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Knight S, Rodda J, Tavender E, Anderson V, Lannin NA, Scheinberg A. Understanding factors that influence goal setting in rehabilitation for paediatric acquired brain injury: a qualitative study using the Theoretical Domains Framework. BRAIN IMPAIR 2024; 25:IB23103. [PMID: 38593747 DOI: 10.1071/ib23103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
Background While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. Methods A semi-structured focus group was conducted with rehabilitation clinicians and those with lived experience of paediatric acquired brain injury (ABI). The 90-min focus group was audio-recorded and transcribed verbatim. Data were thematically coded and mapped against the Theoretical Domains Framework (TDF) to understand influencing factors, which were then linked to the Capability, Opportunity, Motivation - Behaviour (COM-B) model. Results A total of 11 participants (nine paediatric rehabilitation clinicians, one parent and one young person with lived experience of paediatric ABI) participated in the focus group. Factors influencing collaborative goal setting mapped to the COM-B and six domains of the TDF: Capabilities (Skills, Knowledge, Beliefs about capabilities, and Behavioural regulation), Opportunities (Environmental context and resources), and Motivation (Social/professional role and identity). Results suggest that a multifaceted intervention is needed to enhance rehabilitation clinicians' and families' skills and knowledge of goal setting, restructure the goal communication processes, and clarify the roles clinicians play in goal setting within the interdisciplinary team. Conclusion The use of the TDF and COM-B enabled a systematic approach to understanding the factors influencing goal setting for children with acquired brain injury in a large interdisciplinary rehabilitation team, and develop a targeted, multifaceted intervention for clinical use. These represent important considerations for the improvement of collaborative goal setting in paediatric rehabilitation services to ensure that best practice approaches to goal setting are implemented effectively in clinical practice.
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Affiliation(s)
- Sarah Knight
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia; and Department of Paediatrics, The University of Melbourne, Vic., Australia; and Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital Melbourne, Vic., Australia
| | - Jill Rodda
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Emma Tavender
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia; and Department of Paediatrics, The University of Melbourne, Vic., Australia
| | - Natasha A Lannin
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia; and Alfred Health, Melbourne, Vic., Australia
| | - Adam Scheinberg
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Department of Paediatrics, The University of Melbourne, Vic., Australia; and Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital Melbourne, Vic., Australia; and Department of Neuroscience, Monash University, Melbourne, Vic., Australia
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2
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Wolters L, White WF, Ellerton H, Watson S, Psaila K, Ford C, Gracey F. An Evaluation of the Use of the Child and Adolescent Scale of Participation (CASP) to Measure Social Participation After Pediatric ABI in a Specialist Service in East Anglia. Dev Neurorehabil 2023; 26:419-428. [PMID: 38198641 DOI: 10.1080/17518423.2023.2301607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 12/28/2023] [Indexed: 01/12/2024]
Abstract
Pediatric acquired brain injury (ABI) can lead to lifelong challenges restricting social participation, which is an important goal for rehabilitation due to associations with improved wellbeing. This evaluation considered the utility of the Child Adolescent Scale of Participation (CASP) in ABI rehabilitation services. The 20-item measure is rated on a Likert scale with reference to what the rater would expect of their child at that age, including "not applicable" (N/A). It showed high internal consistency (α = 0.954-0.968). Two-step cluster analysis indicated greater difficulties in children with lower participation, including more impairments of executive function and higher staff involvement. Between-group analysis indicated higher rates of N/A answers for younger children and those of ethnic minorities. Overall, the CASP is reliable and clinically useful on an individual level, helping identify people who may need prioritizing for neurorehabilitation; however, group-level analyses were more challenging due to high frequency of N/A responses.
