Category: Blog

In the serene surroundings of Elkins Park, Jefferson Moss-Magee Rehabilitation Hospital stands as more than a medical facility; it is a symbol of hope and healing, profoundly influenced by the compassionate spirit of Nancy Wachtel Shrier. Her connection to this institution was not just philanthropic—it was a vital part of her very being, a manifestation of her unwavering commitment to bettering the lives of others. This tribute, drawn from the rich tapestry of memories shared by her family, including her husband, Marc, and children, Peter Shrier and Lee Yonish, celebrates a woman whose empathy and dedication have indelibly shaped the essence of these institutions.

Marc Shrier’s voice softens with affection as he recalls his wife’s deep involvement with the institution. “Nancy was a whirlwind of activity at Moss, always looking for ways to contribute more meaningfully,” he says. This passion wasn’t solitary; it enveloped Marc, transforming him from a patient to an ardent supporter. Their collaborative efforts, notably their substantial contributions to Moss Rehabilitation Research Institute and the Shrier Family Topics in Rehabilitation Science Lecture Series, are now cornerstones of the institution.

Their children paint a vivid picture of a life exemplified by generosity and empathy. “Our parents cared deeply about a range of causes, but it was always done with so much love,” Lee reflects. Peter adds, “They have giant hearts, and that was evident in everything they did.” For them, Nancy was not just a mother but an exemplar of kindness, her life a lesson in the power of giving.

Nancy’s commitment to Moss Rehabilitation Research Institute and Jefferson Moss-Magee Rehabilitation – Elkins Park was characterized by her visionary approach and tireless dedication. The pinnacle of her contributions was the establishment of the Directorship in her name, a testament to her profound impact on the field of rehabilitation science. Dylan J. Edwards, PhD, the inaugural holder of this directorship, exemplifies the values and vision Nancy cherished, particularly in advancing rehabilitation research.

Her involvement went far beyond financial support; Nancy was a catalyst for innovation and growth. The Shrier Family Topics in Rehabilitation Science Lecture Series, an initiative she spearheaded, has become a tool for disseminating knowledge and fostering collaboration among experts worldwide. This series, along with her other endeavors, has significantly propelled the Institute’s standing in the global rehabilitation community.

Moreover, Nancy’s support was instrumental in developing programs that emphasized the importance of art and sports in rehabilitation. Her enthusiasm for All About Moss Through the Arts and the wheelchair tennis tournament at Penn reflected her belief in the resilience and capabilities of individuals, regardless of their physical challenges.

The legacy of Nancy within the walls of Jefferson Moss-Magee Rehabilitation Hospital – Elkins Park and Moss Rehabilitation Research Institute is both profound and enduring. The establishment of the Directorship in her name stands as a poignant homage to her relentless pursuit of progress in rehabilitation science. This directorship not only honors her memory but also serves as a beacon, guiding future innovations in the field.

Her children reflect on the enduring impact of these tributes. Lee observes, “The Directorship in our mother’s name is more than an honor; it’s a continuation of her life’s work, inspiring others to follow in her footsteps.” Peter adds, “It’s a living testament to her dedication and passion.”

Additionally, the staff and patients of the hospital often speak of Nancy’s influence. Rejoice Jula, the Director of Development, reminisces about Nancy’s readiness to assist in any capacity, underlining her indomitable spirit and dedication to service. These tributes collectively paint a picture of a woman whose life was defined by generosity, innovation, and an unwavering commitment to help others.

Nancy’s story is not just one of personal achievement but a narrative of unwavering compassion and philanthropy. Her profound dedication to Jefferson Moss-Magee Rehabilitation – Elkins Park and Moss Rehabilitation Research Institute has set a benchmark for future rehabilitation philanthropy. Her legacy, echoed in the corridors of these institutions and in the hearts of those she touched, serves as a powerful reminder of the transformative impact one individual can have. Nancy’s memory, defined by purpose and generosity, continues to inspire, and guide us in our efforts to support and uplift those in need.

Finding the right mentor at the right time can have a tremendous impact on the trajectory of an early-career scientist. MRRI Institute Scientists are outstanding mentors who are invested in helping train the next generation of researchers in neuroscience and neurorehabilitation. Frank Garcea, PhD, was a postdoctoral fellow at MRRI from September 2017 through August 2020 under the mentorship of Laurel Buxbaum, PsyD, and he has been successful in establishing his independent research program at the University of Rochester Medical Center. In this interview, Dr. Garcea talks more about his experiences at MRRI and his current research.

