Paediatric Interventions in Acquired Brain Injury Rehabilita

[DrB]

The nervous system is in a dynamic state of development throughout childhood, thus treating a child with a brain injury is distinctly unique from treating an adult.

Brain injury in children may disrupt established functions, as well as functions that are in the process of developing or those that have yet to emerge. With respect to general functioning, most children less than seven years of age have not achieved independence in their activities of daily living. Baseline functions are therefore variable and constantly changing.

Children are growing between 5 – 8cm per year, learning to control basic impulses, and rapidly acquiring information within their school program. A brain injury interrupts this complex pattern of growth and development, leading to increased variability in baseline skills, the need for age/stage appropriate testing and rehabilitation programming, as well as longitudinal follow-up to address the increasing gap between the skills of the child and age appropriate peers.

Unlike the stroke population, children and adolescents comprise a significant portion of the traumatic brain injury population (Crowley & Miles, 1991). It has been suggested that young children are particularly vulnerable to brain injury as many skills are in the developmental stages (Didus et al., 1999)). Furthermore, the notion that rehabilitation following brain injury does not simply expedite recovery, but helps to improve functional outcomes beyond that expected from spontaneous recovery has been posed (Greenspan & MacKenzie, 2000).