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Affiliation(s)
- Leona Wolters
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - William F White
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Holly Ellerton
- The Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
| | - Suzanna Watson
- The Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
| | - Kate Psaila
- The Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
| | - Catherine Ford
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
- The Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
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3
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Ryan JL, Beal DS, Levac DE, Fehlings DL, Wright FV. Integrating Transcranial Direct Current Stimulation into an Existing Inpatient Physiotherapy Program to Enhance Motor Learning in an Adolescent with Traumatic Brain Injury: A Case Report. Phys Occup Ther Pediatr 2023:1-19. [PMID: 36624962 DOI: 10.1080/01942638.2022.2163214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Describe how transcranial direct current stimulation (tDCS) was incorporated into an inpatient physiotherapy program for an adolescent with severe traumatic brain injury (TBI), detail the motor learning focus of the physiotherapy sessions, and summarize gross motor progress. METHOD This case report describes an adolescent who received 20 minutes of anodal tDCS immediately prior to 16 physiotherapy sessions over four weeks. Potential side effects were tracked pre/post tDCS. Gross motor outcomes were measured pre-intervention, post-intervention, and three months post-intervention. Physiotherapy session content was analyzed using therapist documentation and the Motor Learning Strategies Rating Instrument. RESULTS The youth tolerated tDCS well. The primary side effect was itchiness under the electrodes during tDCS sessions. His mobility progressed from wheelchair use pre- 'tDCS + physiotherapy' to ambulation with a walker post-intervention. His Gross Motor Function Measure score increased 33.1% points pre/post intervention. Session tasks often had several foci (e.g., skill acquisition, strength, and balance) with task focus changing as the youth progressed. Various motor learning strategies were layered within tasks to support performance and learning. CONCLUSIONS tDCS was successfully integrated into an existing inpatient physiotherapy program for an adolescent with TBI. This protocol provides a structure for implementing, monitoring, and measuring tDCS + physiotherapy in pediatric rehabilitation.
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Affiliation(s)
- Jennifer L Ryan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deryk S Beal
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Danielle E Levac
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - Darcy L Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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Cámara-Barrio S, Esteso-Orduña B, Vara-Arias MT, Rodríguez-Palero S, Fournier-Del Castillo MC. A neuropsychological approach in a paediatric acquired brain injury unit under the public health system. Neurologia 2023; 38:8-14. [PMID: 36162700 DOI: 10.1016/j.nrleng.2020.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 04/01/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Paediatric acquired brain injury (ABI) causes cognitive and behavioural difficulties and alters the course of child development. The ABI unit at Hospital Infantil Universitario Niño Jesús is the first within the public Spanish health system to provide comprehensive coverage to these patients and their families. OBJECTIVE This study aims to show the working methodology followed with patients and their families, and to describe the clinical characteristics of the patients treated and the outcomes of treatment. PATIENTS Fifty-three patients aged between 3 months and 16 and a half years received treatment. The conditions treated were brain tumours, stroke, traumatic brain injury, damage secondary to epilepsy surgery, and hypoxia. METHODS All patients were evaluated at admission and at discharge. Treatments were adapted to each patient's difficulties and their severity, as well as to the patient's age. Families received individual and group therapy. RESULTS Older age was associated with better cognitive recovery and shorter duration of treatment. Different conditions show differential impact on intelligence quotient and developmental quotient scores at the beginning of treatment, with hypoxia and encephalitis being associated with greatest severity. Intelligence quotient and developmental quotient scores and visual memory and attention scores at discharge improved significantly after the faceted neuropsychological treatment with respect to scores registered at admission. CONCLUSIONS The care of patients with ABI should include neuropsychological rehabilitation programmes and provide emotional support to the family so that they may actively participate in the recovery of the child or adolescent.
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Affiliation(s)
- S Cámara-Barrio
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, Spain.
| | - B Esteso-Orduña
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, Spain
| | - M T Vara-Arias
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, Spain
| | - S Rodríguez-Palero
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, Spain
| | - M C Fournier-Del Castillo
- Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, Spain
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Xia C, Jing Q, Chen G, Sun M, Lu J. Association between Participation of Children with Disabilities and the Child, Family, and Environmental Factors in Shanghai, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:615. [PMID: 36612936 PMCID: PMC9819672 DOI: 10.3390/ijerph20010615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Participation is essential to a child's health and well-being, whereas children with disabilities may lack the associated benefits because of physical restrictions. This study aims to examine the association between the participation of children with disabilities and the child, family, and environmental factors. A total of 433 children with disabilities aged 3-18 and their family caregivers were included. Three binary logistic regression models were respectively established to identify the significant factors associated with children's home, school, and community participation. Our main empirical results showed that among 433 children with disabilities, 44.3%, 47.6%, and 58.7% of them never or seldom participated in home, school, and community activities. Child and family factors were found to be dominantly associated with children's participation, and significant factors associated with the home, school, and community participation of children were different, including children's disability type, sleep problems and emotional stability, caregivers' education, mental HRQOL, rehabilitation belief, and number of children in the family. These results highlight that the participation of children with disabilities in mainland China urgently needs to be enhanced, and further research might be focused on validating the causal relationships between participation and significant child and family factors identified in this study.
