HORIZONS A NEWSLETTER FOR FAMILIES AND FRIENDS OF CROTCHED MOUNTAIN FALL 2011 VOLUME 11 NUMBER 3 COMPREHENSIVE CARE, INSIDE AND OUT ON THE COVER: Hospital patient Ron Nepomuceno is provided with a portable ventilator so he can explore Crotched Mountain's accessible trails - just one of many unique opportunities available to CM patients as part of our multilevel continuum of care and recovery. Simplifying the Journey of Recovery by Don Shumway President and CEO THE SPECIALTY HOSPITAL at Crotched Mountain is a very different place today than it was even five years ago. That’s because we focus on the changing health care environment and respond in ways that increase both the breadth and depth of our services. This process is on-going as we work to meet emerging trends in rehabilitation and the needs of those who look to us for high quality, comprehensive rehabilitative services — our patients, families and the medical providers who refer people to our care. The evolution has been exciting as we’ve expanded our post acute and multi-level specialty care to address a wide range of diagnoses and patient needs at every step of the rehabilitative process. We are able to admit patients with more complex healthcare needs sooner in their recovery and offer a path to recovery that moves patients seamlessly through acute, sub-acute and skilled nursing stages of rehabilitation. Most recently we instituted a ventilator program to serve stable adult and pediatric vent users, and we will offer a vent weaning program soon. Both patients and families benefit from a course of recovery in a single multi-specialty setting offering physical, occupational and cognitive therapies in an environment with amenities not typically found on a hospital campus. Universal hiking trails, waterfront activities, accessible recreation, arts and more are available to our patients at every stage of their healing process. But our services don’t stop there. We are proud that after discharge from Crotched Mountain, nearly ninety percent of our patients are able to return to their communities. Our patients can take advantage of an array of community-based supports including home care management, supportive housing, assistive technology, accessible recreation programs and comprehensive outpatient services featuring a wide variety of therapeutic specialties. The journey of recovery from brain injury, spinal cord injury or a medical-surgical procedure can take any number of paths. At Crotched Mountain we are proud to offer a path that is well-planned, with smooth transitions from acute care to home with all the supports needed to achieve optimal independence. The ABCs of ABA NO, IT’S NOT A MISSPELLING of the 70s Swedish pop band ABBA. ABA, or Applied Behavioral Analysis, is an evidence-based approach to teaching young children with autism. And despite its rather clinical name, it’s motivational, fun and effective. At Crotched Mountain we know the value of fun and motivation when it comes to learning, and are pleased to announce our new ABA-based program, Ready, Set, Connect!, a half to full day program for young children two to six years old on the autism spectrum. “Studies show that comprehensive and intensive early interventions like ABA significantly increase positive outcomes for children on the autism spectrum,” says Crotched Mountain autism educational consultant Dennis Bradley. ABA is based on two simple concepts. First, when something pleasurable occurs as the result of a specific behavior, we are motivated to continue that behavior. Think dessert for eating your carrots. Secondly, when a skill is practiced repeatedly and in different settings, it becomes second nature. Think hitting the brakes in your car when you see something in the road. When these concepts are used early and often with children with autism, studies show significant improvement in a number of areas including communication, socialization, self-care, play and motor skills. “One thing that separates ABA from many other modalities is its reliance on data to shape teaching strategies,” Dennis notes. “If results indicate a child is not learning, the therapist analyzes the behavior to determine why and makes systematic adjustments in the teaching approach.” An individual assessment determines areas of needed focus and shapes the psychological and behavioral approaches that will best teach the functional skills identified. “The goal is to decrease repetitive, ritualistic or self-injurious behaviors that interfere with learning and increase those skills that facilitate engagement such as eye contact and sustained attention,” says program director Perry Olson. A typical session might ask the child to mimic an action initiated by the instructor such as clapping. Every time the child successfully repeats the action, he receives a token. The tokens can be traded for a special activity, toy or food the child enjoys. This activity might teach sustained attention and interactive play skills. In ABA, similar interventions can be repeated up to 30 hours a week to teach a range of skills. Programming is offered in both Concord and Greenfield in child-friendly settings and facilitated by ABA therapists certified by the Center for Autism and Related Disorders (CARD) using their highly regarded SKILLS curriculum. Children receive individualized instruction as well as time in small groups. Parents take part in individualized monthly clinics to observe treatment sessions, review strategies and analyze progress. “When combined with Crotched