As a family physician, Ward Blair, MD, knew how much a family could impact an individual’s health. Aside from issues like genetic disease inheritance, he understood how much a supportive family, strong faith and a positive attitude could help optimize a patient's outcome.

But it wasn’t until his eldest daughter was critically injured in a serious car accident that the power of family support truly hit home.

Abby Blair, then an 18-year-old National Merit Scholar on a full scholarship, had just finished her freshman year at the University of Oklahoma. Returning to her Springboro, Ohio home from a Young Life camp in West Virgina on Memorial Day, 2004, she and three friends were involved in a serious motor vehicle crash.

Hurt the worst and critically injured, Abby sustained a traumatic brain injury with a left occipital condyle fracture, left C1 fracture, right frontal intracranial hemorrhage, right subdural hematoma and left epidural hematoma. She also endured complications such as right-sided pneumonia, diabetes insipidus and hypothyroidism secondary to her pituitary insult.


She was transferred via AirCare to a hospital in Virginia and later relocated to Cincinnati Children's Hospital Medical Center (CCHMC) where she was in a coma for nine weeks.

“When she started with us, she was non-verbal, couldn’t recognize letters, couldn’t walk, [was] very confused, had no day-to-day memory or recall, no problem-solving abilities and [was] very sad. She had to re-learn how to walk, talk, read and eat. It was very tough for her,” says Abby’s speech pathologist, Stephanie Volker, MS, CCC. “If you would have asked me at the beginning when she came here so impaired if she’d be able to be independent and return to college I would not have said yes.”

But for three months Blair and wife, Jill, took turns away from their other five children to spend the night with Abby while she received intensive physical, occupational and speech therapies as an inpatient at CCHMC’s rehabilitation unit.

Abby’s parents began taking the extra steps to advance their daughter’s recovery by playing soft positive music, doing extra range-of-motion exercises, reading to her, talking to her and praying aloud for her. They learned and taught her sign language when she wasn't able to speak.

As things progressed, they brought toys from home, magnetic letters and markers for communication. They even made Starbucks coffee deliveries to stimulate her desire to eat.

“Her mother and I weren't her only helpers,” says Blair. “Grandparents watched the house and other kids so Jill and I could concentrate on Abby. The older boys helped with the younger children. Aunts, uncles and cousins helped at home and in the hospital. They even gave Jill and I a night off here and there from the hospital so both parents could be with the other children for a birthday or special occasion.”

Because of her vast improvements, Abby was discharged home on Sept. 2, 2004.

Once released from CCHMC, Abby began going to three-hour therapy sessions three times a week. But the therapy didn’t stop when she walked out of the hospital doors.

Abby’s parents researched and purchased logic puzzles, word games and books to further develop her writing and thinking skills. 

The family also worked on physical development together with yoga, Pilates, walking, core strengthening, lifting weights and hand coordination exercises. They sang and came up with tongue twisters to strengthen her voice and speech. 

Once Abby was independent enough, the whole family moved out of the house and down the street to stay at a grandparent’s for an entire weekend, so she could learn to manage everything on her own.

“I am sure Abby would not have had as good of an outcome without all her amazing hard work and the grace of God,” says Blair. “The rehab doctors and therapists talked about ‘rewiring the brain’ to stimulate little-used areas, wake up damaged regions [and find] new pathways around other damaged regions by using and challenging different areas of the brain with activity and exercise. With her wonderful attitude and desire to improve, how could extra work do anything but help?”

Abby’s therapists agree. According to Michelle Selin, OTR/L, this family sets a great example for those undertaking therapy and working toward a successful recovery.


“Abby’s parents had an elevated level of commitment for her therapy. They brought her a great distance three times a week without fail. They never canceled, we never heard excuses and they went above and beyond all that we could hope for in a patient’s support system,” Selin says. “I think the value they placed on our program and their commitment to Abby’s therapy expedited and enhanced her therapy.”

In research studies of brain injury patient outcomes, Volker says, one of the top three variables necessary to produce a positive outcome is always strong family support. In fact, Volker says a patient like Abby with severe impairments but extremely strong family support could easily result with a better outcome than a patient with mild injuries and no family support.

Volker and Selin say the most important thing to do for a child going through therapy is to be supportive, but not too supportive. It’s important to let them fail, so they can work harder and move to the next level.

One way for a parent to do this is to document each time they offer assistance and each time they let the child work through it independently. The parent can even time the patient's independent activity to track their progress. This method provides insight into how much assistance the parent is giving their child and if they're maintaining that delicate balance.


According to Volker and Selin, Abby’s parents did a beautiful job of this, and they also helped her to be realistic. She was a merit scholar that will now have to work hard to maintain a  “C” average, Selin says, but with her family’s support and encouragement, she realized college was about much more than just school.

“I’m not going to try to thank my family for helping me through this. I could never do it enough,” says Abby. “I’m just so appreciative of all that they’ve done and are still doing. I couldn’t imagine all the work they went through to be there for me. I’m just so grateful because I wouldn’t be where I am now without that support.”

With the goal to get Abby back to college, her mother began taking her to Bible study to develop cognitive learning skills and shortly thereafter enrolled her in a local community college.

“It was helpful to have people around,” says Abby. “I have a really big family, so when I needed to practice talking or giving a speech, I had a lot of brothers and my sister to do that with. My little [siblings] didn’t fully understand what had happened to me, but the older ones and my parents were there to be supportive.”

Volker helped Abby improve her speech and writing skills so she could graduate as the English major she’d always dreamed of being.

In August 2005, Abby began classes at the University of Oklahoma as an English major. She is currently living independently and enjoying the life she set as a goal to return to one year ago.

Abby says she’s very happy to be back with her close circle of friends and is doing well with classes.

“Just this morning, I was just thinking about how far I’ve come,” says Abby. “I wrote a big part of my paper today and it only took me a couple of hours. But in March, doing that same thing would have taken me so much longer.”

Volker says stories like Abby’s get her – and therapists around the world – out of bed every morning.

“Not everyone reaches the goal they set for themselves at the beginning of therapy. But Abby did with the help of her amazing family,” says Volker. “Abby’s goal was to live independently and go back to college. This was one of the very few times I was able to put in my notes, ‘patient’s goal was achieved.’”


Amy Storer is the editor of TherapyTimes.com.