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Affiliation(s)
- Cong Xia
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Qi Jing
- School of Management, Weifang Medical University, Weifang 261053, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261053, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Mei Sun
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261053, China
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Fafolahan AO, Sodipo OP, Davis AO, Adeoye KK, Musa BO, David O, Muminat AA. Profile of pediatric out-patients managed by physiotherapists at Federal Medical Center, Abeokuta: a retrospective review. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-022-00109-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abstract
Background
Pediatric physiotherapists help children to achieve their optimal physical development. The present study was aimed to evaluate the out-patient pediatric conditions managed by physiotherapists in Federal Medical Centre, Abeokuta, Nigeria (FMCA).
Methods
The present study included all children attended to at Pediatric Unit (outpatient) of FMCA in the period between the beginnings of May 20121 to the end of May 2022. The clinic runs every Tuesdays and Thursdays. All children below and equals to 15 years of age were included. Complete clinical, socio-demographic characteristics of patients and parents were manually scrapped from the electronic medical records (EMR) of the hospital. Descriptive statistics was used to present the results.
Results
During this period a total of 160 patients presented with different disorders were seen. There were 100 males (62.5%) and 60 females (37.5%). Cerebral palsy which can be classified as a neurological disorder was the most common condition managed (63.7%). Obstetric brachial palsy injury (OBPI), injection palsy, post-immobilization stiffness, congenital talipes equinivarus, and among others were managed during this period. Cerebral palsy was common among males, obstetric brachial palsy injury, and injection palsy. Cerebral palsy patients had late presentation for physiotherapy (1–5 years). Only 2 patients out of 11 with OBPI came for early physiotherapy. There is higher risk for cerebral palsy and OBPI among primiparous mothers.
Conclusions
It was concluded that neurological disorders are the most common pediatric cases managed by physiotherapists in Federal Medical Centre, Abeokuta, with cerebral palsy having higher prevalence.
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7
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Ryan JL, Zhou C, Levac DE, Fehlings DL, Beal DS, Hung R, Wright FV. Gross motor change after inpatient rehabilitation for children with acquired brain injury: A 10-year retrospective review. Dev Med Child Neurol 2022. [PMID: 36404436 DOI: 10.1111/dmcn.15471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/16/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022]
Abstract
AIM To estimate gross motor change in inpatient school-aged children with subacute acquired brain injury (ABI), identify factors associated with gross motor change, and describe inpatient physiotherapy focus. METHOD This retrospective chart review involved inpatient children (5-18 years) with subacute ABI who had either two Gross Motor Function Measure (GMFM-88) assessments or one GMFM-88 with another pre/post gross motor outcome measure. Outcome change scores and Goal Attainment Scaling (GAS) T scores were calculated. Regression analyses examined factors predicting gross motor change. GAS goal areas were analysed to determine physiotherapy focus. RESULTS Of the 546 charts screened, 266 (118 female) met study criteria. The GMFM-88 was generally administered first, followed by other measures. GMFM-88 (n = 202), Community Balance and Mobility Scale (n = 89), and Six-Minute Walk Test (6MWT) (n = 98) mean change scores were 18.03% (SD 19.34), 17.85% (SD 10.77), and 142.3 m (SD 101.8) respectively. The mean GAS T score was 55.06 (SD 11.50). Lower baseline scores and increased time between assessments were most predictive of greater GMFM-88 change (r ≥ 0.40). Twenty-five percent of GAS goals were ambulation-based. INTERPRETATION Appropriate outcome measure selection is integral to detecting gross motor change in pediatric inpatient ABI rehabilitation. Mean change score estimates can be used to compare standard inpatient rehabilitation with new treatment approaches.
