This CDA-2 candidate, Emily Grattan, is an occupational therapist and Post-Doctoral Scholar at the Medical University of South Carolina. Her intention is to become a VA RR&D investigator at the Ralph H. Johnson VAMC, Charleston SC. Dr. Grattan's short term goals are to develop advanced skills and knowledge in assessment of neglect, latent trait analyses, and non-invasive brain stimulation as well as enhance her grant writing skills and advance her professional development. Her long term goal is to become an independent investigator with a research focus on neglect rehabilitation and to improve the outcomes of individuals with neglect post stroke. Dr. Grattan has 5.5 years of clinical experience and has considerable research experience having worked on 10 different rehabilitation studies (9 stroke studies, 1 spinal cord study) during her doctoral and post-doctoral training. Her extensive clinical experience and strong doctoral and post-doctoral research training have provided a solid foundation of skills and knowledge. The next step towards becoming an independent VA research scientist requires advanced training and mentoring. To that end, Dr. Grattan has chosen a team of VA mentors with expertise in stroke rehabilitation research (Dr. Woodbury), latent trait analyses (Dr. Velozo), grant writing (Dr. Kautz), and non-invasive brain stimulation (Dr. George) who are uniquely qualified to advise the nominee. Dr. Grattan will conduct the proposed research in an ideal environment since she will have access to the Center for Rehabilitation Research in Neurological Disorders (CRRND), a state of the art research facility jointly funded by the VA and the University affiliate, which houses 4 rehabilitation research laboratories and includes a multidisciplinary staff of investigators and staff. The proposed project is designed to establish a valid assessment of post-stroke neglect that can immediately be used to advance the care of Veterans with stroke. Without precise and functionally-relevant measurement tools, rehabilitation therapists cannot accurately identify individuals with neglect, establish personalized rehabilitation treatment goals/plans, or monitor response to intervention. We will achieve our aims by examining the measurement properties of the items from three commonly used behavioral assessments (Catherine Bergego Scale, Behavioral Inattention Test behavioral subtests, and the Naturalistic Action Test) of neglect in individuals with stroke to define item sets that measure neglect and create forms that link the clinical assessment to a treatment plan personalized to the patient. We will also examine the preliminary effects of an innovative intervention (repetitive task-specific practice + transcranial direct current stimulation) for individuals with neglect. This project is significant because it will inform our understanding of the most effective methods to measure neglect, establish a tool to be utilized to assist in goal planning, and help to advise the development of future intervention studies.
The proposed study has significant implications for the VA given the prevalence of stroke among Veterans. This project will enable the nominee to establish assessments to comprehensively measure post stroke neglect and to develop a tool to assist clinicians in goal planning. Ultimately, this project will enable the nominee to investigate interventions to reduce disability for stroke survivors with neglect. Therefore, this project has the potential to influence clinical practice and research. This project will also help to launch the career of an investigator who is dedicated to improving the outcomes of Veterans with stroke.