Latest / Broken Brains with Bruce Parkman / Dr. Melissa McCart on Childhood Brain Injury, Concussions and Mental Health | Broken Brains Ep. 110

Transcript

Dr. Melissa McCart on Childhood Brain Injury, Concussions and Mental Health | Broken Brains Ep. 110 · Broken Brains with Bruce Parkman

• 0:08
  SPEAKER_01: Hey folks, Bruce Parkman here from the Mac Parkman Foundation on their official podcast, Broken Brains, where we talk about two issues: repetitive impacts and repetitive blast exposure, which we put under one umbrella term called repetitive brain trauma.
• 0:25
  SPEAKER_01: And we look at what these conditions are doing to the brains, the mental health, and the futures of our children, athletes, parents, caretakers, and veterans.
• 0:37
  SPEAKER_01: Why is this important?
• 0:38
  SPEAKER_01: Because the connection between military service and contact sports, damage to the brain, and mental illness is not taught in our nursing, medical, or psychological communities.
• 0:48
  SPEAKER_01: That means most of the people that we trust with our mental health or well-being don't have the information they need to make the best decisions.
• 0:57
  SPEAKER_01: And that's why it's up to you to be informed.
• 0:59
  SPEAKER_01: So we reach out and we grab, you know, anybody that wants to talk about this issue, athletes, veterans, researchers, doctors, scientists, technologists, we really don't care.
• 1:08
  SPEAKER_01: So you get that 360-degree perspective on this issue because it's that important.
• 1:13
  SPEAKER_01: Today, another amazing guest, Dr.
• 1:16
  SPEAKER_01: Melissa McCart, is the director of the Center on Brain Injury Research and Training, CBIRT, and a research assistant professor at the University of Oregon, Oregon.
• 1:29
  SPEAKER_01: Her work focuses on pediatric traumatic brain injury, concussion recovery, and helping students successfully transition back to school.
• 1:38
  SPEAKER_01: With a background in special education, behavioral support, and school administration, Dr.
• 1:43
  SPEAKER_01: McCart works to bridge brain injury research, education, and practical practical support for students, families, and educators.
• 1:52
  SPEAKER_01: Dr.
• 1:53
  SPEAKER_01: McCart, thank you so much for coming on the show.
• 1:55
  SPEAKER_01: We really appreciate it.
• 1:57
  SPEAKER_02: Thank you so much for having me.
• 1:59
  SPEAKER_01: Oh, great, man.
• 2:00
  SPEAKER_01: I mean, you are right where the knowledge gap is kind of the largest, right?
• 2:05
  SPEAKER_01: It's with our children.
• 2:08
  SPEAKER_02: I I I would I would argue it's important in every space, but certainly our children are our prized asset, right?
• 2:15
  SPEAKER_02: So absolutely.
• 2:16
  SPEAKER_01: And I would agree with your pushback 100%.
• 2:20
  SPEAKER_01: I I think that uh it's it's you know, it's needed everywhere, but obviously, you know, where we're, you know, it's just the younger kids are always, you know, they're kids, right?
• 2:30
  SPEAKER_02: Yeah, they're our future.
• 2:31
  SPEAKER_01: So are you a uh pediatrician or how did you get are you focused on how did you get into the brain injury side?
• 2:38
  SPEAKER_01: What's your what's the story?
• 2:39
  SPEAKER_02: Well, it's it's it's kind of long, but funnels into me being in the space I'm at.
• 2:45
  SPEAKER_02: I uh actually started out as a teaching assistant when I was 18 for kids with autism and kind of wove my way through the education field, uh, ended up being a self-contained special education teacher for students in what they call regional behavioral centers.
• 3:05
  SPEAKER_02: So the kids with the worst behaviors in a regional area would get funneled into my classroom.
• 3:10
  SPEAKER_02: And what that meant is back in the 90s was that they were kids with all types of disabilities and extreme behaviors.
• 3:19
  SPEAKER_02: And so I learned a lot about every different type of disability you could imagine.
• 3:24
  SPEAKER_02: Everything from kids who struggled with visual impairment to kids with brain injury who exhibited really difficult behaviors.
• 3:33
  SPEAKER_02: So I started, I started there and found myself being a behavior consultant at the state level of for the hardest kids, and then moved from there into school administration and uh found myself at a very elite private school and missed working with families and kids that really, really needed a lot of support.
• 3:56
  SPEAKER_02: And funny story, the Center on Brain Injury Research and Training at the University, University of Oregon at the time had put an ad in the newspaper because you know, back in the day we did newspaper job posting.
• 4:08
  SPEAKER_02: Um I'm not dating myself or anything, right?
• 4:12
  SPEAKER_02: But uh I wanted to respond to this ad to be the person who translated research to practice to the schools because Ann Glang and Bonnie Todis and those researchers were doing school-based research and needed somebody who kind of spoke school to take research to practice.
• 4:31
  SPEAKER_02: Well, the ad link was broken.
• 4:34
  SPEAKER_02: So I couldn't submit paperwork for this position.
• 4:38
  SPEAKER_02: So I just took it upon myself to walk into their office and tell them I wanted the job.
• 4:42
  SPEAKER_02: And long story short, I started working at Siebert as the research to practice person and 15 years later, uh became director, took over for Ann Glang.
• 4:55
  SPEAKER_02: And it really has been something I kind of stumbled into in terms of TBI and brain injury being being my specialty, but really fits.
• 5:05
  SPEAKER_02: It's a really great fit for me.
• 5:06
  SPEAKER_02: I really care about changing the trajectory of people's lives, or when we speak about our athletes, making sure an injury doesn't change the tr trajectory of a young person's life.
• 5:18
  SPEAKER_02: And so yeah, just a series of you know, planned consequences, I guess.
• 5:25
  SPEAKER_02: Yeah.
• 5:26
  SPEAKER_01: That's amazing.
• 5:27
  SPEAKER_01: And thank you so much for what you do.
• 5:30
  SPEAKER_01: Working with our more challenged children is uh something that is so desperately needed, and not a lot of people have the desire.
• 5:42
  SPEAKER_01: I mean, our our daughter is a CASA attorney.
• 5:45
  SPEAKER_01: She works with um abuse children, and and uh there's a lot of you know, a lot of impact on people that take on these roles.
• 5:52
  SPEAKER_01: So thank you so much for what you're doing.
• 5:54
  SPEAKER_01: It's uh it's an amazing service that that you've been able to get through.
• 5:59
  SPEAKER_01: On your journey, when you started, you know, did you well back then with you know some of these the children that you're dealing with, you know, impulsive, violent, aggressive, apathetic, doesn't matter, artistic, right?
• 6:12
  SPEAKER_01: Did you ever wonder if it might have been a damaged brain that's contributing to their um their particular mental, their struggles, right?
• 6:23
  SPEAKER_01: Their mental illness, or was it more focused on trauma or a combination of both?
• 6:29
  SPEAKER_02: You know, I started at 21 years old teaching.
• 6:33
  SPEAKER_02: Yeah.
• 6:34
  SPEAKER_02: So I uh I actually taught my first job teaching children with brain injuries was kids coming out of incarceration into a special day program.
• 6:44
  SPEAKER_02: So I was I was 21 and a bunch of my students were 18.
• 6:50
  SPEAKER_02: So I was I was completely a deer in the headlights, you know, over way, way in over my head, had to learn really fast.
• 6:57
  SPEAKER_02: So I would say probably I started thinking about trauma, all right, and mostly like abuse, neglect, that kind of thing.
• 7:06
  SPEAKER_00: Right.