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Affiliation(s)
- Jennifer L Ryan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Chuanlin Zhou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Danielle E Levac
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - Darcy L Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deryk S Beal
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Ryan Hung
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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8
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Akyurek G, Aydoner S, Gundogmus E, Gunal R, Demir Ozan A. Correlations between the screen time of children with special needs and their parent-child relationships, home participation, and occupational performance. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:730-737. [PMID: 38983485 PMCID: PMC11229744 DOI: 10.1080/20473869.2022.2141878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/26/2022] [Indexed: 07/11/2024]
Abstract
This study aimed to examine the relationships between the screen time of children with special needs and of their parents with their home participation, occupational performance, and parent-child relationships according to sex and diagnosis. Parents of 150 children with special needs (age range, 4 to 6 years) such as autism spectrum disorder, cerebral palsy, and attention deficit hyperactivity disorder, as well as undiagnosed and developmentally risky children, were included. The Demographic Information Form, Screen Time Usage Form, Parent-Child Relationship Scale, Participation and Environment Measure for Children and Youth, and Short Child Occupational Profile were used for the data collection. There was a significant relationship between the screen time of girls and their parent-child relationships, home participation, and occupational performance. Moreover, we detected a relationship between the screen time of children with autism spectrum disorder and positive parent-child relationships, home participation, and occupational performance. Therapists should account for screen time in their interventions associated with parent-child relationships, home participation, and occupational performance.
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Affiliation(s)
- Gokcen Akyurek
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Selen Aydoner
- Department of Occupational Therapy, Fenerbahçe University, İstanbul, Turkey
| | - Ezginur Gundogmus
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Rumeysa Gunal
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Aysenur Demir Ozan
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
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Bailey A, Chenoweth T, Fisher Z, Joannides M, Watters S, Mazzucchelli J, Taylor S, Harris C. Identifying Suitable Cognitive Assessments for Children and Adolescents with Acquired Brain Injury for use by Occupational Therapists in Acute and Subacute Hospital Contexts: A Scoping Review. Dev Neurorehabil 2022; 25:485-500. [PMID: 35850609 DOI: 10.1080/17518423.2022.2099031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To appraise the literature evaluating psychometric properties and clinical utility of cognitive assessments available for use by occupational therapists in acute and subacute hospital contexts with children aged 4-18 years diagnosed with an acquired brain injury. METHODS Scoping review. Assessments and associated studies were evaluated for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy. RESULTS Forty-one studies evaluated 49 different assessments and reported on assessment psychometrics (n = 40), clinical utility (n = 1) and five reported on both. Fourteen assessments with the strongest psychometric properties and clinical utility were shortlisted. CONCLUSION A gold standard assessment was not identified. Instead, a shortlist of functional, performance-based, technology-based, and self-report assessments were identified as relevant for the setting and population, but requiring further investigation. Future development of a cognitive assessment in partnership with therapists working in tertiary pediatric settings will ensure optimal clinical utility and validity.
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Affiliation(s)
- Ashleigh Bailey
- School of Allied Health, Curtin University, Perth, Australia
| | | | - Zoe Fisher
- School of Allied Health, Curtin University, Perth, Australia
| | | | - Samantha Watters
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
| | - Jodie Mazzucchelli
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
| | - Susan Taylor
- School of Allied Health, Curtin University, Perth, Australia.,Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
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10
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Thorne A, Stagnitti K, Parson J. Pretend play ability in preschool-aged children with an acquired brain injury. Aust Occup Ther J 2021; 68:407-418. [PMID: 34312891 DOI: 10.1111/1440-1630.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 06/08/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study compares the self-initiated pretend play abilities of preschool-aged children with an acquired brain injury, with the self-initiated pretend play ability of their neurotypical peers. METHOD A non-experimental group comparison was conducted between 22 preschool-aged neurotypical children (M = 52.8 months, SD = 7.1 months) and 21 children with an acquired brain injury (ABI, M = 50.5 months, SD = 11.9 months), who had been discharged from inpatient rehabilitation and who were able to engage in a play session. The children were assessed individually using the Child-Initiated Pretend Play Assessment (ChIPPA). RESULTS The children with an ABI had significantly lower scores in pretend play ability than their neurotypical peers as measured by the percentage of elaborate play actions in both the conventional (P < .000) and symbolic (P < .000) sections of the ChIPPA, as well as the number of object substitutions (P < .000). The children with an ABI completed significantly less of the play time required compared with their neurotypical peers (P = .001); 66% could not play for the required time. There was no significant difference in the ChIPPA scores of the children with an ABI injured before and after the age of 18 months, nor between children with a severe or moderate injury. CONCLUSION The quality and the quantity of pretend play of preschool-aged children with an ABI are significantly below that of their neurotypical peers. Assessment of pretend play ability and direct intervention in ABI rehabilitation by occupational therapists is essential to enable children with an ABI to participate in pretend play and garner the developmental benefit this affords.
