As the United States military brings service members home from active deployment, veterans with mild-to-moderate brain injuries remain in danger of becoming a forgotten population. Despite the growing attention given to athletes who’ve suffered concussions, the long-term effects of mild-to-moderate brain injuries or concussions among military service members is still largely unknown. For the past 20 years, Shenandoah University Assistant Professor of Occupational Therapy Leslie Davidson, MS, OTR/L, has devoted her life to working with these “wounded warriors.” In April 2012, she was awarded a one-year faculty fellowship at the Army Surgeon General’s Office in the Division of Rehabilitation and Reintegration to develop training modules that will help deploying providers—psychologists, nurses, social workers and psychiatrists—to understand what to do when caring for these types of injuries.
Davidson’s interest in traumatic brain injuries began in the early 1990s, after she graduated as an occupational therapist from New York University. She landed her first job at Walter Reed Army Medical Center (now the Walter Reed National Military Medical Center), where she participated in a research study to work with soldiers with mild-to-moderate brain injuries. At the time, Davidson said, little was being done with the concussion population. She worked for two years at Walter Reed, then moved on to Georgetown Hospital, where she continued to pursue her interest in helping those with mild-to-moderate brain injuries or concussions. Although she worked directly with injured vets and their families during her dissertation, Davidson’s work focused primarily on traumatic brain injury education initiatives for deploying providers.
Her opportunity to really make a difference came after she joined the faculty in the Shenandoah University’s Division of Occupational Therapy. As the United States found itself engaged in numerous wars, Davidson was called upon to work with another occupational therapist and three physical therapists to develop a workbook that would help occupational therapists and physical therapists understand how to handle the concussion/mild-to-moderate brain injury population. The team spent a year creating the guidance document, and they identified a number of concerns about whether or not soldiers who had suffered brain injuries could safely return to duty. With no formal assessment tools available to make such a determination, the team received funding to develop a battery of evaluations resembling soldiering skills that would tap into the high level of cognitive and motor skills soldiers need to be successful. The team compiled an assessment protocol, and are now engaged in the second phase of the project, which involves validation of the assessment protocol.
“When someone has a concussion, they come with a variety of symptoms or potential symptoms,” said Davidson. “Thinking skills, visual perception and balance are all affected. Reaction time is slower, and there is anxiety that manifests with a concussion. The individual may go to the grocery store five times, because he can’t remember why he was going in the first place. There may be personality changes or temper flare ups. The individual may not be able to concentrate or comprehend things, or may not be able to cook a simple meal. As an occupational therapist, I’m concerned with how people [who’ve suffered concussions or brain injuries] interact in relationships and engage in the activities of their everyday lives.
“The biggest message I’ve learned is that there’s a lot of effort now working with service members who are coming back from duty,” said Davidson. “There isn’t as much recognition or understanding of how a brain injury or concussion might impact families. Suddenly, spouses feel like they’re married to different people. For service members, taking on the role of a parent again can be very challenging. That’s where a lot of my work is [now]. I don’t work with one person; I work with the system.”
Davidson was recently selected to serve on the Current Procedural Terminology (CPT) Panel. A seven-year member of the Health Care Professional Advisory Committee to CPT, she has worked with 17 allied health professions groups to develop and modify CPT codes to reflect recent changes in health care. Davidson was the first occupational therapist to be selected for this honor.
As a leader in Shenandoah’s Division of Occupational Therapy, Davidson encourages students to consider how their career choices can make a difference in the lives of veterans and their families. She asserts that even for students who aren’t interested in joining the military, numerous opportunities exist for civilian occupational therapists and physical therapists to work with the military and government agencies. Shenandoah University, Davidson stated, has been a major source of support throughout her involvement with service members who have suffered brain injuries or concussions.
“Shenandoah has been supportive in any way they possibly can,” said Davidson. “They’ve embraced the work I’m doing, and [they] have said ‘yes’ to anything I’ve asked for with regard to these initiatives. To me, that shows Shenandoah’s great level of support for the programs that help these service members and their families.
“This is something that’s going to be long term,” said Davidson. “As these wars start rolling down and money gets tight, I foresee that this is going to be a forgotten population. We need to keep them at the forefront of our minds. These men and women left their family and friends, and many have been deployed four or five times. We owe them.”