Mountain’s expert knowledge and therapeutic resources,” Dennis notes, “we believe Ready, Set, Connect! is the most comprehensive program in the region for children with autism.” Quote: "This is the program I have spend the last five years looking for. Jack is finally getting the support he needs to succeed." Adrienne Evans, Jack's mom. For more information about Ready, Set, Connect!, contact Perry Olson, program director, at 603.547.3311, extension 1366 or email perry.olson@crotchedmo untain.org The Passion To Heal: One Artist’s Journey PAT MAHONEY IS AN ARTIST. And his passion for the arts has been instrumental in his ongoing recovery from a brain injury. Struck by a car in October 2010 while riding his bicycle near the University of New Hampshire campus where he was working on a masters degree in Fine Arts, Pat’s life changed dramatically. Severely injured, he was air lifted to Massachusetts General Hospital where he lay in a coma for a week. After regaining consciousness, he still wasn’t out of the woods. “Pat had a very serious setback in January that put him back in the ICU and reversed any progress he had made,” recalls Anne Nelson, Pat’s girlfriend and active partner in his rehabilitation. “When Pat first arrived in April, he couldn’t walk by himself,” reports Jenn Forkey, Pat’s physical therapist. “He couldn’t climb steps and was very quiet. He didn’t communicate during therapy. It was hard to know how he felt about what was happening at first.” The therapeutic team, including occupational, physical and cognitive therapists, reviewed Pat’s progress thus far, discussed his interests, needs and goals and designed an integrated program to facilitate Pat’s physical and cognitive recovery. Pat’s previous passion for artistic expression became a key focus of the rehabilitation program we designed. Shortly after his arrival, Pat began cognitive rehabilitation therapy. According to program coordinator, speech and language pathologist David Hajjar, Pat was a good candidate for the program, as he was ready to participate in group activities. “We focused on sustained attention and learning compensatory strategies for memory. He made good use of the iPad to stimulate recall, improve reading and comprehension, take notes, and plan and schedule activities. He also used it to research a personal scheduling system and choose a word processing program for his writing,” explains David. David also tapped into Pat’s creative passions when he asked him to write a poem. “Pat was studying poetry in his graduate program, and he hadn’t attempted to write a poem since his accident.” Pat readily complied and crafted a compelling and layered poem using the campus resident chickens as metaphor (poem at end of article). “The cognitive rehabilitation therapy really helped me with memory and concentration. But most important was the diversity of therapies,” explains Pat. “The topics and activities were less traditional, like having a grand piano to play any time I wanted.” Occupational therapist Dave Kontak, who worked closely with Pat on basic life skills and other aspects of daily living, provided variety in Pat’s day by tapping into his many passions. “The content of rehabilitation is a huge consideration. Music and art are Pat’s areas of motivation. Using art to stimulate his higher cognitive functions enriched his day and stimulated healing. Having to remember a piano phrase and play with both hands has profound healing implications.” Dave, who is also a musician, introduced Pat to tube drums, an instrument Dave designed and built. “I showed him how to play for about five seconds, and then I gave the paddles to him,” Dave remembers. “I expected him to play for just a few seconds. He went at it for 30 minutes non-stop. You do not have to tell this guy how to work.” All the while, Jenn and Pat focused on building core strength in the therapy pool and on balance working with foam beams and the BAPS Board (Biomechanical Ankle Platform System) to strengthen and condition his lower extremities. He also participated in a regular yoga practice. “Shortly after Pat began cognitive rehabilitation, I noticed a rapid increase in his response time and the quality of his attention,” recalls Jenn. “He communicated more readily, which improved the overall effectiveness of his physical therapy.” During the weeks before his discharge from Crotched Mountain, Pat jogged with his brother, played tennis, climbed the accessible trails with Anne, played the piano at a patient photography show and gave a witty and informative presentation to his peers in cognitive rehabilitation group. “Patrick is back,” says Anne. “He still tires easily, but his humor is there and his passions are the same.” What’s next? Pat has been accepted into a cognitive rehabilitation program near his home town in New Jersey. He will keep working, with plans to return to school next year. We’re confident that Pat’s willingness to work hard and his love of the arts will continue to serve him well as he embarks on this next chapter in his recovery. On the Roost (excerpt) Born on the mountainside at the start of spring, a fog file coated morning time kept us in a womb, free of worldly worries. It kept us free of any knowledge of our impressive surroundings: an outdoor coop, space enough for our mother, her four close friends, and two rough-edged roosters for protection. — Pat Mahoney For full text of Pat’s poem, please visit: crotchedmountain.org/roost THE FACE OF PHILANTHROPY The Perfect Donor AT CROTCHED MOUNTAIN, we