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Affiliation(s)
- Adrienne Thorne
- Kids Rehab, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Karen Stagnitti
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Judi Parson
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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11
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Jones KM, Starkey N, Barker-Collo S, Ameratunga S, Theadom A, Pocock K, Borotkanics R, Feigin VL. Parent and Teacher-Reported Child Outcomes Seven Years After Mild Traumatic Brain Injury: A Nested Case Control Study. Front Neurol 2021; 12:683661. [PMID: 34367050 PMCID: PMC8342814 DOI: 10.3389/fneur.2021.683661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Increasing evidence suggests potential lifetime effects following mild traumatic brain injury (TBI) in childhood. Few studies have examined medium-term outcomes among hospitalized and non-hospitalized samples. Study aims were to describe children's behavioral and emotional adjustment, executive function (EF), quality of life, and participation at 7-years following mild TBI using parents' and teachers' reports. Methods: Nested case control study of 86 children (68% male, mean age at assessment = 11.27 years; range 7–17 years) who sustained a mild TBI 7-years previously, identified from a prospective, population-based study. They were compared to 69 children free from TBI (61% male, mean age at assessment = 11.12 years; range 5–17 years). In addition to parent-reported socio-demographic details, parents (mild TBI n = 86, non-TBI n = 69) completed age-appropriate standardized questionnaires about children's health-related quality of life, behavioral and emotional adjustment, EF, and social participation. Parents own mood was assessed using the Hospital Anxiety and Depression Scale. Teachers (mild TBI n = 53, non-TBI n = 42) completed questionnaires about children's behavioral and emotional adjustment, and EF. Results: Parent reports showed median group-level scores for cases were statistically significantly greater than controls for emotional symptoms, conduct problems, hyperactivity/inattention, total behavioral difficulties, inhibitory control, shifting, planning/organizing, and Global Executive Composite (total) EF difficulties (p-values 0.001–0.029). Parent reports of child quality of life and social participation were similar, as were teacher reports of child behavioral and emotional adjustment, and EF (p > 0.05). When examining clinical cut-offs, compared to controls, cases had a higher risk of parent-reported total EF difficulties (odds ratio = 3.00) and, to a lesser extent, total behavior problems (odds ratio = 2.51). Conclusions: As a group, children with a history of mild TBI may be at elevated risk for clinically significant everyday EF difficulties in the medium-term compared to non-TBI controls, as judged by their parents. Further multi-informant longitudinal research is required, following larger samples. Aspects requiring particular attention include pre-injury characteristics, such as sleep disturbances and comorbidities (e.g., headaches), that may act as potential confounders influencing the association between mild TBI and child behavioral problems.
