What do Kids with Acquired Brain Injury Want? Mapping Neuropsychological Rehabilitation Goals to the International Classification of Functioning, Disability and Health

Abstract

Objective To increase understanding of the community neuropsychological rehabilitation goals of young people with Acquired Brain Injury (ABI). Method 326 neuropsychological rehabilitation goals were extracted from the clinical records of 98 young people with ABI. The participants were 59% male, 2-19 years old, and 64% had a Traumatic Brain Injury. Goals were coded using the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY). Descriptive statistical analysis was performed to assess the distribution of goals across the ICF-CY. Chi Squared and Cramer’s V were used to identify demographic and injury-related associations of goal type. Results The distribution of goals was 52% Activities and Participation (AP), 28% Body Functions (BF), 20% Environmental Factors (EF) and <1% Body Structures (BS). The number of EF goals increased with age at assessment (V=0.14). Non-traumatic causes of ABI were associated with more EF goals (V=0.12). There was no association between sex or time post-injury and the distribution of goals across the ICF-CY. Conclusions Young people with ABI have a wide range of community neuropsychological rehabilitation goals that require an individualised, context sensitive and interdisciplinary approach. Community neuropsychological rehabilitation services may wish to ensure they are resourced to focus intervention on AP, with increasing consideration for EF as a young person progresses through adolescence. The findings of this research support models of community neuropsychological rehabilitation that enable wellness by combining direct rehabilitative interventions with attention to social context and systemic working across agencies.

Detecting mental health problems after paediatric acquired brain injury: A pilot Rasch analysis of the strengths and difficulties questionnaire

“…Similarly, uniform DIF by TPI was also seen for item 3 "Difficulties interfering with friendships" on the impact supplement, with the greatest impact seen in the group over 5 years post-injury and the least impact in the group 2-5 years post injury. Friendship difficulties are common post-ABI (Prigatano & Gupta, 2006;Yeates et al, 2013), and an increased need for support with friendships in young people over 5 years postinjury has previously been identified in this setting (McCarron, Watson, & Gracey, 2019). A possible explanation for this would be that in the first 2 years post injury a young person's post-acute physical and cognitive difficulties impact on their ability to participate and maintain friendships, but things might then improve through a process of rehabilitation, where available.…”

Contextual interference in children with brain lesions: protocol of a pilot study investigating blocked vs. random practice order of an upper limb robotic exergame

“…All rehabilitation goals are individual, yet participation [ 48 ] and independence in daily life are often mentioned as the most important aims for the rehabilitation of children [ 49 ]. The importance of generalisability of motor improvements (i.e.…”

Rehabilitation for children with chronic acquired brain injury in the Child in Context Intervention (CICI) study: study protocol for a randomized controlled trial

“…A psychoeducational booklet with a biopsychosocial framework, authored by therapists with long experience from working with children with ABI, will be provided to all participants in the intervention group, including teachers. The topics for the booklet were selected based on recent research about the needs of children with ABI [ 47 ] and relevant topics for parents were added. Users contributed feedback during the development of the booklet.…”

“…By allowing a more direct access to the home environment, telerehabilitation may be particularly suitable when tailoring interventions to everyday life, compared to rehabilitation delivered in a hospital setting. An effective way of doing so is by identifying and working towards individual rehabilitation goals for the child and parents, which ensures the family’s place at the helm of decision-making and increases their focus on the specific rehabilitation strategies [ 47 , 48 ]. Involving parents in goal-oriented interventions has yielded promising results [ 8 ] and enhances adherence to the treatment program and the feeling of relevance that the treatment holds for the family [ 49 ].…”