Raising Awareness for CTE and Traumatic Brain Injury with Dr. Kelli Uitenham

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Transcript of “Raising Awareness for CTE and Traumatic Brain Injury with Dr. Kelli Uitenham” – Bright Conversations Podcast

Hi and welcome to Bright Conversations. I am Shontaye and I am your host for today. Bright Conversations is the brand new virtual talk series by Bright Ideas Media. Today, I am excited we'll be raising awareness for CTE and traumatic brain injury with Dr. Kelli Uitenham.

She is a medical SLP and I am excited to bring her into the conversation. Hi Dr. Kelli. 

Hi Shontaye, how are you? I'm fantastic, excited to be here with you this morning.

How's everything going? Things are going well. Me too. I am very grateful to be here. Thank you for having me.

Absolutely. Thank you for your time and your expertise. We recently had Dr. Kelli on the January 2025 SLP summit and she gave a special thanks to a phenomenal presentation that really helped to shed light for a lot of SLPs , especially SLPs who work in schools on how we can play a role in TBI and CTE for our students. So Dr.

Kelli, can you just share a little bit about your journey and your story ? Absolutely. Well, believe it or not, I started in journalism and mass communication. So this is a pivot for me. People who know me, I love a pivot.

So from journalism, there weren't a lot of opportunities there when I graduated in '09. And so I had a line sister who is a speech-language pathologist and she told me about it and I looked into it and fell in love with it. I went to grad school and from there I knew that I wanted to work with adults and get into the medical side of things. And I ended up in skilled nursing facilities and then I did some travel therapy for a couple of years on and off. And then I did contract work, but through that journey I was able to acquire multiple licenses and everybody that I spoke to always said, "Oh, I was licensed there and I let it lapse and I wish I hadn't." And so I was thinking, "I'm going to keep all of these licenses and I don't know what I'm going to do with them." But by the time that I had come off of the road from doing travel therapy because the companies actually get your licenses for you.

And so I thought that was of great value and then I learned about telepractice and got into that and figured, well, I would like to start my own at some point. And so during that journey of telepractice and travel therapy I also pursued my doctorate. And so once all of that kind of concluded in 2020, I started my private practice, serenity speech therapy. And that led me to get into different spaces like teaching and adjunct. And so that also brought me into public speaking, which is how Brain Talk Foundation got started.

And then it led me to raise awareness in the brain health space because I saw that there was such a void of that of just the general awareness wasn't there. And so from there I am here in raising awareness and in this brain space, there wasn't a lot of room for speech therapists in that space prior to. And so it was just like, "Well, you're going to have to make a space." And so now I'm doing my best to raise awareness and make sure that many, many SLPs know this so that they can do their due diligence in their circle and their network. I don't want to gloss over everything that you just talked about. You've done a lot.

You've had a very broad experience. You mentioned being licensed in a lot of states and having your hand in tele practice. So you probably were ahead of the curve when COVID happened. You were already familiar with providing teletherapy when the rest of us were scrambling, trying to figure out, "What do we do now?" Very much. So I probably had three or four years in on telepractice before we all had to jump in feet first.

And isn't it interesting how when you're in graduate school and you're learning and studying, you kind of feel pulled in a certain direction and you almost know instantly. I don't know what you're studying, but I know I have a preference for working with this population, whether it's pediatric or adults. And it sounds like you knew early on that adults were the area that you wanted to focus on and you continued in that same trajectory to this day. Absolutely. I always say, "God bless the pediatric SLPs because everybody has their own niche and their passion." And I know pediatric SLPs who are like, "Ugh, the tongue, the swallow, look.

I couldn't possibly." That's me. And while I'm not like yuck-yuck-peeds, I'm understanding that there is a special passion and adoration for that demographic. And you all bring that passion into your work working with the kiddos and I do the same with the adults. And now we're just looking for this bridge so that we can work together because all of us have the skills and the foundation that are required to help with the awareness of brain injury in all populations. But I want to empower the pediatric side so that you all have that confidence as well.

Because a lot of times I'll do these talks and I'll speak to school-based SLPs and they'll say, "Nope, that's not my area. I can't do it. That's not my thing." And so I want to boost that confidence and say, "But you still have the foundation and you can do a little screening and give some recommendations that are going to be professional and acceptable to the kiddos, the schools, and the parents, which is where this message needs to extend to." Yeah. I like that what you said about bridging the gap because this is an area that does touch all age groups from very young to older as well. So let's talk a little bit about raising awareness and you mentioned your brain talk foundation.