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Affiliation(s)
- Kelly M Jones
- School of Clinical Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Starkey
- Division of Arts, Law, Psychology & Social Sciences, School of Psychology, University of Waikato, Hamilton, New Zealand
| | - Suzanne Barker-Collo
- Faculty of Science, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Shanthi Ameratunga
- Faculty of Science, School of Psychology, The University of Auckland, Auckland, New Zealand.,UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Alice Theadom
- School of Clinical Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Katy Pocock
- School of Clinical Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Robert Borotkanics
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L Feigin
- School of Clinical Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
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12
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Diener ML, Kirby AV, Sumsion F, Canary HE, Green MM. Community reintegration needs following paediatric brain injury: perspectives of caregivers and service providers. Disabil Rehabil 2021; 44:5592-5602. [PMID: 34251954 DOI: 10.1080/09638288.2021.1946176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore the processes of community reintegration of children and families at least one year following a paediatric brain injury from the perspective of caregivers and outpatient/community service providers. MATERIALS AND METHODS A qualitative analysis of semi-structured interviews from outpatient or community service providers (N = 14; occupational, physical, and speech and language therapists, neuropsychologists, school counsellors, recreational providers) and caregivers of six children (N = 8) at least one year after their injury. Interviews were transcribed and thematically coded using deductive (employing Bronfenbrenner's ecological systems theory) and inductive approaches. RESULTS Themes from both providers and caregivers indicated additional supports needed at all levels of Bronfenbrenner's ecological systems theory (i.e., individual, microsystem, mesosystem/exosystem, macrosystem, chronosystem). Participants felt that several characteristics would be needed in an ideal service system following paediatric brain injury including: community solutions ("it takes a village"), long-term approaches to care, and new financial approaches. CONCLUSIONS The results suggest that children and families have substantial community reintegration needs following paediatric brain injury. Multi-system interventions are needed to support long-term community reintegration, especially those that increase communication and support transitions. There is also a strong need for alternative funding to support these efforts.Implications for RehabilitationFamilies with a child with a moderate to severe brain injury face challenges with community reintegration a year or more after their child's injury.Effort should be put into helping families navigate the complex medical, insurance, and school systems with a navigator service and step-down care to ensure a continuum of care and to support community reintegration.Special support should be provided during transitions, such as transitions from hospital care to outpatient care, and across school transitions.
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Affiliation(s)
- Marissa L Diener
- Department of Family & Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Anne V Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, USA
| | - Felicia Sumsion
- Department of Family & Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Heather E Canary
- School of Communication, San Diego State University, San Diego, CA, USA
| | - Michael M Green
- Department of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, USA.,Primary Children's Hospital, Salt Lake City, UT, USA
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Resch C, Hurks P, de Kloet A, van Heugten C. Rationale and description of BrainLevel: Computerized repeated practice with strategy use instruction for children with acquired brain injury. Clin Rehabil 2021; 35:787-800. [PMID: 33517763 PMCID: PMC8191149 DOI: 10.1177/0269215521989652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/18/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In this paper, we provide the rationale behind and a description of BrainLevel, a new cognitive rehabilitation intervention for children with acquired brain injury. RATIONALE Children with acquired brain injury frequently report cognitive problems and consequently problems in participation, psychosocial functioning, family functioning and quality of life. Computerized repeated practice of specific cognitive tasks (so-called 'brain training') improves performance on those specific or highly similar tasks, but rarely leads to better daily life functioning. Adding strategy use instruction as an intervention component, with the aim to transfer task-specific effects to other contexts, may yield positive effects on cognitive and daily life functioning of children with acquired brain injury. DESCRIPTION OF THE NEW INTERVENTION In BrainLevel, computerized repeated practice is offered via the online training programme BrainGymmer. For the strategy use instruction, we developed a protocol to provide and practice function-specific and metacognitive strategies. The intervention period is 6 weeks, during which children train five times per week for 30 minutes per day at home with BrainGymmer. Additionally, they attend a weekly 45-minute strategy use instruction session on the basis of our protocol with a cognitive rehabilitation specialist. DISCUSSION BrainLevel is innovative in combining computerized repeated practice with strategy use instruction as cognitive rehabilitation for children with acquired brain injury. Currently, we are investigating the effectiveness of BrainLevel. In this paper, possible adaptations to tailor BrainLevel to other games or contexts, or to incorporate novel scientific insights, for example regarding optimal intervention duration and intensity, are discussed.
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Affiliation(s)
- Christine Resch
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maastricht, The Netherlands
| | - Petra Hurks
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Arend de Kloet
- The Hague University of Applied Sciences, The Hague, The Netherlands
- Basalt Rehabilitation, The Hague, The Netherlands
| | - Caroline van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
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Keetley R, Westwater-Wood S, Manning JC. Exploring participation after paediatric acquired brain injury. J Child Health Care 2021; 25:81-92. [PMID: 32067469 DOI: 10.1177/1367493520905673] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to explore the levels of participation in a UK sample of children and young people (CYP) with an acquired brain injury (ABI) at home, school and in the community through a cross-sectional study. The Child and Family Follow-Up Survey was distributed to parents/carers of 134 CYP with ABI (CYP-ABI) who received neuro-rehabilitation from 2014 to 2016. Access and recruitment were problematic resulting in a low response rate (4%). Widespread restrictions in participation were reported by four of the five respondents with community-structured events/activities and educational activities being the most restricted. Factors impacting on participation were cognitive-based and movement skills, family stress and lack of support/encouragement in the community. Study results provide information pertaining to the feasibility of undertaking research with this population while also highlighting the restrictions to participation experienced by CYP-ABI more than two years after injury.
