It’s a life of hustle and survival. I remember when my ninth grade teacher asked me, “Lisa, what do you want to be when you grow up?” See I have to fight the Harlem Crip 30’s everyday to get home from school so I looked at her and said, “Alive.” I took an English class, I got a fail in English. And my English teacher said in front of the entire class, “Lisa, you have to be the weakest writer I’ve ever met in my entire life.” Don’t worry, my story is good. Don’t feel sorry for me. I got seven under my belt. And then the same year my speech teacher said after giving me a D minus I knew I had an A in speech, like come on.

He obviously didn’t agree with me. He gave me a D minus and said, “Ms. Nichols, I recommend that you never speak in public. That you get a desk job.” So here’s the beauty of that story, other people’s perception of you ain’t none of your business. Don’t put a period where God put a comma. Everything you ever been through, set through, rose through, cried through, prayed through, everything is a setup for your next best season. Everything is a setup for your next best season.

The only way you can get the resiliency you have to have the life you’re about to have is to go on through that thing you went through. The only way you can celebrate and dance with the gratitude you going to dance with was to have to be humble the way you were. And I need you to move with urgency because somewhere there’s a young man, there’s a young woman who’s waiting to see you, not avoid getting knocked down, but they’re waiting to see how graceful you get back up. Because in that, in the way you forgive the foreseeable unforgivable, the way you love the perceivably unlovable, the way you accept what seems to be unacceptable, the way you embrace after you’ve been betrayed the way you do that is the way you will lead us. And your job is to give us you in the way that you’ve never given us you before.

Your job is to show us why you were born. Your job is to disrupt our lives so that we’re forever changed because we had the blessing of crossing your path. That’s your job. Your job is not let us off the hook by dimming your light, wondering if we can handle your light. Your job is not to ask permission on can you do you? Are we ready for you? Your job is to show up, and show out, and let us do what we got to do to get ready for you. Your light doesn’t belong to you. Your light belongs to everyone who’ll be illuminated because you were bold enough and obedient enough to let your light shine. Yes, yes. Yes, yes.

And every time you cross someone’s path and they can’t handle your light, you know those people. They try to give you reasons why you should tone it down a bit, that they will tell Sheryl not to sing so loud. Right, right, right. They would tell me to shut up in class. They tell you, “You kind of strange.” You know those people. Dream snatchers, vision busters, don’t be mad at them, they can only love you to the capacity to which they’re able to love themselves. Don’t be mad at them, don’t be mad at them, pray for them. Love them. Because they’re dealing with themselves like we’re dealing with us.

But I want you to remember that your 70 watts, your 70 watts has to be turned way up because you got way more to give us. It ain’t over yet. Don’t put a period where God put a comma. When you turn it up to 159 watts, you know you keep turning it up. You stop dimming your light. You say, “Today is the first day of the rest of my life,” and you turn it up. You’re going to find people that can’t handle your light. And before today you might have dimmed your light, you might have shrunk a little bit. You might have tempered it down a little bit, but after today I want you to see this. After today turn the lights up. After today you don’t dare dim your light. As your light gets brighter, as your light gets brighter you’re going to disrupt some people, and they’re going to tell you, “Your lights too bright. Your lights too bright. Your lights too bright. Your lights too bright.” Then you just look at them and say, “Well I’m not dimming my light, I’m just going to hand you some shades.” I’m just saying, why don’t you start carrying around an extra pair of shades.

This guide is based on Canadian Best Practice Guidelines for the Prevention and Management of Pressure Ulcers in People with Spinal Cord Injury, A Resource Guide for Clinicians. It can be hard to learn to manage your health when you have an SCI, especially if you can’t find simple and clear explanations of what you can do to look after yourself. With this guide the authors are trying to increase access to research and education by describing the experts’ recommendations in everyday language, and using pictures to explain important points.