Can you tell us more about your current position and what you are doing now?

After completing a three-year postdoctoral fellowship at MRRI in 2020, I moved to the University of Rochester Medical Center to begin a postdoctoral research position in the Neurosurgery Department. I then accepted a faculty position in the Neurosurgery and Neuroscience Departments in 2022. In my current position, I spearhead a cognitive neuroscience research lab composed of full-time research assistants, undergraduate students, master’s, MD, and PhD students.

What are your current research interests?

We use a range of neuroimaging and neuropsychological methods to study the structure and function of the human brain/mind. From a basic science perspective, our goal is to advance understanding of the cognitive systems supporting activities of daily life, like object manipulation and language production. Much of our work in this context uses functional MRI, diffusion tractography, and voxel-based lesion-symptom mapping to test hypotheses. One exciting problem we’re working on is to better understand how acquired brain injury to one area within a network can disrupt processing in areas outside the site of injury. This puzzling phenomenon is referred to as diaschisis, and its cognitive and neural bases have been investigated for over a century.

From a translational perspective, our goal is to use neuroimaging to support the planning of neurosurgical procedures here at the University of Rochester Medical Center. For example, if a patient has a brain tumor invading the motor cortex, my lab uses functional and structural MRI to identify where sensory, motor, and cognitive functions are represented in relation to the lesion. With this knowledge, our neurosurgery colleagues can tailor their surgical approach to avoid resecting cortical and subcortical tissues identified in our pre-operative mapping. As patients recover from their brain surgery, they are invited to take part in neuropsychological testing, which allows us to relate pre- and post-operative changes in cognitive function to the location of the lesion, the size of the neurosurgical resection, the type of brain pathology, etc.

What was it like working at MRRI and conducting research in MRRI’s Cognition and Action Lab?

Training at MRRI was a tremendous experience. I benefitted from a structured training plan, the regularly scheduled T32 lectures and workshops, and the opportunity to learn from experts in the cognitive and brain sciences. Working in Dr. Buxbaum’s lab was a fantastic experience on multiple levels. I was familiar with Dr. Buxbaum’s research interests, publications from her lab, and how research was conducted. Because of this, it was easy to embed my postdoctoral training within the broader goals of her lab, to collect neuroimaging and cognitive data, and to apply for extramural grants and publish manuscripts within a short time period.

Are there particular things you learned or skills you developed at MRRI that have helped you in your career?

I came to MRRI right after I finished my PhD. At the time, I understood that running a lab while competing for funding was a huge challenge. Because I had protected training time, I was able to learn how to write grants while also conducting research. I also learned that this is a skill that can take years to hone, so it was important to be patient and learn as much as possible while I had the protected time to do so. The experience was incredibly important for my career development, and I’m very appreciative of the faculty and staff at MRRI who took the time to review my grant proposals and provide critical feedback.

What were the next steps of your career after finishing your postdoctoral fellowship at MRRI?

This is the part of the story where my career development was affected by the COVID-19 pandemic. I finished my postdoctoral fellowship at MRRI in August of 2020. At that time, there were hiring freezes at universities across the country, which made finding another position challenging. I’m from Rochester, NY, and I did my PhD training at the University of Rochester. I moved back home in the spring of 2020 to be closer to family and was lucky to find a postdoctoral position in the Neurosurgery department here at the University of Rochester Medical Center (URMC). I then began writing grants immediately upon starting the position and was fortunate to secure a KL2 career development grant through the Clinical and Translational Science Institute here at URMC. This two-year fellowship provided vital resources to facilitate my career development and transition to a faculty position here at URMC.

Can you describe what it was like for you to launch your own independent research laboratory?

It’s rewarding and demanding all at once. With the KL2 funds, I was able to marshal resources and support to start building my lab. Hiring and training full-time research staff to coordinate day-to-day activities was a challenge because of COVID restrictions. Once I had staff trained and ready to go, my lab expanded in exciting ways. I was able to carve out some time to train undergraduate students and medical students working on projects. I’ve been fortunate to have kind and motivated students work in my lab. Probably the most rewarding aspect of running a lab is watching students develop their scientific skills and independence over time. Though it has been less than two years, I’m enjoying the environment, the culture of my lab, and the scientific content driving our projects forward.

