Dinnes aims to fill research gap in writing difficulties after brain injuries

20 Mar 2018     By Kelcey Buck

A few years ago, Carly Dinnes thought she was destined to work with children as a speech-language pathologist. Then she was tasked with helping her first adult patient at the clinic and she discovered a passion for helping brain injury survivors regain some of their lost communication skills. Her career path quickly took a different turn. 

“I went through undergrad and about half of my master’s thinking I would work with kids, and specifically, if I could focus, I was going to do literacy, so reading and maybe some writing with kids,” Dinnes said. “Then I got my first adult patient in the clinic. He had aphasia and he was so much fun to work with. He was so pleased to come in several times a week. With his aphasia he struggled to get the right word, and he was so thrilled when he’d get the right one. Being able to give something back that he had lost almost, that was what really made me interested in and stay with the brain injury area.” 

From that one patient, Dinnes realized she wanted to work with adults, particularly those who were trying to get back something they had lost. Through internships and work after college, she was able to work with people with different types of brain challenges, including aphasia, traumatic brain injury, strokes, brain tumors, and even dementia. 

“I loved it more and more,” Dinnes said. “These are all people who really want to get better. Having that kind of population to work with – where something has happened beyond their control and they’ve lost something – being able to work with them to get them to be better and regain whatever they’ve lost is a huge piece of why I love this area.” 

That area of interest is exactly what brought the Davenport, Iowa, native to the Department of Special Education and Communication Disorders at the University of Nebraska-Lincoln. After earning her bachelor’s and master’s degrees from the University of Northern Iowa, Dinnes found a mentor with similar interests and passions in Karen Hux, now a professor emeritus after retiring from Nebraska in December. With Hux’s guidance, Dinnes has filled the first two years of her doctoral program a variety of research studies, but the area that became her primary focus was in improving writing after brain injury. 

“Actually, my first day on campus was meeting Karen for the first time in person and her saying, ‘We have a new study.’ We worked with someone who came in and said he was having trouble writing after a concussion, a mild brain injury. He really needed some help, so that was our focus. In setting up the study and trying to find research, we discovered there’s not really a lot out there on writing after a traumatic brain injury.

“We have been able to do quite a bit with that topic so far,” Dinnes said. “We found that writing was something that had a big impact on not only being able to go back to work or school, but also on how people communicate with each other. For some people (with brain injuries) it’s now this really daunting task, and for others it’s not quite as anxiety-inducing but it’s definitely an area that needs to be investigated further.” 

Dinnes has learned many lessons through her research, but her biggest takeaway has been realizing how long-lasting the difficulties from brain injuries are for survivors. 

“After rehab, most people don’t have the opportunity to participate in research and try interventions,” Dinnes said. “The people here have always jumped at the opportunity to be involved. They’re reporting from a couple years after injury to more than 20 years after injury that these things like word finding or reading or writing are still a source of difficulty and they’re still struggling with them.” 

Her second biggest takeaway? The term ‘mild injury’ can be deceiving. 

“What they call a mild injury, like a concussion or a mild traumatic brain injury, just because the injury was mild doesn’t mean the difficulties afterward are mild.” 

When Dinnes finishes her doctoral program in May 2019 she hopes to become a professor and continue to teach and do research. She expects writing interventions to continue to be a focus area, but ultimately looks forward to helping people who have exhausted their rehab options but are still in need of strategies to help them cope with their difficulties. Dinnes acknowledges that her short time at Nebraska has helped shape those future goals. 

“Writing wasn’t really on the radar for research at all and now it’s the main focus. Learning more about the writing and knowing that there’s not much out there so it’s a gap to fill and to contribute to has made it appealing to me.” 

She also wants to learn more about the benefits of co-treatment approaches, something that she did while she was working before arriving at Nebraska. Rather than having patients attend physical therapy and speech therapy separately, co-treatment allows speech therapists and physical therapists to engage with a patient simultaneously. It’s another concept that she is currently studying and hopes to continue in the future. 

“The goal of therapy is when the patient leaves rehab they are walking and talking,” Dinnes explained. “Sometimes you find that for people to be able to walk, they have to stop the talking. This is trying to combine the pieces and look at whether they get better faster with the co-treatment approach.” 

Through her education and research, Dinnes has come to have a better understanding of the uniqueness of brain injuries, and the chronic, life-changing effects they leave behind. She quotes Hux, who often says, “If you’ve seen one person with a brain injury, you’ve seen one person with a brain injury.” 

“People don’t realize that a brain injury isn’t like a broken arm that heals and is better. A brain injury leaves behind something that people are going to struggle with. Some people will struggle with their difficulties more obviously than others but the struggle will still be there. They may not struggle as often as some people, but they still struggle. And it doesn’t matter if the brain injury happened five months ago or five years ago or 15 or 20, it’s still there and it’s something that can be frustrating for a long time.”