• 7:06
  SPEAKER_02: And as I grew in in my career and knowledge, I started kind of putting together the pieces, you know, that trauma has similar impacts on folks who experience it, but the trauma looks looks different, right?
• 7:22
  SPEAKER_02: It can be something like a physical injury, like a brain injury, or an emotional injury, or, you know, um domestic violence, all of those kind of things, um, or even just witnessing something horrible can have similar impact.
• 7:36
  SPEAKER_02: So I started putt slowly putting together the pieces.
• 7:40
  SPEAKER_02: And uh when it really kind of connected for me was gosh, probably 10 years later when I was a principal at a school, we had a uh student who was really difficult.
• 7:51
  SPEAKER_02: I got to know him as a kindergartner, followed the student for multiple years.
• 7:54
  SPEAKER_02: And it wasn't until he was in fifth grade and was exhibiting really challenging behaviors, and the parents were exhibiting challenging behaviors when we were working with.
• 8:06
  SPEAKER_01: I'm sorry, but it usually does go hand in hand.
• 8:09
  SPEAKER_02: Right.
• 8:10
  SPEAKER_02: So, but what put the pieces together for me was I was meeting with the mom trying to help problem solve for this child.
• 8:19
  SPEAKER_02: And the mom, you know, six years later said to me, you know, when he was three, we were in a horrific car crash.
• 8:26
  SPEAKER_02: And she said, I sustained a brain injury.
• 8:29
  SPEAKER_02: And she goes, I'm dealing with the results of that brain injury right now.
• 8:35
  SPEAKER_02: And so I asked about the student, and she said they didn't diagnose him with a brain injury.
• 8:40
  SPEAKER_02: You know, he was a three-year-old in a car seat.
• 8:43
  SPEAKER_02: And I remember sitting there going, wow, like this whole situation is because of this car crash, right?
• 8:50
  SPEAKER_02: Because fundamentally, this child was a good child, and fundamentally she was a good mom.
• 8:57
  SPEAKER_02: But because of the lasting effects, we were in a really difficult situation and nobody communicated the situation to me as the school person.
• 9:06
  SPEAKER_02: So I I really wasn't connecting the dots until just randomly she said that.
• 9:11
  SPEAKER_02: And then for me, it was like a flood of information and a flood of connection came.
• 9:17
  SPEAKER_02: And then I stumbled across the work with Siebert, and it's been, you know, all brain injury work since.
• 9:25
  SPEAKER_01: And how often do you think it takes place where you have somebody struggling with mental health, and we just do not do the proper assessment to kind of start dialing in to see if possibly, despite the emotional impact of trauma, you know, you know, emotional trauma, right?
• 9:46
  SPEAKER_01: Seeing events, being a part of it, that we missed the probable biological cause of the mental illness or you know, a contributing cause to the mental illness as well.
• 10:00
  SPEAKER_01: We're dealing with a family right now whose kid played from four to fourteen, played lacrosse from four to fourteen, fell apart.
• 10:08
  SPEAKER_01: That kid was hospitalized, you know, under therapy and medicated for seven years until they found us.
• 10:15
  SPEAKER_01: And during that journey, no one had ever, ever asked them if he had played contact sports.
• 10:22
  SPEAKER_01: And that child has unnecessarily been suffering.
• 10:25
  SPEAKER_01: When we have, you know, we have ways to treat the brain.
• 10:27
  SPEAKER_01: We'll talk about that in a second.
• 10:29
  SPEAKER_01: But look at you know, at your case right now, it seems that if we can connect the dots, we could absolutely accelerate healing or you know, at least, you know, you know, provide different treatment pathways.
• 10:43
  SPEAKER_02: Or at least uh from the school perspective, you know, we can put in in place accommodations and adjustments.
• 10:49
  SPEAKER_02: You know, if we if we're in a situation where, you know, the brain maybe isn't healing the way we would like to see it healing, and the child needs supports, we can put in place supports.
• 11:00
  SPEAKER_02: The the hard part is actually finding out about it and then helping people know what supports to put in place for those folks.
• 11:09
  SPEAKER_02: And that's why we developed a program.
• 11:11
  SPEAKER_02: It's called In the Classroom for educators working with students with brain injury and concussion.
• 11:16
  SPEAKER_02: And it's designed to teach teachers how to work with students who have brain injury.
• 11:22
  SPEAKER_02: And one of the fundamental things we assume is teachers are good at this, right?
• 11:26
  SPEAKER_02: They already make accommodations for all kinds of other things.
• 11:28
  SPEAKER_02: They're trained to make accommodations and adjustments in the classroom.
• 11:32
  SPEAKER_02: But the missing link is finding out about it and helping folks understand that the great accommodations and great work educators do for kids with other types of disabilities generalizes it works for kids with brain injury as well.
• 11:47
  SPEAKER_02: The problem is we just can't see brain injury.
• 11:50
  SPEAKER_02: And so oftentimes it gets missed in settings like that.
• 11:54
  SPEAKER_02: And so so kids just don't get the attention that they that they need.
• 12:00
  SPEAKER_01: I mean, and that brings up a good point that the first indicator that we have really that the brain has been impacted is mental illness.
• 12:08
  SPEAKER_01: I mean, that's I mean, that's the first demonstrative indication that we might have a brain injury.
• 12:15
  SPEAKER_01: But if we're not knowledgeable of that potential connection, then you know we can't, to your point, look at children that are struggling and you know attempt to better understand how to treat them because of we just don't know.
• 12:31
  SPEAKER_01: But an assessment tool for teachers would be an amazing option.
• 12:36
  SPEAKER_01: Have you seen assessment tools out there?
• 12:39
  SPEAKER_01: I mean, I know there are some, but is that is that potentially part of screening for new children coming in, or if they are struggling with mental health, is there like an assessment that we could possibly, you know, could be put in place so that that at least that potentiality is looked at?
• 12:56
  SPEAKER_02: Yeah, I am our team actually developed a screener in partnership with the state of Alaska.
• 13:01
  SPEAKER_02: So the state of Alaska had a contract to screen kids who are justice involved because we know you know 40 to 60 percent of kids who are justice involved have a history of brain injury depending on whose article you read.
• 13:16
  SPEAKER_02: So they approached us and asked us to develop a screener for them to use.
• 13:21
  SPEAKER_02: And initially I declined to do it because it was simply counting kids.
• 13:27
  SPEAKER_02: So what was important to me that was that if we found kids, that we put in place something to support them, not just counted the kids.
• 13:35
  SPEAKER_02: And so they went back to their drawing board, came back and said, Hey, we found some money for a school liaison.
• 13:42
  SPEAKER_02: And if we develop this screener together, we will have a liaison that when we identify the kids, their job is to go back to the schools and families and put in place accommodations and supports to get this kid back into school.
• 13:55
  SPEAKER_02: So we developed what we call the Rapid Alaska brain injury tool.
• 13:59
  SPEAKER_02: We call it the rabbit, and it's designed for practitioners.
• 14:02
  SPEAKER_02: So it's a series of five questions.
• 14:05
  SPEAKER_02: The first two are basically have you experienced any kind of head trauma?
• 14:11
  SPEAKER_02: And we list examples for kids because it's put in kid language.
• 14:14
  SPEAKER_02: If they say no to both of those questions, screener's over, right?
• 14:18
  SPEAKER_02: Because it's got to be fast for probation officers or practitioners.
• 14:23
  SPEAKER_02: And they already do a ton of screening anyway.
• 14:25
  SPEAKER_02: If they say yes to those questions, they move on to question three, which asks them if they're still experiencing anything, any of the symptoms, if they're having any trouble.