What have been some of the biggest challenges you have had to overcome in your career or research?

Of the many challenges, I’d say the most challenging was recognizing and accepting my limitations. For years I’ve felt comfortable balancing the demands of multiple projects. Though it feels great to publish manuscripts and secure grant funding, this line of work can really wear one down without a proper work-life balance. As I started building my lab, I realized there are probably  5 – 10 tasks on my to-do list every day. I found that when I crossed a task off the list, a new task appeared. It’s overwhelming. I had to learn to say ‘no’ to new projects and to prioritize certain activities while putting other tasks on the back burner. This is incredibly difficult for me. Though I wouldn’t say I’ve ‘figured it out’, I do believe I’ve identified a strategy that allows me to stay productive while also maintaining my mental health.

Do you have a favorite scientific success story from your work?

It’s tough to pick just one! On a personal note, I’m thrilled that I’ve maintained a close relationship with my mentors. Earlier this year, I shared a meal with my postdoc advisor (Dr. Laurel Buxbaum) and my PhD advisor (Brad Mahon, PhD). We had a great time discussing problems we’re working on and challenges in our field. I feel truly blessed that I can call them up on the phone and ask for advice and know they’d be there to support me. I hope to be that person in the lives of the next generation of trainees whom I mentor.

On the scientific side, I’d say one success story that is front of mind is having students in my lab prepare manuscripts for publication. It’s incredible to see a person grow and develop when provided with the right resources and support. This is what success looks like from my point of view.

Knowing what you do now if you could go back in time and give advice to yourself when you were just starting your postdoc, what would you say?

I would tell myself to slow down and be patient. We often view success through the lens of papers published or grants funded. These endeavors can take years to accomplish. Life moves pretty fast, so appreciate the little victories and trust the process. I would also tell myself to go to more concerts! The music scene in Philadelphia is truly special. Though I had a great time seeing some of my favorite bands, I could have branched out and done more. I guess I would tell myself to be more present and enjoy living in Philadelphia while you have the opportunity.

How do you like to spend your free time?

Most of my family and friends live here in Rochester, so I’m lucky that I get to see them often. I’m also fortunate that I have a loving and supportive partner who enjoys traveling. We like to find new restaurants and places to visit in Rochester and in the Finger Lakes area. Upstate NY has a lot to offer in terms of history and culture, so we make a conscious effort to visit attractions close to us and outside of Rochester. In addition, I’m pretty regimented when it comes to working out and running. It helps to clear my head and is a huge stress reliever. I still try to go to concerts as often as I can. Last but not least, I enjoy spending time with my dog Rosie!

Jaclyn Barcikowski, DO, is a physiatrist who treats patients in the Drucker Brain Injury Center. Certified in Physical Medicine & Rehabilitation and Brain Injury Medicine, she serves as a Clinical Director of the Stroke Rehab Unit, as well as Associate Program Director of the MossRehab/Einstein Physical Medicine & Rehabilitation Residency Training Program.

“I work as a physiatrist in the Drucker Brain Injury Center in Elkins Park. I came straight to MossRehab after completing my fellowship. Coming here was a huge opportunity for me. MossRehab has a wonderful reputation, particularly for brain injury medicine. My patients include those admitted to the hospital who require a high intensity of medical care due to brain injuries. I also work with outpatients discharged from the hospital. They come to my practice to get care and may receive different outpatient therapies such as physical, occupational, and speech.

I have been excited to work with Dr. Rabinowitz and her team on the Get Up & Go study – a research program to promote physical activity in people living with TBI. I am thrilled to be part of this research. As a marathon runner and avid hiker, I am passionate about the benefits of exercise and experience it personally in my own life. Evidence suggests that encouraging regular exercise not only aids in the rehabilitation process but also brings about a myriad of health benefits. From improved cognitive function and mood enhancement to enhanced cardiovascular health, the positive outcomes are vast. I am enthusiastic about the potential impact this research could have on the well-being of my patients and others living with brain injuries.”

* This article was adapted from an article published in The Moss Traumatic Brain Injury Model System’s Spring 2024 Edition of Brain E-News.