Adult ADHD Self-Report Scale (ASRS) Version 1.1

Background Information

The screening version of the Adult ADHD Self-Report Scale (ASRS) Version 1.1 is a 6-question scale designed to screen for adult ADHD in community samples. As detailed elsewhere (Kessler et al., 2005), the ASRS was developed by a World Health Organization (WHO) work group in conjunction with the creation of the WHO World Mental Health (WMH) Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI). For more details on the WMH-CIDI, see Kessler & Ustun (2005) or refer to the WMH-CIDI materials posted at www.hcp.med.harvard.edu/ncs and www.hcp.med.harvard.edu/wmh.

The ASRS can be used to estimate the prevalence and correlates of adult ADHD in population surveys. Data from a nationally representative sample of the U.S. can be used for this purpose to assign predicted probabilities of clinician-diagnoses adult ADHD to each value on the ASRS Screener v1.1 in order to calibrate ASRS Screener v1.1 scores to DSM-IV diagnoses. These calibration rules are discussed in Kessler et al. (2005). It is important to note, though, that these rules may not hold in countries other than the United States or for segments of the U.S. population other than the general population. As a result, it would be wise to carry out a clinical calibration study in conjunction with administration of the ASRS Screener v1.1 in samples of other populations. See the ADHD section in the WMH-CIDI , for the scripting of the ASRS Screener v1.1 in the WMH-CIDI. See Kessler et al. (2005) for scoring rules.

The ASRS Screener v1.1 can also be used to screen for adult ADHD at the individual level. This can be done, for example, as part of an ADHD screening day or in primary care waiting room screening. However, as the ASRS Screener v1.1 is only a screening scale, not a diagnostic test, diagnostic assessment by a trained clinician is needed to follow up on patients who screen positive. A positive screen for this purpose is defined in the accompanying clinical screening materials. The latter have been translated into a number of languages using the standard WHO translation and back-translation protocol through an unrestricted educational grant from the Eli Lilly Company. No cultural validations of these translations have been conducted to date. These materials are posted here for unrestricted use. No approval is required to use the ASRS or these translations for individual-level screening so long as the user acknowledges in all print materials that the ASRS Screener v1.1 is copyrighted by the World Health Organization. In addition, scientific papers making use of the ASRS Screener v1.1 should also cite Kessler et al (2005), the key methodological paper on the development of the ASRS Screener v1.1.

The human brain is the most complex organ in the body. This three-pound mass of gray and white matter sits at the center of all human activity—you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities. In brief, the brain regulates your body’s basic functions; enables you to interpret and respond to everything you experience; and shapes your thoughts, emotions, and behavior.

The brain is made up of many parts that all work together as a team. Different parts of the brain are responsible for coordinating and performing specific functions. Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug abuse that marks addiction.

The International Institute of Therapeutic Intervention and Learning is a great resource for those utilizing brain entrainment and neurofeedback. Their soundscapes specifically target areas where a client may be having trouble.

For those unfamiliar with Brain Entrainment, it refers to the capacity of the brain to naturally synchronize its brainwave frequencies with the rhythm of periodic external stimuli, most commonly auditory, visual, or tactile. The external stimuli elicit the brain’s ‘frequency following response’, encouraging the brainwaves to align to the frequency of a given medium. FFR can be useful because brainwaves are very much related to mental state. For example, a 10 Hz brainwave is associated with relaxation, so a 10 Hz sound pattern would help reproduce the relaxed state in your brain. I have successfully used it with varying conditions including; ADHD, ASD, PTSD, Anxiety, and Sensory Integration. However, one does not have to have a diagnosis to utilize brain entrainment. Positive research on brain entrainment continues to grow and expand.

Hey OTs/OTAs!!

One ADL that I love to encourage is leisure. Participating in leisure activities can help you better manage stress and reduce depression. Leisure provides you the chance to find balance in your life; it also puts you in control of how you're spending your time, which is an important consideration because you may feel overwhelmed by obligations.

Spinal cord injury (SCI) is a catastrophic, life-changing event that results in severe sensory, motor, and other neurological impairments. There are approximately 276,000 individuals currently living with SCI in the United States, with an estimated 12,500 new cases annually (National Spinal Cord Injury Statistical Center, 2014). Individuals with paraplegia and tetraplegia experience diminished physical capacities and face life-long challenges such as pain, fatigue, depression, and anxiety, all of which influence their ability to lead healthy and fulfilling lives. Occupational therapy practitioners (occupational therapists and occupational therapy assistants) enable people with SCI to return to productive lives.