What have you been doing to help educate communities as well as educating SLPs in their role with TBI and CT? Talks, talk, talk, talk, which is appropriate since we're specialists in communication. I always say I need a microphone and an audience. There isn't any population that doesn't need to know this information because while sports is a huge area where concussion and traumatic brain injury can happen and now we're learning more about CTE, chronic traumatic encephalopathy, there are kids who are in-car accidents. There are kids who fall off of their bikes.

There are kids that end up with injuries from the playground and they're hitting their head. And from that space, that means I need to get into not just the speech therapy spaces. So I do a lot of work at submitting proposals or getting invited to speak at the different state and national conventions. Right now I'm doing my best to branch out into other areas because while I'm doing this work, I'm learning that physicians aren't completely aware of the complete scope of practice of speech therapists. And so I find that a lot of medical doctors, including neurologists and even some concussion specialists, they aren't aware of what it is that speech therapists can do.

And so I'm trying to navigate these multiple spaces. And I say this all the time, I can't do it alone. So if you are interested in helping to raise the awareness, I always welcome the team approach. But that is the big thing that I'm doing is getting into these different spaces and giving talks. Right now I'm trying to branch out into kind of like the younger sports spaces and speak to the athletes and the parents because that's a big thing that I'm a former athlete.

And when I talk to athletes, when I talk to parents and coaches, a lot of them are saying that no, like we don't have like actual education on like what the risks are, what signs they should be looking for in their kids. And so that's something that I want to do as well is get into the space where the athletes are as well as their parents. So everybody knows what to keep an eye out for. While we're talking about raising awareness for the folks who are listening, it may not be as familiar. So let's talk about and breakdown what exactly is CTE?

Good question. So CTE, it's a big word. Everybody keeps hearing about it, especially with football season just passing. But I mentioned a little earlier, it stands for chronic traumatic encephal opathy. And I won't bore the audience with the medical mumbo jumbo and the nitty gritty of it all.

But generally speaking, CTE occurs after repetitive repeated head injuries. So taking a hit to the head over and over and over and over again. It's not something where you would hit your head on a door, you know, opening the car door and it's like, "Oh, CTE, no, it would have to be repetitive." So that's why you see it in a lot of athletes. You can see it in military personnel, you know, with them experiencing blasts and other kinds of drills or even being in combat themselves, they can experience it. And unfortunately, a space that is going to need to be to have awareness raised as well as in domestic violence survivors because again, repetitive head injury.

But what CTE essentially is, is it is cutting off the nourishment, which is blood, to the part of the brain that requires blood to function. And the brain is our mother board. So it needs all of the nutrients, all of the blood that flows through it. But through those repetitive head injuries, you end up getting kind of like roadblocks to where the blood can't get to the area that needs it. And so when it doesn't get the nutrients, it doesn't get the blood, that part of the brain essentially starts to die.

And so when you think about those different parts of the brain, your frontal lobe, your temporal lobe, I always talk about going around the brain. So back up your head, that's your occipital lobe, so vision, all of those different parts of your brain, if they are not getting what they need, then they're not going to function in the way that they are supposed to. So that means your decision making can be off, your emotional regulator can be off. So little things that may not have been an issue to someone prior to these injuries could be an explosive reaction. And a lot of times in CTE patients or patients who are suspected are showing signs of CTE because you can't get diagnosed with it until you are dead, unfortunately.

And a lot of the loved ones of those people who either have died or who say they're showing signs, the main comment that you will hear is them saying like, well, this isn 't like you. That's not how they act. This is nothing like how they behave. It's not because those parts of the brain that make them who they are are essentially dying or being starved of the blood that they need to function properly. And CTE is significantly different than a traumatic brain injury.

Yes, yes it is. So a traumatic brain injury, that is, well, first, concussions are considered mild traumatic brain injuries or TBIs. Right now we're working on moving away from using the word mild because that kind of gives people a get out of jail free card, if you will, so kind of like, oh, if it's just mild or that word, just, it's just a concussion. It's not just a concussion. Three concussions equals one traumatic brain injury.

And a traumatic brain injury can be classified if someone is in a coma when it 's like really, really severe. You go to traumatic brain injury. But the difference in that is a traumatic brain injury could happen from three concussions or one very, very, very, very volatile or traumatic event. So something could pierce the skull and enter the brain or something severe like that. But with CTE, that's where you have those repetitive head injuries.

Parts of the brain start to die and you start to see kind of things that aren't really able to be fixed without the help of a professional or at least some compensatory strategies to help create and develop some new neuropathways. But the traumatic brain injury, those are, I don't want to say easier, but a different kind of recovery because with the TBI, there are ways to circumvent or provide intervention that can be different for CTE because with traumatic brain injury, you're dealing with something that's injured with CTE, you're dealing with something that's dying. 