Physical activity stands as a cornerstone for holistic health, playing a pivotal role in disease prevention, emotional well-being, and physical vitality. Engaging in regular physical activity isn’t merely a lifestyle choice; it’s a powerful prescription for a healthier, more fulfilling life. Scientific evidence consistently highlights the myriad benefits of an active lifestyle, from lowering the risk of chronic diseases such as heart disease, diabetes, and certain cancers to fostering emotional resilience and mental well-being. Unfortunately, nearly 80% of Americans, fall short of recommended physical activity guidelines, leading to a surge in public health initiatives, campaigns, and smartphone applications aimed at increasing activity levels.

For those with living with moderate to severe traumatic brain injury (TBI), the challenge of meeting recommended activity levels is compounded by mobility limitations, pain, and the loss of social opportunities. The unique barriers faced by those living with the effects of TBI, from safety concerns to emotional hurdles, make the need for tailored interventions all the more critical.

Dr. Rabinowitz recently initiated a new study funded by the National Institute of Disability Independent Living and Rehabilitation Research, examining a novel program developed in her Brain Injury Neuropsychology Laboratory designed to boost physical activity among individuals living with TBI. This 10-week program, called GetUp&Go, was designed with input from persons with lived experience of TBI, and includes one-on-one meetings with a therapist by video conference and phone, as well as a supportive smartphone application to offer real-time reminders and encouragement. Dr. Rabinowitz stated, “We hope the results of this research will lead to improvements in treatment that, not only promote physical activity, but also to redefine possibilities for those navigating life after TBI.”

Recruitment for participation in this clinical trial began at the beginning of this year and will continue until reaching the target enrollment of 70 participants (expected in early 2027).

* This article was adapted from an article published in The Moss Traumatic Brain Injury Model System’s Spring 2024 Edition of Brain E-News.

Brain injury is a chronic condition. However, many people think about a brain injury as a single, isolated event from which a person fully recovers. This incorrect perception is something that Monica Vaccaro, M.S., is determined to change. Ms. Vaccaro is a Research Associate at MRRI as well as the Director of Programs at the Brain Injury Association of Pennsylvania, a non-profit organization dedicated to preventing brain injuries and fostering an inclusive community of education, advocacy, support, and research to maximize quality of life for people with brain injuries and their families.

At MRRI, Ms. Vaccaro works in the Brain Injury Neuropsychology Laboratory directed by Amanda Rabinowitz, PhD. In this role, Ms. Vaccaro assists with clinical trials of potential treatments for brain injury rehabilitation, co-chairs the Advisory Council, represents the Moss TBI Model System on the Pennsylvania Department of Health Brain Injury Advisory Board, helps with planning an annual consumer conference, and coordinates focus groups with individuals with brain injury and their caregivers.

“The persons with lived experience with brain injury (the survivors and their family members), their stories, their experiences — that’s what drives me. Because in my role, I get to directly interact with people with lived experience all the time, and they really inspire me. It’s a group of people who are brave, navigating a difficult world, and doing so many wonderful things,” Ms. Vaccaro explained.

Ms. Vaccaro’s Path To a Career in Brain Injury

Her career began in education, and Ms. Vaccaro spent about ten years as a teacher for children in preschool through fifth grade with significant learning disabilities. During her time as a teacher, Ms. Vaccaro became fascinated by the kinds of errors she saw her students making, and she wanted to learn more about the brain and how disabilities could impact learning. She decided to go back to school to study the brain and neuropsychology.

As a student, Ms. Vaccaro had an opportunity to work at Einstein Healthcare Network and Moss in the early 1990s through a pre-doctoral clerkship program. This experience allowed her to conduct inpatient neuropsychological evaluations, and it was a major turning point in her career. Working with patients was powerful and eye-opening. After her internship, Ms. Vaccaro accepted a position in the inpatient unit of the hospital, and she worked there for years before transitioning to directing an outpatient program, and then moving into research at MRRI.