1. Spinal cord injury patient handbook - Carolinas healthcare system

1. Evaluation of an occupational therapy program for patients with spinal cord injury – Spinal Cord (46), department of neurological sciences, University of Bologna

1. Improvement in function after spinal cord injury: the black – box entitled rehabilitation – university of Zürich

1. Psychosocial guidelines in spinal cord injury rehabilitation – D Asian spinal cord network

1. Rehabilitation of spinal cord injuries – world journal of orthopedics

1. Living with spinal cord injury – the American occupational therapy Association

1. Occupational therapy skills for the job of living calling a guide for you after spinal cord injury – Hamilton health sciences patient education

1. Spinal cord injury rehabilitation – Brazilian association of rehabilitation

1. The lived experience of drivers with spinal cord injury (a qualitative inquiry – South African journal of occupational therapy

Who were like, “Who do you think you are? You’re a dumb blonde, or you must be some rich girl. Life’s been really easy for you.” My past is not a beautiful one. My sister had an extreme drug problem when I was in high school. I remember one night coming home and I could hear her screaming at the top of her lungs. My mom is on top of her, choking her. My sister’s attempting to scream, trying to throw punches, and all this stuff. I go over and I’m trying to shove my mom off, and she throws an elbow at me, knocks me in the face. My sister breaks free from my mom, because I’m trying to hold my mom.

She runs into this washing room. She tries to shut the door, and my mom breaks through and again just starts choking her. She’s turning blue, and I’m screaming. Finally, we got my mom out of the washing room. We locked ourselves in between the two. My mom is kicking the door so hard that the door is breaking and it’s splintering. My sister is in this little ball just screaming, “Why doesn’t my mom love me? Why doesn’t my mom love me?” She moved out that night.

I had this very bipolar experience with love, in the sense that it was unpredictable, and it was kind of scary about my mom’s, and my dad was just this … I just felt safe. I felt like I could do no wrong. It just felt natural, and it would flow. He taught me how to two-step in the living room. I had my feet on his boots, and I had my hair in little braids, my little feet on his, and we’re two-stepping and I’m giggling because I’m messing up, and he’s twirling me around. That was all the time with him, was that feeling.

When I was 11 years old, I took my mom to court so that I could live with my father. I had to write a letter to the judge, telling everything that my mom had did, and they read it in court in front of her, and I was like, “There’s no way any judge would ever let me go back to her,” so I was just 100% confident, and I remember the call, and I was sitting in this little living room in Oklahoma, my step-mom, and she picks up the phone, and I’m so excited because I’m like, “Oh, she’s gonna tell me my life’s gonna change,” and I just saw her face just look at me with just deep concern, and I was like, “Say something,” and she’s like, “Baby, we didn’t win.” I just started screaming, and I grabbed the phone, talked to my dad, and he had fought tooth and nail, maxed out every credit card he had to try and fight for me. He must have felt so defeated in that moment.

I remember having to get on that plane and go back to my mom’s, and I wouldn’t even let her be at the airport. I said, “I will not go home if you’re at the airport,” and I hated her. I was so mad.

I remember when I was 13, getting home, and a few hours later, I get a call from my father, and he didn’t sound right, and I could just hear in his voice … He just called to say, “Hey,” but something was really wrong. I said, “Daddy, are you okay?” He’s like, “I’m fine.” I go to my mom, and I’m like, “I know you don’t really like this man, but he’s not okay right now and something’s wrong.” She picks up the phone, and she’s like, “Do I need to call people like last time?”

Immediately, I knew. I was like, “This is so bad. This is so, so bad.” I grabbed the phone from her, and I say, “Daddy, I need you. Me and my sister, we need you. Please, whatever’s going on, please be stronger than this. We love you. You’re amazing. You’re perfect,” and he stops, and I will never forget the words, because it hit me so hard, and he’s like, just quiet, and he goes, “Honey, Daddy’s just tired,” and I could feel the weight of the world on him in that moment where he could not see past his darkness, and I couldn’t take it from him. I was this 13-year-old girl saying, “Just please, Daddy. Don’t go. I don’t know where you are. I don’t know what happened. I don’t know why you’re in this space, but can I help?”