So the treatment approaches for that look different. Okay. So when we're thinking about a pediatric SLP, for example, I know earlier on in my career when I worked in a school setting where I saw students who had been sent to a more specialized or most medical based school system, I remember having students who had experienced shaken baby syndrome.

And so they have a form of TBI and also needed intervention. But when you're working in a typical school setting, what are some things that an SLP could look for that might be an indication of an early sign of a concussion or TBI in a child? Really good question. So similar, definitely behaviors. So if you're seeing things in a kiddo or if you're hearing reports from a teacher and they're saying like, this isn't how they act, this is a little different.

What's going on? You know, a lot of times people are going to ask, especially in education, they 're going to ask what's going on at home. So you can also see difference in attention. You can see the same thing, difference in irritability. Are they more moody checking for?

Are they falling asleep in class when they didn't do that before? Are they complaining about fatigue? So they're not able to sleep like they used to. So with teachers, educators on all levels, I always say that they have great baseline information because if a student is doing really well and then you see that their grades are starting to tank, that is a really good indicator. And so I know the SLPs can take a look at how scores are going.

And so just having that interprofessional collaboration between the SLP and teachers, I know that there's a lot of collaboration in that in the school space, but also memory. So if they're having a hard time remembering certain things, their vision. So if they're complaining about not being able to see the board or I've even heard of some kiddos who have what they call floaters in their vision. And so that can come from, again, that occipital low pit, something happening to their vision. And so also word finding.

So if you see kiddos who are saying, give me them that, before they were able to name these kinds of things. So those are some of the signs and symptoms that can help with identifying something might not be right. And it would be worth giving a screen or at least pulling them in for an evaluation. And regardless of your setting, you touched on communication and collaboration. And there are other folks outside of the school setting too that we should be trying to work with and collaborate with when it comes to identifying these students.

Can you talk a little bit more about pulling in the neurologist or making the referrals, maybe even some of the other service providers like an occupational therapist or physical therapist? Yes. So we all should be working as a team. And I think that's part of that bridge gapping. So I'm glad you're asking this question.

I would say just where you see the signs and symptoms go to that professional, especially if they're lasting. So there are a lot of concussions that take place and the lucky cases they recover and they won't need the additional intervention. But going to an occupational therapist, those can help with if they're experiencing things motor-wise, same thing with physical therapy. So there can be vestibular physical therapists. I hope people write that down.

Vascular physical therapists, they really specialize in the vestibular system and helping to rehab that. Neurologists, they are a great help, especially with scans and reading them. But like I said before, there are doctors, there are neurologists who do not have the expertise in concussion. And so they could end up missing some things. So making sure that the speech therapist educates the parents, educates the student, depending upon the age, and really working as a team because advocating for the injured student or athlete is what is really needed.

And I know that there is the white coat syndrome. And so a lot of people can go to the doctor and think like, well, if this is what the doc said, then this is what it is. And sometimes that's not the case. That's not always the case. There are doctors who are trained and excellent in what it is that they do and can refer you to the necessary specialist.

But you really want to make sure that you're advocating and that you have a doctor who understands concussion and understands the referral process and who else they need to see. Speech therapy is a really big one to make sure that they're getting that cognitive rehabilitation. There are occupational therapists who can also aid in that cognitive rehabilit ative space. But like I said, that interprofessional collaboration is very important. It's important to have a network where everybody is talking to each other because you wouldn't want the doctor to prescribe a medication.

And then the other professionals that are involved aren't aware of it. And then they're working on something that could be not helpful, less helpful, or even harmful. Often as you were talking, I was just thinking about how so often speech language pathologists may be the first person, the first professional that a student encounters that recognizes that I think that there's some underlying issues that are happening, whether it 's this, as we're talking about today, or maybe some other situations like you're the first to recognize that a child may seem to have some other neurological underlying issue. And it sounds like if you know your students, if you know your clients, if you know their activity and their behavior, you may be the first person to recognize that something seems different. This child didn't typically have issues with their memory or their word finding or their behavior, the demeanor has changed in a way that you feel like it's abnormal because it's lasting, as you mentioned.

So the SLP might be the person that has to initially have a conversation with the family and then maybe encourage them to pursue further evaluation with their doctors. And I also wanted to bring back up to something that you mentioned about. Sometimes the first doctor that you see may not be the doctor who provides the support and the treatment that you need. Would you say that that's accurate too? Yes, I would.