• 14:37
  SPEAKER_02: They say no to that, they're done.
• 14:39
  SPEAKER_02: If they move on, they go to the next two questions, which ask about what symptoms they're currently experiencing, what troubles they're currently experiencing.
• 14:47
  SPEAKER_02: If they say they're currently experiencing any problems at all, then they get referred to the liaison in Alaska that then takes it to the school and the parents and works to get that child who's justice involved, what they need, the supports they need.
• 15:04
  SPEAKER_02: So the we have one that we've developed.
• 15:07
  SPEAKER_02: We're working on validating it.
• 15:10
  SPEAKER_02: It's a challenge because that population is very hard to get to get a hold of or to get permission to look at.
• 15:17
  SPEAKER_02: But that screener could easily be generalized to be used in school settings.
• 15:23
  SPEAKER_02: Um right now it's designed for kids probably 10, 10 and up, but it could be modified to use with younger kids as well.
• 15:31
  SPEAKER_02: And we would just ask the parents the questions about the children.
• 15:35
  SPEAKER_01: Have you ever heard of the traumatic encephalopathy syndrome protocols from Dr.
• 15:39
  SPEAKER_01: Rob Stern?
• 15:40
  SPEAKER_01: Yeah.
• 15:41
  SPEAKER_01: It sounds a lot like that.
• 15:42
  SPEAKER_01: Where, I mean, you and those are actually being reviewed this year for clinical use.
• 15:48
  SPEAKER_01: And so that would be a great assessment tool.
• 15:52
  SPEAKER_01: I guess I in a school situation, knowing what my daughter goes through, it's also going to be hard to get the kids to admit that there's ongoing domestic abuse or whatever.
• 16:00
  SPEAKER_01: But you know, if we can identify that this kid that's been in the justice system has been playing football since five years old, or boxing, or lacrosse, or fighting, right?
• 16:11
  SPEAKER_01: Or has had, you know, domestic abuse, which is a you know, it's repetitive at impact, right?
• 16:16
  SPEAKER_01: Then, oh my gosh, I mean, to just find these kids at that age and be able to impact their life path through proper intervention and treatment is a game changer.
• 16:29
  SPEAKER_00: Yeah.
• 16:30
  SPEAKER_01: And uh that is amazing.
• 16:32
  SPEAKER_01: So how long have you had this tool in place?
• 16:34
  SPEAKER_02: Three years.
• 16:36
  SPEAKER_02: Yeah.
• 16:36
  SPEAKER_01: And what's been the outcome so far?
• 16:39
  SPEAKER_02: We have run it in Alaska and in Oregon.
• 16:43
  SPEAKER_02: With in Alaska, the goal is to get it in every center that they have.
• 16:47
  SPEAKER_02: In Oregon, we've run it in two centers.
• 16:50
  SPEAKER_02: And depending on the time of year, we're looking at about 40% of kids that we screen have at least a history of of brain injury.
• 16:58
  SPEAKER_02: And you know, it varies from month to month.
• 17:00
  SPEAKER_02: But across 40%.
• 17:02
  SPEAKER_02: 40%.
• 17:03
  SPEAKER_02: Yeah.
• 17:03
  SPEAKER_01: And so do you count what what what counts as a brain injury?
• 17:07
  SPEAKER_01: Is it like a you know, a TBI, or do you look at repetitive impacts like contact sports and stuff like that?
• 17:13
  SPEAKER_02: Anything they anything they report.
• 17:15
  SPEAKER_02: So we we leave it up to them to report.
• 17:18
  SPEAKER_02: But the one thing we've done a little differently is when you and if I had it up, I would read it to you.
• 17:23
  SPEAKER_02: But they each question gives examples in language, right?
• 17:28
  SPEAKER_02: Because if we say if we if we say, have you ever had a brain injury, right?
• 17:33
  SPEAKER_02: The kids are gonna say no.
• 17:35
  SPEAKER_02: So we specifically say, like, have you ever been knocked out?
• 17:43
  SPEAKER_02: Have you ever been in a car crash?
• 17:45
  SPEAKER_02: Have you ever and when we're Alaska, we say, have you been in a snow machine wreck?
• 17:51
  SPEAKER_02: We use we try to use language that is regionally part of their dialect that they would understand and give them specific things that might have happened to them.
• 18:02
  SPEAKER_02: Um we we ask if you've ever been very, very ill.
• 18:06
  SPEAKER_02: And if after that illness you were experiencing problems such as, you know, memory, headaches, sleep, sleep disruption, attention problems, those kinds of things, depression.
• 18:17
  SPEAKER_02: We ask questions specifically targeted so the kids can, their memories can be triggered about events that happened in the past.
• 18:25
  SPEAKER_01: So what so you identify a child with a uh a brain injury?
• 18:30
  SPEAKER_01: What what kind of supports do you put in place?
• 18:33
  SPEAKER_01: Uh what is working right now?
• 18:35
  SPEAKER_01: You know, we have a lot of parents that dial into this podcast.
• 18:38
  SPEAKER_01: What what seems to be working from the school side?
• 18:41
  SPEAKER_01: And then I'd like to talk about treatments on the other.
• 18:44
  SPEAKER_01: So right.
• 18:45
  SPEAKER_02: So so from the school side, it it's really allowing that brain to recover.
• 18:52
  SPEAKER_02: And, you know, because most kids, you know, they recover enough that they can be successful in school for the most part if we give them a break.
• 19:00
  SPEAKER_02: And I I really point that out because one of the common accommodations or adjustments that schools give is they give kids extra time on assignments.
• 19:09
  SPEAKER_02: Well, if you really think about that, that's not really helpful because extra time means that assignment is still there, right?
• 19:15
  SPEAKER_02: So say you've got three weeks out or three weeks when you're just going to school and your brain can't handle doing, you know, 50 math problems on a page or reading the computer, you get three weeks of a piled up assignment.
• 19:29
  SPEAKER_02: And your extra time really just makes this mountain of work that when you come back, it it's hopeless, right?
• 19:37
  SPEAKER_02: And so when we put a kid in a situation where they're hopeless, that's where the mental illness really starts, right?
• 19:43
  SPEAKER_02: When you look at suicide ideation, it starts with hopelessness, right?
• 19:48
  SPEAKER_02: Hopeless hopelessness, and then we move into access to or hopelessness thoughts, suicidal ideation, and then access to a means to do it, right?
• 19:59
  SPEAKER_02: And so that that's that's the progression that that happens.
• 20:03
  SPEAKER_02: And so if we put a child in a situation where it becomes hopeless, like I can't possibly deal with this mountain of assignments and I was going to go to college, but now I was gonna play football in college, and now I'm in my senior year, I've been injured.
• 20:20
  SPEAKER_02: I already don't have a perfect GPA.
• 20:23
  SPEAKER_02: I need that 2.5 to get into the college and play football, which was my dream.
• 20:28
  SPEAKER_02: And now I've got this mountain of assignments that I can't possibly tackle.
• 20:31
  SPEAKER_02: Now I'm in a hopeless spiral.
• 20:33
  SPEAKER_02: And we don't want to put kids in that situation.
• 20:35
  SPEAKER_02: So from the school angle, we can just make those assignments either go away.
• 20:40
  SPEAKER_02: You know, why does a child have to do the same kind of math problems 50 times to prove that they know how to do it when they've just recently been injured?
• 20:48
  SPEAKER_02: Why can't they do it two times to prove that they know how to do it?
• 20:52
  SPEAKER_02: Right.