My mom grabs the phone, and she’s screaming at him, she’s like, “You fucking bastard, don’t you leave these girls. Don’t you do this to them. This is so selfish. Tell me where the fuck you are.” He eventually tells my mom where he is, and I remember thinking that day if someone had just been there before, before he took the pills, if someone had told him that he was okay, that all of his mistakes were forgiven, he deserved to be loved exactly as he was, then he wouldn’t have been in that space in the first place.

I shut off. It was too painful, and the feeling of the most important person in your life and you can’t save them, I made that my excuse for a long time. I’m a victim, and I ran with that for as long as I could. I started getting bad grades. I stopped trying, and I remember one of my teachers saying, “What has happened to you? You’re gonna go nowhere if you keep this up.” I remember smiling, being like, “Yes. I wanna go nowhere.” It was this cycle that I would create, and I created it into my twenties and unhealthy relationships and in my job experiences and allowing people to treat me ways that were totally disrespectful to my soul.

I was in a relationship with someone who I should have never been in a relationship with in the first place, and I remember one night, we were sitting in our bedroom, and he was an extremely jealous and insecure person, verbally and emotionally abusive, and it was the first night that he became physical, and he took a wine glass and he threw it at me full force. The wine hit my face, and it smashed into the wall behind me, and I remember in that moment, this pain, this lack of self worth was so much darker than anything that anyone should ever feel or experience or even … It wasn’t real, and I prayed, and I got on my knees, and I said, “God, I know that I’m here for a reason. I can’t see it. I sure as hell can’t get to it, but I know I’m here for something far bigger than this bullshit,” and it was like this wave of energy came over me.

I looked at him, and I was like, “Get out. Get out of my life.” I just was like just strong in it, and he left. I don’t know who spoke through telling him to get out, but thank God it did because it gave me a couple days to be like, “Why? Why did I let this in?” It gave me distance to create enough clarity to let the fog start to lift, to see things as they really are.

Why did I go into that? I was afraid to be unaccepted. I was afraid to live my life without someone constantly there. I was afraid to fully be loved, so I attracted someone who wouldn’t love me fully. Well, I don’t want to live a life of fear anymore. I want to live a life of love, so every day, I will make decisions from love, and, sometimes, they’re really courageous. They’re crazy. They’re perfect. They make me a better person.

Long-Distance Caregiving: Twenty Questions and Answers focuses on issues that are unique to long-distance caregiving whether you live next door or across the country.

Developed by the National Institute on Aging (NIA), part of the National Institutes of Health, this booklet is a gateway to ideas and resources that can help make long-distance caregiving more manageable and satisfying.

This resource often refers to caregiving for aging parents, but in fact, you can use the tips no matter who you are caring for—an older relative, family friend, or neighbor. The information is organized in a question-and-answer format. Each of these commonly asked questions has a brief answer. You can read them separately or together for a more complete picture of all the facets of caregiving from afar.

The International Institute of Therapeutic Intervention and Learning is a great resource for those utilizing brain entrainment and neurofeedback. Their soundscapes specifically target areas where a client may be having trouble.

For those unfamiliar with Brain Entrainment, it refers to the capacity of the brain to naturally synchronize its brainwave frequencies with the rhythm of periodic external stimuli, most commonly auditory, visual, or tactile. The external stimuli elicit the brain’s ‘frequency following response’, encouraging the brainwaves to align to the frequency of a given medium. FFR can be useful because brainwaves are very much related to mental state. For example, a 10 Hz brainwave is associated with relaxation, so a 10 Hz sound pattern would help reproduce the relaxed state in your brain. I have successfully used it with varying conditions including; ADHD, ASD, PTSD, Anxiety, and Sensory Integration. However, one does not have to have a diagnosis to utilize brain entrainment. Positive research on brain entrainment continues to grow and expand.