from Temple University. In September of 2015, Patterson-Davis was gathering clothes for the wash off the floor when she struck the back of her head on a dresser.

“I was starry-eyed, and I had a contusion,” she said. “I realized that I had a concussion the next day. I was dizzy, light sensitive and sound sensitive.”

Other symptoms began to emerge as time passed. She had difficulty maintaining her balance, finding certain words and concentrating for extended periods of time. Her short-term memory and ability to organize information were also affected. Soon after, she suffered another similar hit to the head and was diagnosed with a traumatic brain injury (TBI).

“Ironically, I was doing my speech homework when the second concussion happened,” she said. “I stood up and hit my head on a cabinet. You don’t think about how many times you’ve hit your head until doctors specifically ask how many times you’ve hit your head. I’ve had between five to seven other head injuries that I can recall. Only one of those was diagnosed as a concussion as a young child. The others, I do remember having some symptoms at the time, but because concussions were not as well known by coaches or treated by doctors, I didn’t have medical attention.”

Now, a year after the concussion that kick started her TBI diagnosis, Patterson-Davis has made some improvements, but her life has been anything but smooth. She still struggles with certain everyday tasks such as meal planning, coordinating her children’s schedules and time management. She has been out of work since April 2016 due to regular cognitive and physical symptoms. She sees a litany of doctors, including: a neurologist, a cognitive neurologist, a physical therapist, an ophthalmologist, a vision therapist and a speech-language pathologist, Jill Grogg of the Speech-Language Institute (SLI) of Salus University.

Grogg explains that Patterson-Davis came to SLI because her TBI symptoms were interfering with her daily life.

“Think about what you need to do during the day, especially if you are a parent – getting up on time, grooming tasks, getting the kids up and ready for school, making breakfast, figuring out who goes where, seeing if homework was done, etc.,” she said. “Now, imagine attempting to do those activities when you actually have to think about the steps you need to do as you complete that task.  It's a lot easier when it is automatic, and you just get it done without thinking.”

When Patterson-Davis first came to SLI, she was paired with Grogg and a speech-language pathology student Samantha Rubin who asked her to explain some of the issues she was experiencing. Patterson-Davis pulled out an overflowing folder, filled with a variety of documents, such as checklists for the day, medical information, sticky notes with reminders and a list she wrote with all the problems she was having because of the head injuries; it promptly fell apart. 

“Organization was something we immediately began working on,” Patterson-Davis said. “The strategies that I’ve learned are helping me to function. Before working with the SLI at Salus, I was very disorganized and unaware of the impact my executive functioning deficits were having on my life, especially because I was very organized pre-injury. I had to-do lists and sticky notes everywhere with no sense of structure or completion of tasks; I was constantly leaving the house without the items I needed to complete the tasks I was working on. I was carrying around anything anyone has ever given me, which wasn’t a terribly effective way to do things.”

She now uses a binder-system developed by Grogg and Rubin. She has different tabs for her daily schedule, her monthly schedule, her children, major medical information and homework for her speech-language therapy.

Patterson-Davis enjoys the student- and clinician-centered approach SLI uses when treating patients. She likes the consistency of working with the same professional speech-language pathologist every time and a different student for each semester.

“As someone who works in education and has worked with many speech-language pathologists, the fact that someone is coming fresh off their studies is great because they have up-to-date research and technology ideas,” she said.

Her new area of focus this semester is to make strategies to plan meals and grocery shop effectively. Her difficulty with concentration, attention and executive functioning make grocery stores overwhelming for her.

“My grocery shopping lists aren’t in order,” Patterson-Davis said. “I often come home with groceries that don’t go together to make a meal for my three children. I’ll unpack the groceries and realize I didn’t buy any protein so it’s peanut butter for everyone that day. The student I’ve been working with this semester has been trying to make my lists more functional, which hopefully can result in real meals being prepared.”

At times, progress can be frustrating for Patterson-Davis because the harder she works, the harder her brain works, which can bring her symptoms to the forefront including migraines, light and noise sensitivity, and decreased executive functioning capabilities.

“This is the first time in my life that hard work hasn’t equaled success,” she said. “It’s been difficult because we’ve been trained to think that if you work really hard at something, it’ll happen. I’ve been diligent with my therapies and treatment, and it’s not necessarily resulting in me being the person that I was. I’m determined to try and figure out how to get back there or how to accept this new person.”

Grogg admires Patterson-Davis’ determination throughout the course of her treatment.

“Progress has been slow and steady,” Grogg said. “We have needed to assess and reassess the treatment plan. We recently found that we will need to break all of our tasks into much smaller parts and build upon each step. Lauren remains highly motivated, and she works hard.”

It has been a mutually rewarding experience working with Patterson-Davis on an academic and personal level for Rubin.

“I enjoyed working with her and helping her find out strategies to implement in order for her to get through her day-to-day activities in the best way possible,” she said. “Lauren also taught me a lot about life; she is a very strong, hard-working and determined individual who is not willing to giving up. I hope Lauren will be able to feel a sense of independence and confidence.  She’s a very strong woman, and I hope the best for her.”

When thinking about her future, Patterson-Davis is optimistic of her progress.

“I hope some of the strategies that are now in visual format are automatic and don’t require the same level of strategy long-term,” she said. “I hope that I can shop independently and be able to prepare healthy meals. I would like to be working in education in some capacity or volunteering for community service, even if I can’t return to work as a principal.”