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Affiliation(s)
- Rachel Keetley
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.,School of Health Sciences, Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK
| | - Sarah Westwater-Wood
- School of Health Sciences, Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK
| | - Joseph C Manning
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.,School of Health Sciences, Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK
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Allonsius F, de Kloet A, Bedell G, van Markus-Doornbosch F, Rosema S, Meesters J, Vliet Vlieland T, van der Holst M. Participation Restrictions among Children and Young Adults with Acquired Brain Injury in a Pediatric Outpatient Rehabilitation Cohort: The Patients' and Parents' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041625. [PMID: 33567741 PMCID: PMC7914578 DOI: 10.3390/ijerph18041625] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022]
Abstract
Improving participation is an important aim in outpatient rehabilitation treatment. Knowledge regarding participation restrictions in children and young adults with acquired brain injury (ABI) is scarce and little is known regarding the differences in perspectives between patients and parents in the outpatient rehabilitation setting. The aims are to describe participation restrictions among children/young adults (5–24 years) with ABI and investigating differences between patients’ and parents’ perspectives. At admission in 10 rehabilitation centers, patients and parents were asked to complete the Child and Adolescent Scale of Participation (CASP; score 0–100; lower score = more restrictions) and injury/patient/family-related questions. CASP scores were categorized (full/somewhat-limited/limited/very-limited participation). Patient/parent-reported outcomes were compared using the Wilcoxon signed-rank test. 223 patients and 245 parents participated (209 paired-samples). Median patients’ age was 14 years (IQR; 11–16), 135 were female (52%), 195 had traumatic brain injury (75%). The median CASP score reported by patients was 82.5 (IQR: 67.5–90) and by parents 91.3 (IQR: 80.0–97.5) (difference = p < 0.05). The score of 58 patients (26%) and 25 parents (10%) was classified as ‘very-limited’. Twenty-six percent of children and young adults referred for rehabilitation after ABI had “very-limited” participation. Overall, parents rated their child’s participation better than patients themselves. Quantifying participation restrictions after ABI and considering both perspectives is important for outpatient rehabilitation treatment.
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Affiliation(s)
- Florian Allonsius
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Correspondence: (F.A.); (M.v.d.H.)
| | - Arend de Kloet
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA;
| | - Frederike van Markus-Doornbosch
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Stefanie Rosema
- National Department Level, Specialists in Youth and Families, 1105 AZ Amsterdam, The Netherlands;
| | - Jorit Meesters
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Centre of Expertsie in Health Innovations, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands
| | - Thea Vliet Vlieland
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Menno van der Holst
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence: (F.A.); (M.v.d.H.)
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16
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Jones KM, Ameratunga S, Starkey NJ, Theadom A, Barker-Collo S, Ikeda T, Feigin VL. Psychosocial functioning at 4-years after pediatric mild traumatic brain injury. Brain Inj 2021; 35:416-425. [PMID: 33539250 DOI: 10.1080/02699052.2021.1878553] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: Behavioral and emotional difficulties are reported following pediatric mild traumatic brain injury (TBI). But few studies have used a broad conceptual approach to examine children's long-term psychosocial outcomes. This study examines children's psychosocial outcomes at 4-years after mild TBI and associated factors.Methods: Parents of 93 children (<16 years) with mild TBI completed subscales of age-appropriate versions of the Strengths and Difficulties Questionnaire, the Behavior Rating Inventory of Executive Function, the Pediatric Quality of Life Inventory, and the Adolescent Scale of Participation questionnaire at 4-years post-injury.Results: Mean group-level scores were statistically significantly higher for hyperactivity/inattention and lower for emotional functioning than published norms. Levels of participation were greater compared to those observed in normative samples. More than 19% met published criteria for clinically significant hyperactivity/inattention, emotional functioning problems, peer relationship problems, and social functioning difficulties. Lower family socio-economic status and greater parental anxiety and depression were associated with overall psychosocial difficulties.Conclusions: Findings indicate that as a group, children with mild TBI are characterized by elevated rates of behavioral, emotional, and social difficulties at 4-years post-injury. Parent mental health may be an untapped opportunity to support children's psychosocial development following mild TBI, with replication required in larger samples.