After more than three decades of working with people with brain injuries, Ms. Vaccaro has important insights into the needs of the brain injury community that remain unaddressed. These include greater awareness of brain injury as a chronic condition, funding for brain injury research and resources,

Raising Awareness About Brain Injury

While Ms. Vaccaro and many others are committed to increasing awareness of brain injury year-round, brain injury awareness and advocacy efforts are particularly concentrated during the month of March as The Brain Injury Association of America leads nationwide efforts in observing Brain Injury Awareness Month. A key goal of these efforts is to change the public perception of brain injury from thinking about it as one transient event to understanding that it is a chronic condition. After experiencing a brain injury, individuals can show substantial improvements in the acute phase, but many may take longer to recover or may have life-long impairments.

It is critical for the public, as well as legislators and other policymakers to realize that many people with brain injury require ongoing treatment and services for a long time. Currently, traumatic brain injury is not recognized as a chronic condition by either the Centers for Disease Control (CDC) or Centers for Medicare & Medicaid Services (CMS), and this has a detrimental impact on the availability and affordability of long-term care for people with brain injury, as well as funding to support brain injury research and resources.

Advocating for More Funding for Brain Injury Research, Resources, and Clinical Care

Recently, Ms. Vaccaro joined others from the Brain Injury Association of America and the brain injury community in participating in a rally on Capitol Hill for Brain Injury Awareness day on March 5, 2024. One of their goals was to encourage legislators to reauthorize the Traumatic Brain Injury (TBI) Act which was signed into law in 1996. The most recent TBI Program Reauthorization Act in 2018 ensures funding of the Program through 2024. Brain injury advocates are hoping to include language in a new reauthorization act that would add brain injury to the CDC and CMS’s list of chronic conditions.

The TBI Act also provides funding to states to support brain injury resources and initiatives. In Pennsylvania, the Department of Health has received funding to develop infrastructure that is crucial for serving the needs of people with brain injuries and their families. For example, the Pennsylvania Department of Health has contracted with the Brain Injury Association of Pennsylvania to provide education and training about brain injury to professionals in the community who will come into contact with individuals with brain injury in their everyday work, including counselors, nurses, general practitioners, first responders, law enforcement, and others. The Brain Injury Association of Pennsylvania also operates the Brain Injury Resource Line, which is a venue for people from the community to call in with questions and learn about resources. Another key program in Pennsylvania supported by funding from the TBI Act is the NeuroResource Facilitation Program for Brain Injury Services which helps people with brain injury and their families identify and navigate brain injury resources, services, and supports.

In addition, during her visit to Capitol Hill, Ms. Vaccaro shared important work being done by the TBI Model Systems nationwide, including at the Moss TBI Model System, and requested additional funding to support these critical efforts to advance brain injury research and clinical care. Further research, including research being done at MRRI, is critical for understanding which interventions are effective and ensuring that people with brain injury can access effective interventions that are developed.

Thinking about other areas of need, Ms. Vaccaro highlighted the importance of providing services to marginalized populations, including individuals with brain injury in the justice system, those with mental health conditions, and people who are homeless or have housing insecurity. She would also like to see funds budgeted at the state level for services such as conferences, information lines, support groups, or other necessary resources.

Ms. Vaccaro is part of a coalition of stakeholders working with policymakers in Pennsylvania to try to get funding to support clinical care beyond acute inpatient rehabilitation. Currently, there is limited funding to support outpatient rehabilitation and post-acute care, so many individuals with brain injury are not getting the care they need. To address this care gap, the coalition has proposed a plan for commercial insurance providers to pay for post-acute rehabilitation services for brain injury. “This, again, emphasizes that brain injury is a chronic condition. It isn’t over after a person leaves the acute care setting,” Ms. Vaccaro stated.

As part of The Brain Injury Association of America’s Brain Injury Awareness Month Campaign, they are asking people with brain injury to share their story to help reinforce the chronic nature of brain injury. “Brain injury is a lifelong journey for many people,” Ms. Vaccaro reflected. Visit The Brain Injury Association of America’s website to learn more about the Brain Injury Awareness Month Campaign and read some of these stories.

MRRI is pleased to announce that Kelly Horel, M.S., SLP, has recently accepted a position at MRRI. Ms. Horel graduated from Rutgers University with a B.A. in Linguistics and minors in Psychology and Cognitive Science. While at Rutgers, she worked as a Research Assistant in a Phonetics Laboratory. After graduation, she began working at MRRI under Erica Middleton, PhD, and Myrna Schwartz, PhD, in the Language and Aphasia Lab. Ms. Horel worked as a Research Assistant at MRRI from 2011-2013.

