Screening and Assessment

Did You Know?

Given its high prevalence, identification of TBI is critical in delivering appropriate services and supports to those who need them. Screening is an effective method for identification of potential positives, which are those factors consistent with a probable history and/or etiology of TBI. But it is only a small, though helpful, first step in improving the lives of the literally millions of individuals who knowingly or unknowingly have TBI.

Each agency, provider, and organizational screener will use a positive screen differently depending upon his or her particular role within the State systems. However, no matter where each operates in the systems, the screener’s major, ongoing effort is (and should be) concentrated on what’s done as a result of the screen, i.e., how best to connect individuals with services and supports they need to go about their daily lives and for which they are eligible. For some, a positive screen will help establish a probable basis for neuropsychological testing which may ultimately lead to an official, medical diagnosis.

Screening instruments are extremely important because traumatic brain injuries are often overlooked or misdiagnosed for a variety of reasons but primarily due to a lack of awareness of brain injuries and their consequences. Often, an individual with TBI seeking services from a State Agency or community organization does not present with a TBI, but with a co-occurring disorder (such as a mental health issue or substance use), an unknown cause, or an important need (such as assistance with school, employment, or housing). Often the screening questions trigger an individual’s or family member’s memory of an incident which could have caused a TBI, but was not recognized at the time of injury. Often the remembered incident is a car crash, fall, physical abuse, or unintentional injury to the head or face.

Screening for TBI among people accessing State and community services and supports helps enormously in defining the size of this population. It also aids in data collection. Whatever the use, screening is an important first step in coordinating appropriate resources and services for people that need them. While implementing TBI screening may require adjusting your State Agency’s or community organization’s way of doing things, the benefits of this effort far outweigh the costs. A number of screening instruments may be used and/or adapted for a variety of settings.

Resources

• CDC's Heads Up: Brain Injury in Your Practice
  
• The Behavioral Risk Surveillance System (BRFSS)
  Fact Sheet [Word 85KB]
• Center on Outcome Measurement in Brain Injury - COMBI
• Colorado BRFSS Questions [Word 35KB]
• Kentucky BRFSS Questions [Word 25KB]