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About Nashia

Dear Guest,

In 1990, the first State of the States in Head Injury was organized and held by State government employees administering programs for individuals with brain injury and their families. Four years later, the National Association of State Head Injury Administrators (NASHIA) was formed, providing a forum to address State government's significant role in brain injury. Serving as the premier source of information and education for State Agency employees who are responsible for public brain injury policies, programs, and services, NASHIA provides information on national trends, best practices, and State contacts to Federal governmental agencies, national associations and TBI stakeholders. Through its membership, NASHIA provides collective representation as the voice of State government in Federal TBI policy issues.

In the United States, TBI is a major public health concern and the leading cause of death and disability among children and young adults. A brain injury can happen at any time and at any age. Approximately 40% of TBIs occur in youth, with the highest rates being between the ages of 0-4 years. The incidence of TBI peaks during three specific age periods: birth to 5 years of age, 15-24 years of age, and over 70 years of age. Although a common myth is that children recover more quickly than adults after a brain injury, their brains are still growing and maturing and an injury can interrupt this development. This disruption in development can cause a wide variety of functional changes – both short and long term. These changes may impact memory, processing speed, attention, inhibition, sensory, language, emotional regulation and many physical/mobility aspects. All of which affect how a person is able to return to school, work, home and community and may necessitate lifelong considerations for these individuals.

With proper health care and community services, some causes of TBI-related problems can be prevented or treated, and the impact can be reduced. Because the problems faced by people with TBI are lasting, they require long-term solutions. Such complexities challenge States' ability to respond to the needs of individuals often in a timely fashion – the right services at the right time. As no two brain injuries are alike, no two States are alike in terms of how they are organized and how they provide services and supports. Individuals may need services that cross multiple programs including Medicaid, vocational rehabilitation, employment, education, home health care, mental health, substance abuse, and long-term care programs. Without coordinated systems of care, individuals are often placed inappropriately into nursing homes or left to the families to care for without much support or assistance. When families are no longer able to care for these individuals, the families turn to the State, which is generally the only resource for these chronic and/or crisis situations. As the signature wound of the Iraq and Afghanistan War, TBI presents additional challenges to researchers, clinicians, and public programs.

NASHIA welcomes all State Agency employees who interact with individuals with brain injury, as well as TBI advocates, professionals, and organizations with an interest in State and local policy and service delivery. Please feel free to contact me to find out how you can become involved in NASHIA's activities.

Heather Hotchkiss,
NASHIA President

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