CBIST Spotlight: Brenda Eagan-Johnson
Categories: ACBIS Insider, Professionals
Dr. Brenda Eagan-Johnson received her doctorate in neuroscience of education from Johns Hopkins University. She serves on the Board of Governors for the Academy of Certified Brain Injury Specialists and the Board of Directors for the International Pediatric Brain Injury Society. She is also a Certified Brain Injury Specialist Trainer with Advanced Practice in NeuroRehabilitation.
What made you choose a career in brain injury? Why are you passionate about BI?
When I was 14 years old, my 13-year-old brother was hit by a car while riding his bike. I arrived at the scene before the ambulance did. He suffered a traumatic brain injury and spent months in the hospital and a year in rehabilitation, consequently missing his entire seventh grade year. When he returned to school in the eighth grade, none of his teachers knew how to support a student with a brain injury. Although he appeared physically normal, he was a completely different student. For instance, despite studying extensively with our mom for tests, he repeatedly failed them the next day, even though he knew the material the night before. While the hospital had focused on educating my parents about the long-term outcomes following the multiple, significant fractures throughout his body, education regarding his brain injury was never provided. My parents were told, “He will be fine.” I didn’t know it at the time, but this experience solidified my future career path: helping educators understand the complexities of brain injury.
Based on your knowledge and experience, what should brain injury professionals know about intimate partner violence (IPV) and brain injury?
Intimate Partner Violence (IPV) is a public health issue closely linked to acquired brain injury (ABI). Both clinicians and non-clinical professionals need to recognize the intersection of IPV and ABI, due to the sheer number of individuals who experience both. Furthermore, it is unfortunately common to see co-occurring child abuse when children live in households with IPV. To complicate things even more, brain injury signs can manifest differently in children compared to adults. So, ongoing monitoring of children is required as they age, because new learning and behavior issues can arise from a prior injury as their brains develop.
IPV frequently leads to multiple brain injuries yet professionals and individuals who have experienced violence may not be aware of this fact. Many do not know that being hit in the head, struck by objects, thrown against a wall, or falling down the stairs may cause a brain injury, with non-fatal strangulation being another significant but frequently overlooked cause. In my professional experience, I have encountered a distressing number of adults who reported experiencing repeated non-fatal strangulation during their childhood at the hands of their parents/caregivers. When these individuals become aware of the signs and symptoms of possible brain injury, it is as if previously missing pieces of a puzzle start to come together.
When IPV is involved, it is often even more difficult for the individual with a brain injury to access support and services due to reasons such as the inherent difficulty in accurately recounting the details of their violent event due to memory issues or concerns about court repercussions if identified as having a brain injury due to fears it could affect child custody decisions.
Action steps include comprehensive awareness training on the nuances of IPV and ABI. Screening for brain injury during any kind of initial interview or intake. Identifying a network of local community healthcare providers who understand and can accurately diagnose brain injury. However, this is challenging because we cannot assume all providers know how to identify IPV-related brain injuries in a timely manner, if at all. When a brain injury is not properly identified and diagnosed, the person wrongly attributes their symptoms to other causes, thus missing out on specialized brain injury-specific medical rehab and intervention.
Equally important is the training of non-medical providers—police, emergency services, 911 operators, attorneys, judges, clergy, crisis shelter workers and advocates, school staff, and social workers—who often are the first to encounter IPV situations. If a non-medical provider is trained to conduct a screening and identifies that an individual following IPV might have a brain injury, they then rely on a local healthcare provider to have knowledge of diagnosing IPV-related brain injuries in the chain of events to provide the next line of support. But this is not always the case. This societal systemic issue requires collaboration, partnerships, and training. Luckily over the last several years, many organizations and institutions have focused on IPV and ABI research, training, and outreach which is very exciting!
Non-medical providers can be instrumental in educating individuals who have experienced IPV about the nature and impacts of brain injury on daily activities. They can provide coping strategies and support, empowering individuals with self-awareness about their IPV-related brain injury deficits. This empowerment is crucial for individuals who have experienced IPV to regain control over their lives, access necessary support, and ultimately break free from the cycle of abuse – a task made more difficult when a brain injury is involved.
How can brain injury professionals advocate for survivors of IPV and child abuse? What have been your experiences at the local, state, and/or federal level?
As brain injury professionals, we are in a unique position to educate others on a leading cause of disability. We have a responsibility in our day-to-day work to educate community-based providers we encounter. All involved in supporting individuals who have experienced abuse should become skilled at identifying red flag signs and symptoms of brain injury and resulting next steps to take. If you have your CBIS, offer to provide an ABI awareness training this year during March (Brain Injury Awareness Month) to one of the non-medical provider groups listed above. It’s a simple start that can lead to increasing awareness in your region.
I have worked with the Neighborhood Legal Services organization and PA Legal Aid Network to advocate for legal aid in Washington, DC to assist individuals involved in IPV and child abuse. I’ve also spoken to Congressional and Senate panel briefings for the federal organization, Legal Services Corporation. When opportunities arise, I always try and raise awareness about brain injury.
I’m also an active member of the Enhancing Neuroimaging and Genetics through Meta-Analysis (ENIGMA) Consortium Intimate Partner Violence (IPV) international workgroup. I served on the executive board of the Lawrence County Crisis Shelter for many years. During that time, we created a video highlighting the signs and symptoms of brain injury from IPV or child abuse. We received so many responses from individuals who had no idea that issues they experienced may be due to a prior brain injury such as their:
- Lack of motivation and the cognitive/emotional strength to leave their partner, find a job, find housing, hire an attorney, battle for custody, file for divorce, manage money;
- Repeatedly forgetting appointments with their attorney;
- Being unable to follow multistep instructions from the court; and
- Experiencing ongoing headaches when reading due to vision changes.
Why is having a CBIST important to you? How is it helpful in your daily work?
When I see other providers with the CBIS, I immediately know that they have met a knowledge standard in the brain injury field. Through my work directing the BrainSTEPS Program, we are now covering the cost for all our statewide lead consultants to obtain CBIS training and certification because it is valuable when working with local districts to show they have obtained a level of expertise in brain injury. I cannot tell you how many times over the years I have recommended medical rehab providers to families all over the United States, and I always explain how important it is to try and identify one who also has the CBIS credential.
What recommendations would you make regarding increasing CBIS and CBIST involvement with BIAA or ACBIS (other than certification)?
One of the best things I have done in my career is to serve on the ACBIS board. But you don’t have to serve on the board to get involved. We have many ACBIS workgroups that need active help. We would love the help! And an exciting opportunity that will be available soon through ACBIS is to become a Certified Brain Injury Specialist with Advanced Practice in NeuroRehabilitation (CBIS-AP), the highest level of CBIS certification.