TBI Foundations: Key Knowledge Impacting Clinical Approach

Presented by Kristen Keech and Jessica Asiello

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Traumatic brain injury (TBI) is a complex and often misunderstood condition with widespread implications for function, recovery, and quality of life. This course equips clinicians with foundational knowledge about the neuroanatomy, mechanisms, classifications, and health disparities associated with TBI. Participants will gain critical insight into how different types of brain injury—focal, diffuse, traumatic, and nontraumatic—present in clinical practice as well as how to anticipate complications and guide treatment planning accordingly. The course also introduces the new CBI-M framework for TBI classification and explores a dual-lens approach to care that integrates prevention and rehabilitation. Designed for clinicians working across acute and postacute settings, this course supports safe, informed, and equitable care delivery for individuals at all stages of TBI recovery.

Learning Objectives

Identify the primary neuroanatomical structures affected by traumatic brain injury (TBI)
Recall the mechanisms of injury leading to TBI, including acceleration-deceleration forces and direct impact
Paraphrase the new classification system for TBI severity and its clinical implications
Differentiate between focal and diffuse brain injuries and their associated pathophysiology
Build knowledge of neuroanatomy and injury mechanisms to anticipate clinical outcomes and inform treatment planning
Compare dual lens approaches related to TBI care: Preventative vs. Rehabilitative

Meet your instructors

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Kristen Keech

Dr. Kristen Keech is an occupational therapist passionate about advancing care and advocating for survivors of brain injury. She holds a Master of Science in Occupational Therapy from the University of New Hampshire and a Doctorate in Occupational Therapy from the MGH Institute of Health Professions. She is recognized as a…

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Jessica Asiello

Jessica Asiello is an assistant professor in the Department of Occupational Therapy in the School of Health and Rehabilitation Sciences at the MGH Institute for Health Professions in Boston, Massachusetts. She primarily teaches in the online postprofessional OTD program. Her clinical practice is in acute care at…

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Chapters & learning objectives

1. Neuroanatomy, Prevalence, Mechanisms, and Classification

This chapter lays the groundwork for understanding TBI by exploring key neuroanatomical structures, mechanisms of injury, and prevalence across populations. Clinicians will examine how forces like acceleration-deceleration and direct impact affect brain function, how injury severity is classified using the new CBI-M framework, and how social determinants of health influence outcomes. The content highlights the importance of linking brain region to function when evaluating impairments and planning care.

2. Types of Traumatic Brain Injury

This chapter explores the full spectrum of brain injuries, including subdural and epidural hematomas, diffuse axonal injury, contusions, skull fractures, and concussion. It also includes nontraumatic causes, such as infections, tumors, and anoxic injuries. Clinicians will learn to differentiate injury types, recognize complications, and consider how pathophysiology and imaging findings impact prognosis, precautions, and interdisciplinary management.

3. Approach: Preventative and Rehabilitative

The final chapter introduces a dual-lens model for TBI care, emphasizing the integration of prevention and rehabilitation strategies. Occupational therapy practitioners will explore evidence-based approaches for reducing injury risk across populations and gain tools to support recovery through early intervention, interdisciplinary coordination, and long-term functional goal setting. The chapter empowers clinicians to tailor care that promotes both safety and independence across the continuum.