• 20:52
  SPEAKER_02: So making a huge part of that go away so they get not only a cognitive break, but but a break from this inability to overcome the obstacle in front of them.
• 21:06
  SPEAKER_02: So really that when I had work with teams to design accommodations, I really think about where was this kid?
• 21:14
  SPEAKER_02: Where are they, where were they trying to go?
• 21:17
  SPEAKER_02: And how can we modify, accommodate, adjust their situation to get them back on the trajectory that they were on.
• 21:26
  SPEAKER_02: One of the things I always like to say is those of us in the know, it's our responsibility to not let this injury change the trajectory of, if I'm talking with kids, I say a child's life, but really it's a person's life, right?
• 21:40
  SPEAKER_02: Any person you take in the situation they're in and an injury occurs or repetitive injuries occur and they have problems.
• 21:47
  SPEAKER_02: Those of us who know it's our job, our responsibility to get them back on track.
• 21:52
  SPEAKER_01: So what do you say to that football player when he really shouldn't be playing football anymore?
• 21:58
  SPEAKER_01: Where football is pretty Probably the cause if they've been playing Pee-Wee in all their whole life.
• 22:03
  SPEAKER_01: I mean and I and I understand, you know, uh to your point.
• 22:07
  SPEAKER_01: I mean, the only option that kid has to not be, you know, you know, unfortunately to harmed anymore is I mean, is that is that one of the supports?
• 22:17
  SPEAKER_01: Yeah.
• 22:18
  SPEAKER_01: Is that one of the supports you would look at to educate the the child and say, hey, you know, I mean, it it could be your sports career that's actually impacting your brain.
• 22:29
  SPEAKER_02: Aaron Powell Depending on the situation.
• 22:31
  SPEAKER_02: You know, it's always situational.
• 22:32
  SPEAKER_02: Yeah.
• 22:33
  SPEAKER_02: We all say if you know one brain injury, you know one brain injury.
• 22:37
  SPEAKER_02: That's true.
• 22:38
  SPEAKER_02: So different.
• 22:38
  SPEAKER_02: I have worked with multiple kids and people who have to retire the sport that they're on.
• 22:44
  SPEAKER_02: One one, for example, is Oregon's club sports law.
• 22:48
  SPEAKER_02: Not every state has a club sports law.
• 22:49
  SPEAKER_02: Most states just have a high school law.
• 22:51
  SPEAKER_02: Oregon has a club law that our brain injury policy coordinator, David Crackkey, he'll be coming with me to the conference.
• 22:59
  SPEAKER_00: Okay.
• 22:59
  SPEAKER_00: Yeah, yeah.
• 23:00
  SPEAKER_02: You've met Dave.
• 23:01
  SPEAKER_02: Yeah.
• 23:03
  SPEAKER_02: He was one of the people that drafted this law.
• 23:05
  SPEAKER_02: And it's because kids who play at a high high school often play in club.
• 23:12
  SPEAKER_02: And then we didn't have laws that covered the younger kids, right?
• 23:14
  SPEAKER_02: We just had high school.
• 23:15
  SPEAKER_02: So our Jenna's law covers younger kids and any kind of club recreational sports that's outside of school.
• 23:23
  SPEAKER_02: But she was a downhill skier.
• 23:26
  SPEAKER_02: She did ski across Jenna, who's the namesake of our law, and you know, started skiercross at a young age, played soccer at a young age.
• 23:34
  SPEAKER_02: By the time we found her, or she found us, she had had 11 documented concussions and um was not doing well.
• 23:42
  SPEAKER_02: She was depressed, she was struggling at at college, was had suicidal ideation, all these kinds of things that were going on for her.
• 23:51
  SPEAKER_02: And part of the working with her was she had to leave sports.
• 23:55
  SPEAKER_02: That was not an option for her anymore.
• 23:57
  SPEAKER_02: It just wasn't safe.
• 23:59
  SPEAKER_02: And every doctor that she went to confirmed that was not safe.
• 24:03
  SPEAKER_02: So what we had to do is find her other avenues where she could experience self-fulfillment.
• 24:09
  SPEAKER_02: You know, she had spent her whole life finding her self-worth through sports.
• 24:13
  SPEAKER_01: Identity, yeah.
• 24:14
  SPEAKER_02: Yeah.
• 24:15
  SPEAKER_02: And so we had to help her find other areas where she could experience self-fulfillment and find success, right?
• 24:24
  SPEAKER_02: Because hope and self-efficacy and all those things come from success.
• 24:28
  SPEAKER_02: And when you're when you feel like you're not successful, that never gets you into a good space.
• 24:33
  SPEAKER_02: So she actually started going to conferences with me initially, and she would talk about her experience.
• 24:39
  SPEAKER_02: And then we moved from from doing that kind of work into she got to because she had was an adult by the time we found her, she was assistant coaching soccer teams.
• 24:51
  SPEAKER_02: So she could be with sports and get that piece.
• 24:54
  SPEAKER_02: Um, started doing some golfing because that was a sport she could do and channel.
• 24:59
  SPEAKER_01: It's a good sport.
• 25:00
  SPEAKER_02: Yeah, I know you like golf.
• 25:02
  SPEAKER_02: She could channel that uh competitive nature that she had into something that was a little, a little safer for her.
• 25:09
  SPEAKER_02: That's not the case with everybody.
• 25:11
  SPEAKER_02: Some people we have to find different activities, but really the goal is to give them something that they love to do that maybe they didn't know about and now they've discovered.
• 25:21
  SPEAKER_01: And I think it's safe to say that if these children didn't start contact sports till high school, like a lot of us recommend, these issues would not be around.
• 25:32
  SPEAKER_02: Potentially.
• 25:33
  SPEAKER_02: Potentially.
• 25:34
  SPEAKER_02: Yeah.
• 25:35
  SPEAKER_01: Okay.
• 25:42
  SPEAKER_02: I experienced it probably just like you, starting when they were tiny and going through the the whole thing.
• 25:48
  SPEAKER_02: It's it's difficult to navigate as well.
• 25:51
  SPEAKER_01: It is.
• 25:52
  SPEAKER_01: Yep, it is, man.
• 25:54
  SPEAKER_01: And uh well, I think we're all making progress.
• 25:57
  SPEAKER_01: I was like, all right, uh, let's talk about the treatment side, because I want to go back to your early experience as uh working with uh troubled youth.
• 26:05
  SPEAKER_01: Do you make recommendations for treatments or do you like when you have a brain injury, we know that right now most of these kids are just medicated, right?
• 26:15
  SPEAKER_01: They don't get really any options to heal the brain, you know, and and whether it's you know, the you know, the you know, the um, you know, some of the diets that are brain brain effective, any of the electronic modalities that are out there that have been, you know, pretty much evidence-backed proof that you know there is some significant healing that takes place.
• 26:38
  SPEAKER_01: Are you able to make recommendations or do you have a partnership with like a clinic or a brain treatment center or something?
• 26:45
  SPEAKER_01: Or is that part of what your uh CBIRT does?
• 26:48
  SPEAKER_01: Do you provide treatment alternatives for individuals with with brain trauma?
• 26:54
  SPEAKER_02: We uh we don't do uh medical uh treatment at all.
• 26:57
  SPEAKER_02: We do cognitive and social work.
• 27:00
  SPEAKER_02: We really do a lot of intervention work and research on on that.
• 27:04
  SPEAKER_02: We partner with uh pediatricians and we have them vet most of most of our stuff.
• 27:09
  SPEAKER_02: We partner with uh a group in Eugene called Slocum Sports Rehab.
