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Fortunately for Reimann, a therapist suggested
he work with Mary Kennedy, an associate professor
in CLA’s Department of Speech-Language-
Hearing Sciences, to rehabilitate his brain’s
“executive function” — the ability to reflect on
one’s past and use it to shape the present.
Reimann jumped at the chance.
“If it were not for Mary and her program, I
would not have graduated,” says Reimann, who
walked across the stage last May in CLA commencement
exercises. “Those first few semesters
I was back depended on her help.”
As founder and director of the fledgling
College Program for Students with Brain Injury,
Kennedy works with TBI victims who can benefit
directly from her research. Here, she talks about
her work and its impact.
Researchers estimate there are 1.7 million
new cases of TBI in the United States each
year. That seems like a lot.
Most injuries are considered mild, and the
majority of those individuals will not have any
long-lasting speech, language, or cognitiveprocessing
problems. But among every 100 who
have a mild injury, there may be 10 or 15 who
have enduring problems.
When it comes to TBI, do you have a personal
connection or motivation?
I had a cousin who had a severe brain injury
when he was 19 — the result of a car accident.
The driver of the car was killed, but my cousin
survived. He ended up with aphasia and a
language impairment similar to Gabby Giffords’.
He’s paralyzed on the right-hand side of his body.
But nonetheless, he went back to work part-time
and learned to live independently. He even ended
up getting married. He got back on his feet.
Physiologically, what happens during a TBI?
The neurons in the brain get damaged — pulled,
stretched, and sheared. The injury damages the
white matter, so impulses that travel between
neurons either can’t make the leap or they get
there more slowly. In some cases, the brain may
be bruised by striking the walls of the skull,
leading to swelling and creating pressure that
needs to be alleviated. If the injury impacts the
parts of the brain that regulate the heart, the
lungs, and other vital functions, the TBI can
be life-threatening.
What’s the potential impact on behavior?
An injury can affect memory, reading, writing,
listening, and word recall. It may affect speech
and other high-level complex activities like
planning, organizing, scheduling. It also can affect
metacognition and executive function — how we
think about ourselves, how we think about our
actions. For most of us, decisions made in the
frontal lobe are split-second choice. We do them
without thinking: Do I need to take notes? Do
I need to schedule time to get a task done? But
after a brain injury, you have to make a special
effort to consider such things.
Initially, your research focused on “post-TBI
metacognition.” Would you explain?
Metacognition is the ability of someone to
self-monitor or self-assess before making a
decision. The hypothesis was that people with
TBI have poor metacognition because they can’t
assess how they’ve performed in the past and use
those assessments to make decisions and plan
ahead. But what we found was that there were
certain conditions under which people with TBI
are actually good at assessing their own memory
and making decisions.
Mary Kennedy directs CLA’s College Program for
Students with Brain Injury.
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