Brain Injury

About the Client



Age at Intake:



Ella's Story

Ella was a high-performing, advanced, seventh-grade student at a traditional public school when she suddenly experienced a stroke while playing lacrosse. Her injury left her requiring life-saving care and several months of in-patient rehabilitation to re-learn how to eat, walk, and speak. When her in-patient services expired, although she had made strides from her initial injury, she was left with severely impaired speech, cognition, and mobility. 


Ella’s family considered having her rejoin her previous school, where she would have been placed in a self-contained classroom with students experiencing drastically different needs. Through a referral from a nurse at Children’s Healthcare of Atlanta, Ella came to Jacob’s Ladder to continue her journey of recovery.

Incoming Evaluation Results

During Ella’s initial evaluation, she could not speak more than two words at a time and would often revert to saying “um” or “like” rather than an appropriate answer or exchange. Despite her previous experience as an advanced student, Ella could not verbally identify the letters of the alphabet, numbers, or basic words at the time of the evaluation. 


Ella was increasingly frustrated about the discrepancy in what she knew years ago but could not identify after her injury. When communicating, Ella frequently lost her train of thought and attempted to change the subject or retreat altogether. Her ability to access language was severely impaired. 


Ella also experienced significant changes in her muscle tonicity, which severely impacted her right side. She noted a loss of sensation in many areas and kept her right hand in a fist and her arm drawn up to her chest. Ella could not open or close her right hand and could no longer point using her index finger. As a previously right-handed individual, Ella had to write and complete tasks with her left hand. Further, Ella’s right foot and leg were impacted, resulting in her walking with a distorted pattern and with challenges completing coordinated motor movements, including running. 


Academically, at the time of the evaluation, Ella should have been in eighth grade, but she had dropped to a Kindergarten level in math, and her reading was at a first-grade level. Ella described looking at math problems as if they were written in another language despite her advanced academic status pre-injury. She was embarrassed and frustrated with the significant regression and strongly desired to return to her previous levels.

Results at Program Completion

Ella’s family came to Jacob’s Ladder hoping for intensive support to allow her to regain lost function. Ella required a highly individualized evaluation and therapeutic plan to target her unique needs using the Interpersonal Whole-Brain Model of Care® (IWBMC™). Although there was a high level of challenge to overcome, Ella participated in nine months of intensive programming for six hours each day. She transitioned from Jacob’s Ladder after making tremendous strides. 


Ella’s bright spirit and determination to improve, paired with appropriate and intensive input and daily stimulation, were the successful combination she needed to continue sharing her gifts, growing, and learning in nearly any environment.


Through Jacob’s Ladder, Ella…


  • Communicated in complete sentences and initiated conversations with peers and adults without challenge
  • Regained confidence as her communication increased
  • Regained sensation in her right hand and could extend her hand and fingers with minimal support
  • Improved her mobility, running on uneven surfaces without falling
  • Engaged in various complex motor movements requiring increased core strength and coordination
  • Improved walking and running patterns and increased stamina 
  • Increased by more than two years cognitively in each subject area, with some areas improving by more than four years

Academic Subject Area

Improvement Within 9 Months

Ella’s academic abilities increased by an average of 3.5 grade levels within 9 months of intensive programming.

These qEEG images show the electrical activity occurring within the brain. Areas with insufficient activity are noted by cool colors (blue and teal), whereas areas with too much activity are indicated by warm colors (lime green, yellow, red, and orange). The blank spots or white colors indicate any areas with activity occurring within the normal range. All data is collected from raw EEG data and is compared to a normative database based on the client’s age, gender, and handedness.

At Ella’s initial evaluation, significant dysregulation was noted in Broca’s area under the frequencies of delta, beta, and high beta, corresponding to spoken and written language challenges. Further, significantly increased activity was seen in the high beta frequency, with increased activity in the right hemisphere, reflecting compensatory activity to compensate for lost function in the left hemisphere, where Ella’s injury occurred. Further, Ella showed significantly decreased communication between key brain regions, as shown by the blue lines under the coherence measure. 


After 9 months of intensive programming, Ella’s brain map significantly improved. The dysregulation in Broca’s area was much less severe, and the dysregulated activity in alpha frequency had cleared entirely. When looking at the communication between brain regions under the line of Phase Lag, the pathways between brain regions show improvement, as seen by the fewer lines and the decreased thickness of the lines. 

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