• 27:13
  SPEAKER_02: We have physicians that we work with in that space, but I'm not I'm not by by any means.
• 27:20
  SPEAKER_02: So I lean heavily on my friends who are, especially when we're looking at things like parents frequently asked questions, which we we have on our Seabert website.
• 27:31
  SPEAKER_02: And uh interesting, you'll find this interesting.
• 27:33
  SPEAKER_02: My soccer player, this this came about because my daughter was, oh gosh, I think she was 11 and she was playing Olympic development soccer and got a concussion.
• 27:43
  SPEAKER_02: I wasn't with her.
• 27:44
  SPEAKER_02: She had uh gone with another parent two hours north to play on the Olympic development team and took a huge hit.
• 27:51
  SPEAKER_02: The mom was driving her home.
• 27:52
  SPEAKER_02: She started vomiting in the car, got her home.
• 27:55
  SPEAKER_02: And, you know, I was working in the brain injury field.
• 27:57
  SPEAKER_02: I was brand new to it at the time, but I panicked as a parent and didn't know what to do.
• 28:02
  SPEAKER_02: Even though I, you know, I had every physician and brain injury and organs phone phone number in my phone.
• 28:08
  SPEAKER_02: I didn't think to call them and I just panicked.
• 28:10
  SPEAKER_02: And so we developed the frequently asked questions for parents that we put out, which we utilized all of our MD friends to get out there.
• 28:21
  SPEAKER_01: Are you like, are are is there any treatments that you're aware of right now that are assisting any of these uh children?
• 28:28
  SPEAKER_01: Because usually when they have a mental illness or in a in or a brain injury, they are under you know some form of pharmaceutical intervention.
• 28:37
  SPEAKER_01: Is that the case in a lot of the children you're working with now?
• 28:40
  SPEAKER_02: Honestly, most of the children I work with or that we we have in our studies are not being treated with pharmaceuticals.
• 28:48
  SPEAKER_02: Most of them are yeah, most of them are really just struggling on the school level, and that's how we find out about them.
• 28:56
  SPEAKER_02: Things like not coming to school.
• 28:58
  SPEAKER_02: Yeah, attendance is a is a good, a good metric for how the kids are doing.
• 29:03
  SPEAKER_02: Failing in school.
• 29:04
  SPEAKER_02: You know, I I did a study where I, with our in the classroom program, which was you know designed to help teachers do a better job with these kids, um, we wanted to see if it made any difference for the kids.
• 29:15
  SPEAKER_02: And so I stood in the back of classrooms and took data on teachers and kids.
• 29:21
  SPEAKER_02: And really what I saw, and this was earlier in my career as well, now I know this, but what I saw kind of surprised me.
• 29:28
  SPEAKER_02: You know, everyone always said, Oh, you know, the kids, kids with brain injury are behavior problems and, you know, they're not coming to school and all that kind of thing.
• 29:36
  SPEAKER_02: But really, what I saw was a bunch of high school students, because I was looking at high school students, sitting in the classroom completely disengaged, sitting in the class with their hood over their head, messing with their phone, playing with their pencil, but not paying any attention to the classroom, you know, putting their heads on their desks.
• 29:55
  SPEAKER_02: And I kind of coined it the epidemic of silent failure because they don't get attention, right?
• 30:03
  SPEAKER_02: The kids who what I would see in the classrooms are the kids that were being disruptive getting getting attention, and the child who was recovering from a brain injury silently slipping, slipping away.
• 30:16
  SPEAKER_02: And I saw it time after time after time, and uh really made a pointed effort to help effort to help those educators see that this this child needs needs your help, not the maybe not so much the kid throwing the paper airplane across the room.
• 30:31
  SPEAKER_02: Granted, you have to deal with that as well.
• 30:32
  SPEAKER_01: But that's yeah, that's a whole different side of trauma.
• 30:35
  SPEAKER_01: That was my side of trauma.
• 30:37
  SPEAKER_01: I wanted attention.
• 30:38
  SPEAKER_01: Yeah, so I got that.
• 30:39
  SPEAKER_01: Yeah.
• 30:41
  SPEAKER_01: So, you know, going back to your early time, the these uh the the incarceration, the the troubled youth, right?
• 30:47
  SPEAKER_01: Now that we understand a little bit more about brain injury, right?
• 30:51
  SPEAKER_01: And you said I think what 40 to 60 percent of the troubled youth you dealt with had a brain injury of some type.
• 30:58
  SPEAKER_00: Correct.
• 30:59
  SPEAKER_01: What would happen if we you know finally started treating these brains?
• 31:05
  SPEAKER_01: Like treating these children, if they have a brain injury, I mean, we have a we have a healing issue, right?
• 31:11
  SPEAKER_01: It's not a I mean, it's not just a school issue anymore.
• 31:14
  SPEAKER_01: I mean, and without you know, treating the brain as well as you know, stabilizing the child, putting the support system in place, you know, we we let them down, right?
• 31:25
  SPEAKER_01: Because we now we know.
• 31:27
  SPEAKER_01: What would be your recommendations on what we could recommend to like I I I educate um the justice system here in Florida on veterans, veterans' courts, right?
• 31:39
  SPEAKER_01: Make them aware of repetitive blast exposure, stuff like that, so they can, you know, you know, there are some crimes you just can't, you know, you can't make go away, right?
• 31:49
  SPEAKER_01: But there are other ones, you know, nonviolent crimes where we could say, hey, with some form of treatment which you've never had, we can hope to reduce recidivism, we could hope to improve your mental health, your employment, the whole nine yards.
• 32:05
  SPEAKER_01: What can we do for these troubled youth?
• 32:07
  SPEAKER_01: I mean, they are an overlooked segment of our population.
• 32:11
  SPEAKER_01: Nobody wants to touch these children.
• 32:13
  SPEAKER_01: And yet they need it the most.
• 32:16
  SPEAKER_01: And and they can improve.
• 32:18
  SPEAKER_01: They can be functional, they can be they can could they can contribute.
• 32:23
  SPEAKER_01: You know, you've dealt with these children.
• 32:25
  SPEAKER_01: What what could well, you know, what could we do to improve that segment of our population or help them?
• 32:33
  SPEAKER_02: Yeah.
• 32:34
  SPEAKER_02: One of the things that is so important with that is one, finding them and recognizing them.
• 32:39
  SPEAKER_02: That's a huge, huge barrier that we really have overlooked.
• 32:43
  SPEAKER_02: It's starting to gain a lot of traction right now.
• 32:46
  SPEAKER_02: So there's there's a lot of work around juvenile justice.
• 32:49
  SPEAKER_02: NASHA is really working in that space.
• 32:52
  SPEAKER_02: I'm sure you know the National Association of State Head Injury Administrators, they're they're doing a lot of work in that space.
• 32:58
  SPEAKER_02: There's actually quite a bit of work happening in Florida, where you're at.
• 33:02
  SPEAKER_02: But I think the biggest thing is finding them.
• 33:04
  SPEAKER_02: That's step number one.
• 33:06
  SPEAKER_02: Step number two is providing targeted treatment and instruction.
• 33:12
  SPEAKER_02: A lot of kids in the situation where they're justice involved, right, they've already failed in school.
• 33:18
  SPEAKER_02: They're already significantly behind in school for a multitude of reasons.
• 33:23
  SPEAKER_02: But so you take a 15-year-old who, for all these, you know, they've had brain injuries, they've missed school, they've got a family that doesn't get them to school, they sit in the principal's office in school because they've got behavior problems.
• 33:36
  SPEAKER_02: You think about how much instruction those kids have missed.