She was inspired to go to graduate school to become a Speech Language Pathologist (SLP) after working with Adelyn Brecher, SLP, and with the people with aphasia who would come in to participate in research studies. Ms. Horel graduated from Boston University in 2015 with an M.S. in Speech-Language Pathology. From there, she worked clinically in a variety of settings including sub-acute rehabilitation, home health, and in local schools. After taking some time off for the births of her children, Ms. Horel began working part-time at the Adler Aphasia Center (Maywood, NJ) as an aphasia group facilitator. This position renewed her passion for working with people with aphasia. Remembering her experiences at MRRI, Ms. Horel explained, “When I saw that MRRI was looking for a research SLP, I knew I had to reach out!”

She is excited to be starting her position as a Research Associate – Speech Language Pathologist in the Language and Learning Laboratory under Dr. Middleton and the Speech and Language Recovery Laboratory under Marja-Liisa Mailend, PhD. In this role, she will be administering language and cognition tests and transcribing and coding data, among other tasks. In thinking about her new role, she noted “I am eager to contribute to research that will support clinicians in helping people with aphasia in their recovery process.”

In celebration of Black History Month, MRRI is excited to be highlighting the careers of Black scientists in neuroscience and neurorehabilitation and their important contributions to the field. One such scientist who has been a valued colleague and collaborator in the area of traumatic brain injury research is Monique R. Pappadis, MEd, PhD, PhD. Dr. Pappadis is a tenured Associate Professor and Vice Chair in the Department of Population Health and Health Disparities at the University of Texas Medical Branch (UTMB) at Galveston. In addition, Dr. Pappadis is an Investigator and the Director of Dissemination and Cultural Humility at TIRR Memorial Hermann’s Brain Injury Research Center in Houston, Texas. Learn more about Dr. Pappadis, her career, and her research in our interview below.

1) How did you get interested in rehabilitation research?

 I became interested in rehabilitation when I got my first research job after finishing my postbaccalaureate degree in psychology. I worked as a Research Associate at the Brain Injury Research Center at TIRR Memorial Hermann under the supervision and mentorship of Angelle Sander, PhD, and Margaret Struchen, PhD. I worked in this capacity for 11 years before becoming a faculty member at the University of Texas Medical Branch at Galveston. Thankfully, I am still able to hold an appointment with TIRR Memorial Hermann Hospital and collaborate with their researchers.

2) Can you tell us more about your research and/or a contribution to the field of neurorehabilitation research that you are most proud of?

 Broadly speaking, my research addresses disparities in care and outcomes after traumatic brain injury and stroke and coming up with solutions to address the needs of underserved populations with disabilities. I am also exploring ways to better support and protect older adults with cognitive impairments from experiencing harm, neglect, or exploitation.

3) Can you tell us more about your interactions with MRRI and MRRI scientists?

My interactions with MRRI and MRRI scientists started very early in my career due to being a data collector for the Traumatic Brain Injury Model System National Database study. It also helped that my research supervisors are friends with some of the greats of MRRI — John Whyte, MD, PhD, and Tessa Hart, PhD. I am thankful that I have co-authored manuscripts and/or served on national stakeholder meetings with Drs. Whyte and Hart. I have also developed a great professional relationship with Amanda Rabinowitz, PhD, and Umesh “Umi” Venkatesan, PhD, where we are collaborating on TBI Model Systems-related projects. Most recently, I was invited as a Visiting Scholar and had the opportunity to share my research with the MRRI research and clinical teams.

4) What have you enjoyed most about working with the team at MRRI?

 I have enjoyed working with so many professionals who are creative thinkers and have a passion for improving the lives of individuals with disabilities.

5) As an expert in the field, what do you think are the biggest challenges or opportunities right now in rehabilitation and rehabilitation research?

One of the biggest challenges is related to funding. We need more funding to support rehabilitation research and funding to support treatment and services during acute and post-acute care, as well as within the community. We need to be able to still support individuals who are aging with disability who will have varying needs with time.

Thank you to Brandon Knight for inspiring the Black History Month blog series.