And also possibly, and you know, this is no slight to doctors, but there are doctors where their bedside manner just isn't up to par, just in, you know, emotionally, culturally, just all of the things. And so it can be devastating to finally feel like, "Oh, like I got in with a doctor." But then you get a doctor who's like, "You're just here because of the movie concussion." Or you, you know, it's in your head. And it sounds wild to come from, you know, the medical side where we are taught to be compassionate and you're inserting yourself into someone else's crisis, treat people the way you want to be treated. And there are medical professionals, not just doctors, but there are medical professionals who don't have that bedside manner and they can dismiss what it is that someone is experiencing. And I want to empower people with this awareness, with this knowledge.

If you are experiencing these things and you know it, stand up for yourself, stand up for your kid and explain. And if that isn't working, then it's okay to get a second opinion. Yeah, that's so important, very important message to share and reiterate. For anyone who's listening and has now become more interested in learning more about this, as you mentioned, you know, speech therapists, we do all have a foundation, but some may not work in this area often and it may feel very fuzzy, like, you know, it's something you learned quite some time ago. Do you have any recommendations for where someone could go to learn a bit more, brush up on their skills, to understand better how TBI and concussion can impact their clients and students?

Yes. I say get involved, get involved with your local associations. So organizations like the Brain Injury Association, they have a national one where it's BIAA Brain Injury Association of America, but they also have local state chapters that will have conferences. So going to get continuing education units there, ASHA is another great resource and Basla is a wonderful source to get CEUs on this. I will actually be presenting at in Basla this year on this topic and National Black Association for Speech Language and Hearing Sciences.

Yes, thank you very much. And also at the state and local associations where you can gain CEUs and you really, like, it's not like there's a school or, you know, another program that you can necessarily go through. You're going to have to do your due diligence and educate yourself, but there are courses that are online that you can purchase for that have been done in the past where you can log on to places like speechtherapypd.com. I've done actual courses for them. So really just casting your net and looking for opportunities to just absorb as much as you possibly can, which is something that I still do myself always learning.

And we should also mention that you have a podcast too where folks can come and learn and hear more stories directly from you. Yes, very true. Thank you for that. So there is the podcast route. You can also do the social media route.

So I follow pages like mine where I'm posting information about the brain, science to look for, how you can care for your brain. There are organizations. So there's concussion legacy foundation is really good. They also have a page that is based out of Canada where they have new research and studies looking up articles. But yes, my podcast is called Candid Conversations with Dr.

Kelli. And I have retired professional athletes on and doctors. I just interviewed a doctor who specializes in concussion in pediatric populations. And I also incorporate survivors. So people who may have been concussed or suffered a traumatic brain injury when they were younger or even in the adult space.

And I've also interviewed parents. So parents who either still have their children, but they, you know, suffered an injury and they talk about how their child is not the same. This one particular family that I'm talking about, there was a young man who was, I believe, 12 or 13, and he suffered a really, really bad concussion on the football field . And his IQ dropped 39 points. And so they are extremely grateful that their child is still alive because I've also interviewed someone that they know who was in the news as well, and their son died from what sounds like professionally speaking, second impact syndrome.

And there the child's brain swelled to a point where the brain was not able to function the way that it was supposed to and he never woke up. And so having that kind of conversation with a parent is absolutely devastating . But those are the kinds of stories that I want people to have access to where you don't have to pay for it because the way the human brain works is we're very much, you know, inevitable. And that's not going to happen to me or that's not going to happen to my kid. And you know, I want people to see and have a tangible grasp like, no, this can happen to an everyday person and not someone who's in the NFL or even at the collegiate level.

Like these are kiddos who are 11, 12 years old whose lives either will never be the same or whose lives are gone. And tuning into the podcast is a great way to hear those stories. And a lot of times the parents are giving wonderful information on what they wish they would have known, gems that they're dropping on in hindsight, what they would have done differently, which gives listeners an opportunity to learn from their story and do things differently. So they're not in that same situation. That's a really powerful way to learn, unfortunately, from other stories.

But it's a great way to spread awareness and let people know that we're not invincible and this could happen to you or your child or your neighbor. I want to go back again and just mention the podcast is called Candid Convers ations with Dr. Kelli. And where is it available? You can listen and stream on Spotify as well as Amazon Music, Apple Podcast.

And we also put a version up on YouTube. Awesome. Awesome. And while we're here, let's also just talk a little bit about where folks can follow you on social media. Yes, you can follow me on Instagram also TikTok.

I'm on LinkedIn, but my handle is Dr. Kelli dot medical SLP and that's d r k e l l i dot medical SLP. And you can also find me on Facebook. And Dr. Kelli also has a website so you can go there as well.