• 33:40
  SPEAKER_02: They're so behind academically that going back to school is not successful, right?
• 33:46
  SPEAKER_02: It feels bad.
• 33:46
  SPEAKER_02: It's another step of failure.
• 33:49
  SPEAKER_02: And then we get kids who continue with crimes, inappropriate behavior, um, going down the cis through the system, right?
• 33:56
  SPEAKER_02: And then they go down this path of being in the system for forever, right?
• 34:01
  SPEAKER_02: And that that is a huge problem for society, right?
• 34:05
  SPEAKER_02: So if we can intervene with those kids and give them corrective behavioral instruction, right?
• 34:12
  SPEAKER_02: They need the instruction at that point and academic instruction so they can stay in a school situation, come out with a high school diploma or high high school equivalency, right?
• 34:24
  SPEAKER_02: Just getting them to that.
• 34:26
  SPEAKER_02: We set them up to look at their rest the rest of their life where they can be employed.
• 34:31
  SPEAKER_02: Right.
• 34:32
  SPEAKER_02: If we don't get them to that point where they transition from school age to adulthood in a situation where they can be functional as an adult, which means being employed, being able to feed themselves, house themselves, close themselves, and be functional in society, then we're going to have a lifetime of problems with that person for them, for their family, and for society.
• 34:55
  SPEAKER_02: So getting them those targeted instructional interventions for both behavior and academics really could change the course of a person's life.
• 35:05
  SPEAKER_02: The other thing is providing family supports.
• 35:07
  SPEAKER_02: Families really need support.
• 35:09
  SPEAKER_02: Even we think about, say, you're a parent of a very high-functioning athlete who gets injured, and that parent has the skills to, if they recognize what's going on, put in place access interventions, access care.
• 35:23
  SPEAKER_02: When we think about the kids who are justice involved, often their parents don't have the means to to access those things.
• 35:32
  SPEAKER_02: And so those parents especially need need supports.
• 35:40
  SPEAKER_01: They they do.
• 35:41
  SPEAKER_01: And and but in a lot of times also the parents just aren't there.
• 35:44
  SPEAKER_01: I mean, that's why the kids struggle.
• 35:46
  SPEAKER_01: And that's why and if they're coming out of the justice system, kind of the usually the state already owns these kids for the most part.
• 35:54
  SPEAKER_01: And I think what what could be like in Florida right now, we have the Sheriff's Association runs um these houses where they bring these kids in.
• 36:04
  SPEAKER_01: You know, they've been given up by the families.
• 36:06
  SPEAKER_01: They're all troubled.
• 36:07
  SPEAKER_01: You know, they're all, you know, they come from very, very, very broken homes.
• 36:11
  SPEAKER_01: They end up in the justice system.
• 36:13
  SPEAKER_01: And they have an unbelievable success record.
• 36:17
  SPEAKER_01: They put them in these homes.
• 36:18
  SPEAKER_01: You know, they they're each home is run by a couple that's been vetted.
• 36:22
  SPEAKER_01: They're on these private properties, they get schooling, they get church, they get, you know, they get fed, they get athletic, they get support, they get structure.
• 36:33
  SPEAKER_01: 90-something percent of them go on to college, the military.
• 36:36
  SPEAKER_01: I mean, they have uh and I mean it's uh something that can be easily templated.
• 36:41
  SPEAKER_01: What we got to do is we gotta stop looking at incarceration as an industry for profit and start focusing on, you know, the human capital that's inside these prisons and what can we do to, you know, you know, get them out and keep them out, right?
• 36:57
  SPEAKER_01: Because, you know, too many of them go back in.
• 37:00
  SPEAKER_01: And and because they don't have what you said, you know, you talk about the and the thing is everything that they need is here.
• 37:06
  SPEAKER_01: It's available.
• 37:07
  SPEAKER_01: It's not a magic pill.
• 37:08
  SPEAKER_01: You know, it's not you know, it it's available.
• 37:11
  SPEAKER_01: You know, you talk about support, you talk about structure, you talk about treatment.
• 37:15
  SPEAKER_01: We know how to heal brains now, and it does not take a lot of money to heal brains.
• 37:20
  SPEAKER_01: And once they're healed, you know, are they cured?
• 37:23
  SPEAKER_01: No, you can't get them all the way.
• 37:25
  SPEAKER_01: I I don't think, but they could be, you know, neuroplasticity.
• 37:28
  SPEAKER_01: We're talking about younger children whose brains aren't developed, you know.
• 37:31
  SPEAKER_01: We start giving them the support, the diet they need, not McDonald's and Taco Bell and all that stuff.
• 37:37
  SPEAKER_01: I mean, I think you're on to something.
• 37:39
  SPEAKER_01: I think there's something that if the state could get provided, could be absolutely amazing at impacting these this uh whole generation of children that have given up.
• 37:50
  SPEAKER_01: And we've given up on them.
• 37:52
  SPEAKER_01: I think that's the point that they they though you talk about hopelessness.
• 37:56
  SPEAKER_01: It's like, you know, it's constantly reinforced that I am worthless, that I am a failure, that I am no good, that I'm not gonna get anywhere, whether it's from the parents, you know, the school system, their friends, society, and they're just they're fighting, they're fighting back.
• 38:11
  SPEAKER_02: Right there as the the bad, the bad kid.
• 38:15
  SPEAKER_02: And what and once somebody identifies as the person who does bad things, it's very hard to get somebody out of that that space.
• 38:24
  SPEAKER_02: Yeah.
• 38:24
  SPEAKER_02: So I I I have a soft spot for the justice-involved youth with the case.
• 38:29
  SPEAKER_01: I can feel it.
• 38:29
  SPEAKER_01: I love it.
• 38:30
  SPEAKER_01: Uh, wish we all had a hard, you know.
• 38:32
  SPEAKER_01: I mean, I didn't even start developing that soft spot.
• 38:34
  SPEAKER_01: I didn't even know there was an issue, right?
• 38:36
  SPEAKER_01: So we started dialing with this.
• 38:37
  SPEAKER_01: And BIAA did a study here in Florida.
• 38:40
  SPEAKER_01: I think it was 80 something percent of our adult population in jail right now has had at least 4.2 TBIs.
• 38:47
  SPEAKER_01: Many of them have played contact sports, right?
• 38:50
  SPEAKER_01: Yeah.
• 38:50
  SPEAKER_01: And then our j I think our Juvie population was in the range that you said, 40 to 60 percent, have had significant TBIs.
• 38:58
  SPEAKER_01: A lot of them, again, you know, we find that less and less, you know, wealthier families of all demographics are not playing contact sports because they're becoming aware, which means you got to feed the machine, right?
• 39:12
  SPEAKER_01: So larger and larger um chunks of our economically challenged and and uh, you know, primarily people of color are paying the price for this, you know, epidemic, you know, because it's my way out, right?
• 39:26
  SPEAKER_01: And it's not.
• 39:26
  SPEAKER_01: I mean, uh, you know, the skin has nothing to do with capability, right?
• 39:30
  SPEAKER_01: We all know that, right?
• 39:31
  SPEAKER_01: It's all about access to qualitative care, love and support that makes these children successful.
• 39:38
  SPEAKER_01: So uh yeah, amazing.
• 39:40
  SPEAKER_01: Amazing.
• 39:40
  SPEAKER_01: Uh so you know, one more question.
• 39:43
  SPEAKER_01: Our parents are always asking about concussions, okay?
• 39:47
  SPEAKER_01: What do you think parents should know when their child has had a concussion?
• 39:52
  SPEAKER_01: What do you what do you think they should be aware of?