Apraxia of speech is a disorder that affects a person’s ability to guide the movements of their articulators to produce speech. It can occur in children or adults, and individuals with the disorder are commonly classified into three categories: those with childhood apraxia of speech, stroke or trauma-induced apraxia of speech, or progressive apraxia of speech due to neurodegeneration. The condition is difficult to diagnose, and current diagnostic efforts are limited by the absence of a gold standard diagnostic test or clear diagnostic procedures. These diagnostic limitations impact both research being conducted on the disorder and the ability of clinicians to optimally treat individuals with apraxia of speech.

In the Speech and Language Recovery Laboratory at MRRI, Marja-Liisa Mailend, PhD, is investigating the cognitive mechanism of apraxia of speech to improve assessment and differential diagnosis of the disorder. She is an author on two posters that will be presented at the upcoming 2024 Motor Speech Conference in San Diego, CA, February 21-24. Research for both posters was done in collaboration with Katarina Haley, PhD, CCC-SLP, and Adam Jacks, PhD, CCC-SLP, from the University of North Carolina at Chapel Hill.

In their first poster, Drs. Mailend, Haley, and Jacks completed an important early step in addressing issues surrounding the diagnosis of apraxia of speech without a gold standard test for the disorder. This project involved a literature review of recent research on apraxia of speech in the past five years. Their findings indicated that the differential diagnosis in most of these studies was based on clinical judgments that were not standardized and could be susceptible to bias. They suggest that future research in this area should acknowledge the limitations of diagnosing apraxia of speech in the absence of a gold standard, and aim to reduce bias in the diagnostic procedures by way of converging evidence.

In their second poster, Drs. Mailend, Haley, and Jacks further examined the Apraxia of Speech Rating Scale, an instrument that was developed to standardize how researchers and clinicians diagnose apraxia of speech. The validity of this rating scale has not yet been firmly established for diagnosing apraxia of speech in individuals who do not have a neurodegenerative disease, and more work is necessary to confirm its reliability. Drs. Mailend, Haley, and Jacks were interested in further clarifying the Apraxia of Speech Rating Scale so that it can serve as a valid and reliable scale for diagnosing apraxia of speech in people after stroke. Based on their findings in independently applying the scale to sample videos and audio clips, they proposed refined operational definitions and updated procedures to augment the published guidelines for the scale. These refined definitions and procedures can now be used to formally test the reliability of the Apraxia of Speech Rating Scale in a stroke population.

“I’m really looking forward to sharing our recent work at the Motor Speech Conference this year. One thing that makes this conference unique in the field is that it brings together motor speech researchers whose work focuses on adults with motor speech conditions, as well as scientists who study motor speech in children,” explained Dr. Mailend. “My work bridges these two populations, and there are many benefits to thinking about the bigger picture — how our findings and the methods we develop in childhood apraxia of speech may be relevant for apraxia speech in adults and vice versa,” Dr. Mailend continued.

Dr. Mailend’s presentations at the Motor Speech Conference will provide an excellent opportunity to highlight her expertise as an early-career independent investigator, connect with current and prospective collaborators, and get feedback from other experts in the field.

Meet MRRI Scientific Advisory Board Member Dr. Lewis Wheaton

In honor of Black History Month, MRRI is pleased to be sharing the perspectives and important contributions to science by Black researchers in the fields of neuroscience and neurorehabilitation. One inspirational scientist that MRRI is honored to have as a member of the Institute’s Scientific Advisory Board is Lewis Wheaton, PhD. Dr. Wheaton is a Professor in the School of Biological Sciences at Georgia Institute of Technology (Georgia Tech). Learn more about Dr. Wheaton, his career, and his role on our Scientific Advisory Board in our interview below.

1) How did you get interested in rehabilitation research?

While it may sound cliché, it is being able to help people directly. It is similar to why I got into research in humans. While I appreciate the science that uses cellular, theoretical, and animal models, there was always something special about being able to work with people. While I was a fellow at the NIH, one of the first persons with a neurological disorder that I enrolled in one of my first clinical studies told me something that I will never forget. She enrolled in the study not to help herself (she knew she was not going to live much longer), but so that she might help someone who would have to bear the burden of the disorder in the future. That selfless mindset is still inspiring to me and compels me to think about what part I might be able to play in improving lives.

2) Can you tell us more about your research and/or a contribution to the field of neurorehabilitation research that you are most proud of?

