Fort Campbell Makes Advances in TBI Evaluation

By Kathy Helmick, DCoE deputy director for traumatic brain injury

In December, I had the opportunity to visit Fort Campbell, Ky., to learn more about their Military Functional Assessment Program. Maj. Sarah Goldman, Army Office of the Surgeon General, traumatic brain injury (TBI) program manager, and I were invited to see this comprehensive, advanced five-day assessment, which is part of a 12-week program designed to treat service members with TBIs.

 This evaluation does not rely on a pen and paper test or a computer assessment. It takes place on post and in the program’s simulation lab, exposing service members to realistic combat scenarios while allowing a team of medical and rehabilitation providers the opportunity to evaluate their responses. Service members are observed on camera while combat-related decision-making functions are tested, such as how long it takes a service member to come to the aid of a fallen comrade, identify a threat, plan a course of action, or radio call into a command center. If they perform tasks in simulated combat situations in accordance to Army standards, then this information helps guide return-to-duty decision-making.

 Additionally, the lab tests how the service member performs under environmental stressors, such as lack of light or loud sounds, to approximate scenarios encountered in combat zones.

 One of the program’s best practices relates to integrating the expertise of a non-commissioned officer (NCO) to evaluate the ability of the soldier to perform the tasks to established Army standards. In the assessment we saw, the NCO was instrumental in educating medical providers about Army standards and describing combat scenarios. Leveraging the knowledge of a qualified NCO helps the medical provider offer a comprehensive evaluation of the service member’s impairments associated with TBI and the injury’s effects on their ability to perform military duties on the battlefield to standard.

I was also impressed with how this program focused on function; instead of clicking a dot on a computer test or circling a multiple choice question, service members with TBI are put in an environment to test their performance and capabilities. Some service members may perform well in a controlled rehabilitation environment, but may not be able to perform as well when multitasking during a high-pressure combat scenario. It was clear that the service members appreciated this type of evaluation and gained more confidence, whether they transitioned back to duty, or out of the military into civilian life.

In continuing to follow this advanced program, I hope that we can identify key outcomes that predict return-to-duty success, or help service members return back home.