• 39:54
  SPEAKER_01: What should they do?
• 39:55
  SPEAKER_01: I mean, unlike me, I took my son to the doctor.
• 39:58
  SPEAKER_01: He's like two weeks, you know, no school, whatever, back at plague.
• 40:02
  SPEAKER_01: Okay, that's the system.
• 40:03
  SPEAKER_01: That he's a doctor, no problem.
• 40:06
  SPEAKER_01: There's no symptoms, right?
• 40:08
  SPEAKER_01: I mean, I didn't even know he didn't know to ask my son if he had symptoms.
• 40:12
  SPEAKER_01: So what what's your thought?
• 40:14
  SPEAKER_02: So I think I think as parents, right, our number one responsibility is to know our children and keep them safe.
• 40:20
  SPEAKER_02: But we don't know what we don't know, right?
• 40:24
  SPEAKER_02: So expecting parents to have all the answers is you know unreasonable and unfair to parents.
• 40:30
  SPEAKER_02: I think if your child is one going to be a contact sport athlete, we should expect that the teams they're playing for are giving parents information, right?
• 40:42
  SPEAKER_02: Doesn't mean that the parents have to master it, doesn't mean that they have to carry around a card, you know, watch for these things in your kids, but just a little bit of education.
• 40:51
  SPEAKER_02: So if something does happen to their child, that seed is planted.
• 40:55
  SPEAKER_02: And so, you know, you you see your child sleeping more, you see your child having headaches, you see your child fighting, going to school, those kind of things.
• 41:04
  SPEAKER_02: The seed is planted that the parent might go, Oh, I need to look into this a little more.
• 41:08
  SPEAKER_02: I need to ask some questions of my child.
• 41:11
  SPEAKER_02: I can speak as a parent of an athlete who's been concussed that it's scary and it's it's hard.
• 41:19
  SPEAKER_02: And so we don't want to, as parents, acknowledge that we might have a situation that we have to deal with.
• 41:26
  SPEAKER_02: So I think the the thing parents need to know is right, we all have goals for our kids, but in the moment we need to keep them, keep them safe.
• 41:36
  SPEAKER_02: And we need to be watching for any any changes in our in our children.
• 41:42
  SPEAKER_02: Any change is is a sign that something is going on, whether it be an emotional thing, a physical thing, a mental illness thing, but that change is the thing we should be watching for.
• 41:54
  SPEAKER_02: And if we can teach parents to look for those changes, and when you see those changes, don't just brush them off as you know, teenagers are up and down and all over the place.
• 42:04
  SPEAKER_02: Ask the questions.
• 42:06
  SPEAKER_02: You know, ask ask questions.
• 42:07
  SPEAKER_02: If their responses are different than they typically are, that might be your trigger to ask further questions or look into things further.
• 42:14
  SPEAKER_02: When it comes to mental health specifically, I think if we can put out there that if your child doesn't recover from their brain injury at, you know, a pretty, pretty quick rate, start watching.
• 42:30
  SPEAKER_02: Start start watching for signs of of things that might trigger you to ask questions, right?
• 42:36
  SPEAKER_02: Sleeping more, um, pulling back from their friends, being disengaged, maybe not going to school, those kinds of things.
• 42:42
  SPEAKER_02: And ask for help.
• 42:44
  SPEAKER_02: It's okay, parents, to ask for help because we're not supposed to have the answers, right?
• 42:48
  SPEAKER_02: Not all parents are mental health experts or intervention experts.
• 42:53
  SPEAKER_02: The asking for help is okay.
• 42:55
  SPEAKER_02: And that's there's people out there that can provide that help so we can intervene before a child becomes hopeless in that situation.
• 43:04
  SPEAKER_01: And folks, this is very important, all right?
• 43:08
  SPEAKER_01: Because, you know, when our son was playing contact sports, you know, he complained of headaches.
• 43:14
  SPEAKER_01: So we assumed he needed to drink more water, you know.
• 43:17
  SPEAKER_01: It's like we lived at altitude, man, drink more water, son, all right.
• 43:21
  SPEAKER_01: Then, you know, he was disengaged.
• 43:24
  SPEAKER_01: But in our minds, his 17-year-old getting ready to join the army, all right, you know.
• 43:30
  SPEAKER_01: Didn't even I didn't even know what apathetic was, couldn't spell it.
• 43:34
  SPEAKER_01: Our son was hurting, and his body was letting him know, and we didn't ask the right questions.
• 43:41
  SPEAKER_01: We didn't know.
• 43:43
  SPEAKER_01: And it sucks.
• 43:44
  SPEAKER_01: You know, and this these are the conversations, this is the knowledge that you now have.
• 43:50
  SPEAKER_01: Where if your child's playing, and we tell people all the time, if they've played, and you don't know what you don't know.
• 43:56
  SPEAKER_01: Dr.
• 43:56
  SPEAKER_01: McCart just said that.
• 43:57
  SPEAKER_01: We don't know what we don't know.
• 43:59
  SPEAKER_01: But still.
• 44:00
  SPEAKER_01: Yeah, I mean I go back all the time and I beat the crap out of myself for not asking, for not listening, for not seeing, you know, and uh but you now, you know, you are aware of, all right, you know, and do ask those questions, you know, and and and don't assume that physical maladies are just caused.
• 44:21
  SPEAKER_01: You know, these concussions go on, you know, sometimes for quite a while.
• 44:25
  SPEAKER_01: And then if you're if your kid does play any sports, lacrosse, rugby, soccer, football, you know, wrestling, you know, gymnastics, where the head is involved, you have to stay on.
• 44:37
  SPEAKER_01: And or not, you don't have to stay on it if they're not playing these sports.
• 44:41
  SPEAKER_01: Okay.
• 44:42
  SPEAKER_01: You know, our son's at the Boston University CTE Center.
• 44:46
  SPEAKER_01: There's no baseball players up there.
• 44:48
  SPEAKER_01: There's no basketball players up there.
• 44:50
  SPEAKER_01: You know, there's other sports sometimes that you could play.
• 44:54
  SPEAKER_01: So, yeah.
• 44:55
  SPEAKER_01: Uh Dr.
• 44:55
  SPEAKER_01: McCart, thank you so much for that information because that's um, you know, it's critical to our parents.
• 45:00
  SPEAKER_01: But they need to understand that, you know, not only a concussion's a one-time thing, but you start throwing repetitive impacts in there, you got a whole nother basket of worms that you have to watch out for.
• 45:10
  SPEAKER_02: So Yeah, I'll I will give one more piece.
• 45:13
  SPEAKER_02: If you have an athlete, and this is speaking mom to other parents, not not Dr.
• 45:19
  SPEAKER_02: McCart, if they say they don't want to go to practice and you have a child who's spent their whole life wanting to go to practice and playing sports, ask the questions.
• 45:30
  SPEAKER_02: And I, you know, I can I can tell you from my daughter doing that that I was like, get it together, you have to go to practice.
• 45:36
  SPEAKER_02: That was a mistake.
• 45:37
  SPEAKER_02: I shouldn't have done that.
• 45:38
  SPEAKER_02: I I should have asked more questions and been like, tell me more, why don't you want to go not want to go to practice?
• 45:45
  SPEAKER_02: You know, are you are you hurt?
• 45:47
  SPEAKER_02: Do you have a headache?
• 45:48
  SPEAKER_02: Is there something social emotional going on at practice that makes you not want to go?
• 45:53
  SPEAKER_02: What what what's happening?