Yes, it is brain talk foundation.org. You can also find me on Kensington Academy LLC dot com and for the speech therapy page, it is serenity speech therapy dot com. And we'll have all of this in the show notes as well. So you can be sure to keep up with Dr. Kelli.

Are there any new projects that you have underway that you'd like to share? I know you mentioned that you'll be presenting in Long Beach, California this spring for the Numba in Basla convention. Anything else coming up for you? Yes, I will be finally releasing my course. I'm doing the live version March 13th.

I hope people are getting their tickets. This is actually a course that I'm doing that has been requested so many times. And I always laugh because it's I can talk about concussion and brain injury and raising awareness. So when I mentioned this this course, it's called thinking outside of the box on your speech path. That is a course that I do with, as you said earlier, I've done a lot of different things, but that's a course that I'm teaching to teach other SLPs how to leverage their expertise so that they can earn additional streams of income.

And we all need that. Who doesn't want additional streams of income. But you know, when we're in graduate school, a lot of times we are taught how to be clinicians and how to work for somebody and we don't have the business side of it. And then we get out into the field and we're taught to work for somebody. And that is typically what happens on that speech path.

So there are other ways for you to earn additional streams of income. And I've done a lot of them and I would just like to share that with the masses so that they too can increase the money coming into their accounts. And I'm also going to be teaching or releasing the course that I've done on traumatic brain injury and concussion and CTE in athletes and the role that SLPs play. And later on in the summer, I'm going to do kind of a part two to that because there's so much information that needs to be talked about, especially just from the basis of it so that people can understand what's happening to the brain. And then the part two course is going to really be diving into some case studies looking at how treatments can actually go, things that are functional and big on functional exercises.

I'm not going to give a patient like something like a worksheet and then say, I 'll be back in 20 minutes. No, we're going to do some things that really matter to the patient so that they are motivated to participate because brain injury space is, it can be very emotional and it can, you know, yield depression and if you can make therapy functional and fun for your patients, for your clients, it really motivates them to want to participate and want to get better and I find that you see better results that way. So those are the courses that I have coming up. I will be in also doing talks at different associations this year. You can see all of them on my website.

I keep them on the Brain Talk Foundation organization where you can see where I 'm going to be. I do know I'll be in Florida for Flasha. I'll be in Illinois for the Black Student Athlete Summit and then I'll also be in Virginia. Like you said, California and I'll be in North Carolina doing our state association as well. So just- You are both and busy.

Got to plan. Yes ma'am. So just keep me, keep, go to the website and see where I'll be and, you know, reach out. I would love to connect and like I said, I can't do it alone. So those are places I'll be and check the website to keep up to date.

So that's your call to action listeners. If you are here listening, as she mentioned, she cannot do this work alone. So please do keep up with Dr. Kelli. Look for where she's going to be.

If she's in your area, maybe you can show up for one of the talks and listen as well and become active whether it's just within your school system, with your clients, but there's something that all of us can do by becoming more aware and becoming more educated. I do want to also mention, as you said too, like keep up with your continuing education. So there are lots of resources out there. Take advantage of them. You can follow Dr.

Kelli and listen to her podcast and I am going to also invite you to subscribe to Bright Conversations so that you can hear more conversations with incredible thought leaders and colleagues like Dr. Kelli. Kelli, I'm so grateful to have had you with me this morning. It was a fantastic conversation. I feel like we could keep going because there's just so much to talk about on this particular topic and not enough as being shared.

I think that we need to clone you, which is why it's important that more people are listening and getting involved because parents need to hear this, families need to hear this, as well as providers and physicians. So thank you for the work that you're doing. It's so important and so necessary and thank you for your time this morning. Thank you. Thank you very much.

I'm honored to be here. Just the last little call to action to listeners, please don't be afraid to be the first in your area to do these kinds of things to raise awareness. Talk to coaches, go to Little League. All areas can be at risk. So if you want to start with sports, you can, but get in the ear of the coaches .

I'm sure that parents would want to know the risks. We all have a positive intent when we put our kids into these extracurricular activities. And I just think it's important and parents have a right to know what the risks are and that you don't have to say, "I wish I would have known when you can." So empower yourselves, get into these spaces. I'm actually looking into getting into like pop Warner spaces and raising awareness in those different aspects as well. So don't be afraid to be the first and if you need any help, please reach out.

We are a team, so we've got to do this together. Yes. And I'm going to also encourage you to follow us and listen to us on wherever you listen to your podcast, but also visit us at bethebritus.com, www.bethebritus.com for more of your professional development needs. Thank you, Dr. Kelli, for being with us today.

And thank you all for listening. Thank you. Thank you.

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