My research focuses on how the brain is changing following neural injury and how to leverage those changes to promote neurorehabilitation. In my Cognitive Motor Control Lab at Georgia Tech, we have a particular focus on upper limb amputation and stroke. In amputation, we want to understand how to use neural adaptations following traumatic limb loss to promote prosthesis adoption. I am very proud of one area we are continuing to develop in utilizing action observation in persons with amputation, harnessing the visual system adaptations as a way to promote functional gains in prosthesis use. I am very excited as it might open a door to a validated rehabilitation approach based on nervous system changes. We are pursuing a similar line of thought in action observation work in stroke.

3) Can you tell us more about your interactions with MRRI and MRRI scientists?

MRRI has several outstanding scientists, some of whom I have known well for years. Laurel Buxbaum, PsyD, and I share a strong enthusiasm for understanding apraxia, which drew us together almost 20 years ago, and we have remained connected ever since. As well, through the American Society of Neurorehabilitation, I have come to know the outstanding work of people like Dylan Edwards, PhD. John Whyte, MD, PhD, is someone I have known for years through many shared interests.

4) What have you enjoyed most about working with the team at MRRI?

Working with MRRI has first off led me to get to know better some of the great scientists at MRRI. During a recent meeting, I was very excited to see the growth of the Institute and the breadth of scientific research that is taking place. I look forward to playing whatever small part I can play in helping to support the mission of the Institute!

5) As an expert in the field, what do you think are the biggest challenges or opportunities right now in rehabilitation and rehabilitation research?

 I think our biggest opportunity in neurorehabilitation research is inclusion. Our field is growing fast which is necessary to support the lives of people that need many forms of rehabilitation. However, we have to be sure that we develop thoughtful ways to support the lives of ALL people who need help in the way they want it. There are a variety of emerging statistical and quantitative tools that might start to get at this, but we should strive to go further. At the end of the day, we have to be sure we are reaching more people of different backgrounds and cultures and seeing what is effective in whom, why it is perhaps not effective in some other group, and ensure our theories and approaches aren’t inadvertently leaving people behind.

Thank you to Brandon Knight for inspiring the Black History Month blog series.

Each year on February 11th, The International Day of Women and Girls in Science is celebrated around the world. This day provides an opportunity to honor the achievements of women and girls in science, technology, engineering and mathematics (STEM) fields and to continue important advocacy efforts to advance gender equality and representation in STEM fields. The International Day of Women and Girls in Science was established by a resolution passed by the United Nations General Assembly in 2015. An Assembly is held annually, and a different theme is chosen every year to raise awareness of a particular element of gender equality in science.

For 2024, the main theme is “Women and Girls in Science and Leadership, A New Era for Sustainability”. At Moss Rehabilitation Research Institute (MRRI), we acknowledge and value the significant contributions of women at MRRI and beyond. Within MRRI, women have been instrumental in conducting pioneering research at our Institute and excelling in leadership roles. Women have served and continue to serve in important leadership positions, and women at MRRI have been pivotal in shaping the Institute, its science, and its culture.

Women not only make up the majority of MRRI’s staff, they comprise more than half of the Institute’s scientists, research assistants, post-doctoral trainees, and administrative support staff. At MRRI, women hold prominent roles in senior leadership positions, including the Associate Director (current and past) and Director of the Aphasia Center. This notable representation is rooted in the Institute’s 30-plus year history, with the pioneering presence of MRRI co-founder Myrna Schwartz, who served as the institute’s first Associate Director.

The inclusion of women in science is also evident in our international collaborations, and our current Scientists in Residence are women hailing from University College London and McMaster University in Toronto. Additionally, a Fulbright Fellow from the French National Center for Scientific Research is visiting MRRI currently, further deepening our connections to the international community of women in science.

MRRI would not be the vibrant research institute it is today without the effort, talent, and dedication of each of the remarkable women who have been part of the institute, and we look forward to continuing to help train and support the next generation of female leaders in neuroscience and neurorehabilitation. “The women of MRRI continue to blaze a trail in the United States and abroad. The breadth and influence of their work can be seen through their engagement onsite at the Institute as well as at scientific conferences, within professional societies, and in the scientific literature. Thank you to all of the women of MRRI for your remarkable and ongoing contributions, no doubt you are an inspiration for girls considering a future in science,” remarked MRRI Director, Dylan Edwards, PhD.