celebrate the perfect donor — and we have many to celebrate. Our perfect donors give regularly but aren’t necessarily wealthy. They know each gift, no matter what size, is vital to our mission. Our perfect donors know and care about what we do. Many have visited our Greenfield, New Hampshire campus, and share what they’ve learned about our extraordinary work with friends, family and acquaintances. They are well informed about our current programs while having a good understanding of our future needs. They are the first donors to give to our Annual Campaign. They have supported us for five or more years, with many having made a small provision for Crotched Mountain in their estate plans. They help advance our mission by volunteering on committees or within our community. Our perfect donors have made Crotched Mountain a charitable priority while supporting other organizations. They have sustained our margin of excellence by investing in our people and programs. They have afforded us the resources to transform lives by allowing us to remain the highest quality, lowest cost provider for the most vulnerable individuals in our region. Our perfect donors are true philanthropists. They are our champions. Are you among them? BRIEFLYnoted ORGANIC ALL THE WAY The Crotched Mountain Horticulture Program received its official State of New Hampshire Certified Organic Permit to grow and sell vegetables, flowers, herbs and seedlings as Certified Organic. The Horticulture Program provides hands on instruction for students in plant propagation, basic plant identification, plant care, soil mixes, harvesting and delivery of foral arrangements and vegetables. HOSPITAL EARNS RENEWED ACCREDITATION Crotched Mountain Specialty Hospital received renewed accreditation recently from DNV Healthcare, Inc. Crotched Mountain meets all the conditions of participation required for hospitals by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services. DNV Healthcare’s system of accreditation focuses on quality management and continuous improvement within the organization. EVERETT DANCE TROUPE REINTERPRETS CM Everett Dance Theater, an artist-in-residence in the Healing Arts Program, has integrated their experiences at CM in a new stage production, Brain Storm. Using current neuro-science research as inspiration, the production is informed both by interviews with leading brain scientists and their two-year residency at Crotched Mountain, utilizing theater as a therapeutic and learning tool with patients and students. CM TRAILS EARN ACCESSIBILITY AWARD Governor John Lynch presented Crotched Mountain Foundation with the 2011 Governor's Accessibility Award in recognition of our new accessible hiking trails on July 26th. The award also recognized CM for going above and beyond to remove barriers preventing people with disabilities from participating in the mainstream of society. LEADERSHIP AWARD Jon Eriquezzo, Director of Residential Services at CM, was presented with the Exemplary Leadership and Service Award by the State Division of Children, Youth and Families and Juvenile Justice Services at their 18th Annual Conference. Fellow award winners Garrett Lavalee and Noel Sullivan share the spotlight with Jon. NEW ANNUAL CAMPAIGN CHAIR Meet Bill Monbouquette CROTCHED MOUNTAIN Boston Red Sox Hall of Fame pitcher, Bill Monbouquette, will serve as the Chair of Crotched Mountain’s Annual Campaign. For many years, Bill and his wife Josephine have been great friends of Crotched Mountain having supported the organization as both volunteers and leadership donors. Crotched Mountain’s Annual Campaign raises over $2 million a year in support of our highly skilled and dedicated staff and transformative programs for children and adults with disabilities. After retiring from an 11-year major league playing career, Bill became a beloved pitching coach for many outstanding major league pitchers. A native of Medford, Massachusetts he lived for a time in New Boston, New Hampshire where he came to know Crotched Mountain. Since 1972, Bill has been supporting Crotched Mountain as both a volunteer and a donor often visiting the children at Crotched Mountain School and the adult patients in our Specialty Hospital. According to Bill, “Crotched Mountain does extraordinary work for its children and adults.” “We are delighted to have Bill Monbouquette represent our Annual Campaign as an important member and great ambassador of the Crotched Mountain team,” said Don Shumway, CM president and CEO. Bill Monbouquette has been associated with major league baseball for the past 50 years as a former player, scout and pitching coach for the New York Yankees, New York Mets and the Toronto Blue Jays organizations. In 1962, he threw a no-hitter, just missing a perfect game by walking one batter against the Chicago White Sox, on his way to a 20-game winning season in 1963. For many years, he held the Boston Red Sox Club record for strikeouts (17) until it was broken by three-time Cy Young Award pitcher Roger Clemens. As a teammate of other Boston Red Sox greats, including Ted Williams and Carl Yastrzemski, Bill was the last pitcher to pitch against the great Satchel Paige in a regular American League game. HORIZONS Published by The Office of Advancement Editor: Robin Boyd robin.boyd@crotchedmountain.org Crotched Mountain Foundation One Verney Drive Greenfield, NH 03047 603.547.3311, ext. 1490 Please write us at the above address if you wish to have your name removed from fundraising requests supporting Crotched Mountain.