• 45:56
  SPEAKER_02: So I I guess the the overarching theme is ask the questions and pay attention when you ask, because we as parents, you know, sometimes we ask a question while we're doing something else and don't really hear and don't really see what's happening.
• 46:10
  SPEAKER_02: So so take the moment to pay attention to to your child when they're answering.
• 46:16
  SPEAKER_02: Look for the nonverbal things that, you know, if you're cooking dinner, you are hearing what they're saying, but you're not really focused on what they're saying.
• 46:26
  SPEAKER_02: So take the time.
• 46:26
  SPEAKER_02: It's worth it.
• 46:28
  SPEAKER_01: Amen.
• 46:28
  SPEAKER_01: Hope you all listen to that.
• 46:30
  SPEAKER_01: So, Dr.
• 46:30
  SPEAKER_01: McCart, as we close out, why don't you tell our audience how do they find you?
• 46:34
  SPEAKER_01: Uh, talk about CBIRT, what's going on, what's next, and uh, you know, and and then how can they take advantage of some of the research knowledge, the rabbit survey, whatever you have in order to improve whatever we can while we're still on moving airbags.
• 46:51
  SPEAKER_02: So one of the things that is super important to me as director is that you know, we we need the evidence base, we need research.
• 46:59
  SPEAKER_02: But I firmly believe that research is the beginning, right?
• 47:03
  SPEAKER_02: So we need modalities and ways to take research to practice like this.
• 47:08
  SPEAKER_02: This is why I accept these kind of engagements, is because we can take the knowledge in a situation like a podcast with Bruce's audience and get the information to the people who need it so we can change practice.
• 47:21
  SPEAKER_02: So research to practice is super important to me.
• 47:23
  SPEAKER_02: The other piece is culture doesn't change unless you have uh I call it the triad.
• 47:30
  SPEAKER_02: We have research, we have research to practice and policy.
• 47:34
  SPEAKER_02: And policy work comes out of crisis.
• 47:38
  SPEAKER_02: My husband grew up in China and I learned from him that the characters that mean crisis and opportunity in Chinese cannot be pulled apart.
• 47:47
  SPEAKER_02: They have to be written together because a crisis equals a chance, an opportunity.
• 47:52
  SPEAKER_02: And that's that's where we're at with uh this epic epidemic of concussion and brain injury, right?
• 47:59
  SPEAKER_02: We're in a crisis situation.
• 48:00
  SPEAKER_02: That's why we're all talking about it.
• 48:02
  SPEAKER_02: But that gives us the opportunity to make change.
• 48:04
  SPEAKER_02: So if you're looking for information on this, Siebert works in the lifespan.
• 48:10
  SPEAKER_02: I specialize in pediatrics, but we have collected a team of people who work across the lifespan.
• 48:18
  SPEAKER_02: We have folks in the veteran space.
• 48:21
  SPEAKER_02: David Crackkey, who is going to be with me at the conference, will be speaking about screening and the veteran population.
• 48:29
  SPEAKER_02: And he likes to say TDI screening is suicide prevention.
• 48:34
  SPEAKER_02: And so he will be speaking on that.
• 48:37
  SPEAKER_02: His work is available.
• 48:39
  SPEAKER_02: We it's cbirt.org is our main website.
• 48:42
  SPEAKER_02: But if you're looking for um information for parents, it's returned to school, all one word.
• 48:49
  SPEAKER_02: And we have multiple states who have bought bought into it, are working with us.
• 48:54
  SPEAKER_02: We have a page for Alaska, we have a page for Arkansas, we have a page for Texas.
• 49:00
  SPEAKER_02: Anyway, there's a but there's a bunch on the drop-down menu for the different states, and it's specified to the states, and there's lots of tools in there, and there's, gosh, hundreds of pre-recorded webinars.
• 49:12
  SPEAKER_02: There's evidence-based training, there's stuff for college professors, all kinds of things on that website.
• 49:18
  SPEAKER_02: We are doing work, we call it TBI-SOS, which is traumatic brain injury systems of support.
• 49:24
  SPEAKER_02: And uh, we're doing work in Washington where we do peer-to-peer mentors.
• 49:29
  SPEAKER_02: We train peer and certify peer-to-peer mentors to work with folks who have uh sustained brain injury across the lifespan.
• 49:36
  SPEAKER_02: We are providing support groups in that, in that space.
• 49:39
  SPEAKER_02: We are doing community events to give get people back involved in the community, things like accessible bike riding, cooking courses, arts and crafts, you know, just anything to bring people together, that kind of space.
• 49:52
  SPEAKER_02: We have a person, Megan Coons, who specializes in very, very early ed.
• 49:58
  SPEAKER_02: So our youngest, most vulnerable populations and working with providing supports for parents.
• 50:05
  SPEAKER_02: We do, we have the American with community living uh grant, the ACL grant, where we work with state systems to provide supports, things like veteran stand downs.
• 50:15
  SPEAKER_02: Like I said, we we are in the lifespan.
• 50:17
  SPEAKER_02: So both websites, return to school.org and cbirt.org, and also tbisos.org, will get you all the resources that you need.
• 50:27
  SPEAKER_01: Well, Dr.
• 50:28
  SPEAKER_01: McCart, thank you so much for a wonderful interview.
• 50:30
  SPEAKER_01: Uh what a great podcast.
• 50:32
  SPEAKER_01: And I I want to thank you sincerely for your dedication to this cause, you know, to to improving brain health.
• 50:38
  SPEAKER_01: No matter where you go.
• 50:39
  SPEAKER_01: You've had an amazing career, and I know it's not over yet.
• 50:42
  SPEAKER_01: And we look forward to seeing you at the summit.
• 50:45
  SPEAKER_01: And thank you so much for your time and bless you on your journey as you go forward.
• 50:49
  SPEAKER_01: Don't forget the new book is out now, updated, five new chapters.
• 50:52
  SPEAKER_01: It's a whole new book of hope, not the book that I had to write when my son died, um, and I was an angry man.
• 50:59
  SPEAKER_01: But we it's out there now.
• 51:00
  SPEAKER_01: We're now working on the audio book.
• 51:02
  SPEAKER_01: It'll be issued in Spanish, and that's all for free.
• 51:04
  SPEAKER_01: It's on our website.
• 51:05
  SPEAKER_01: Please go there.
• 51:06
  SPEAKER_01: Uh go to the Apple store, get our Head Smart app.
• 51:09
  SPEAKER_01: It's the only app out there for parents with concussions and information on RHI.
• 51:15
  SPEAKER_01: And if you like what we're doing here, and we hope you do, please like us, subscribe us, send us to your friends.
• 51:22
  SPEAKER_01: We are right now one of the fastest growing podcasts on brain health on the internet.
• 51:26
  SPEAKER_01: And it's all because of you, our supporters.
• 51:29
  SPEAKER_01: And I cannot thank you enough for going ahead and having the success that we've had because of the support that you provided us.
• 51:39
  SPEAKER_01: And please keep sending those questions in.
• 51:41
  SPEAKER_01: We love those questions, and I love answering them.
• 51:44
  SPEAKER_01: So please, you know, just keep that.
• 51:46
  SPEAKER_01: So until next time on Broken Brains at Bruce Parkman, the official podcast of the Mac Parkman Foundation.
• 51:52
  SPEAKER_01: We thank you for your time.
• 51:54
  SPEAKER_01: Wish you blessings on your journey.
• 51:56
  SPEAKER_01: And remember, your children only have one melon, and so do you.
• 51:59
  SPEAKER_01: Take care of it.
• 52:00
  SPEAKER_01: We'll see you next time.
• 52:01
  SPEAKER_01: Thank you so much.