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Affiliation(s)
- Kelly M Jones
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Shanthi Ameratunga
- School of Population Health, Faculty of Medical & Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Nicola J Starkey
- School of Psychology, Division of Arts, Law, Psychology & Social Sciences, The University of Waikato, Hamilton, New Zealand
| | - Alice Theadom
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | | | - Takayoshi Ikeda
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L Feigin
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
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Burrough M, Beanlands C, Sugarhood P. Experiences of Using Pathways and Resources for Participation and Engagement (PREP) Intervention for Children with Acquired Brain Injury: A Knowledge Translation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238736. [PMID: 33255468 PMCID: PMC7727834 DOI: 10.3390/ijerph17238736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 11/16/2022]
Abstract
Background: Children with acquired brain injury experience participation restrictions. Pathways and Resources for Engagement and Participation (PREP) is an innovative, participation focused intervention. Studies have examined PREP in Canadian research contexts, however little is known about implementation in real-life clinical settings. This study aimed to understand experiences of clinicians implementing PREP in a UK clinical context, with a focus on implementation processes and key factors for successful implementation. Methods: A qualitative single-site 8-week knowledge translation intervention study, guided by an action research framework, explored clinicians’ experiences of implementation. Six occupational therapists (OTs) working in a neurorehabilitation setting participated. The therapists provided two intervention sessions per week, over four weeks for one child on their caseload. Planning, implementation and evaluation were explored through two focus groups. Thematic analysis was used to analyse data. Results: Two themes, “key ingredients before you start” and “PREP guides the journey”, were identified before introducing PREP to practice. Four additional themes were related to PREP implementation: “shifting to a participation perspective”, “participation moves beyond the OT”, “environmental challengers and remedies” and “whole family readiness”. A participation ripple effect was observed by building capacity across the multi-disciplinary team and families. The involvement of peers, social opportunities and acknowledging family readiness were key factors for successful implementation. Conclusions: The findings illustrate practical guidance to facilitate the uptake of participation-based evidence in clinical practice. Further research is required to understand aspects of knowledge translation when implementing participation interventions in other UK clinical settings.
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Affiliation(s)
- Melanie Burrough
- The Children’s Trust, Neurorehabilitation, Tadworth Court, Surrey KT20 5RU, UK
- Correspondence: ; Tel.: +441-737-365-072
| | - Clare Beanlands
- Occupational Therapy Division, Department of Allied Health, Social Care and Advanced Practice, School of Health and Social Care, London South Bank University, London SE1 0AA, UK; (C.B.); (P.S.)
| | - Paul Sugarhood
- Occupational Therapy Division, Department of Allied Health, Social Care and Advanced Practice, School of Health and Social Care, London South Bank University, London SE1 0AA, UK; (C.B.); (P.S.)
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Cámara Barrio S, Esteso Orduña B, Vara Arias MT, Rodríguez Palero S, Fournier Del Castillo MC. A neuropsychological approach in a paediatric acquired brain injury unit under the public health system. Neurologia 2020; 38:S0213-4853(20)30127-4. [PMID: 32586695 DOI: 10.1016/j.nrl.2020.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/06/2020] [Accepted: 04/01/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Paediatric acquired brain injury (ABI) causes cognitive and behavioural difficulties and alters the course of child development. The ABI unit at Hospital Infantil Universitario Niño Jesús is the first within the public Spanish health system to provide comprehensive coverage to these patients and their families. OBJECTIVE This study aims to show the working methodology followed with patients and their families, and to describe the clinical characteristics of the patients treated and the outcomes of treatment. PATIENTS Fifty-three patients aged between three months and 16 and a half years received treatment. The conditions treated were brain tumours, stroke, traumatic brain injury, damage secondary to epilepsy surgery, and hypoxia. METHODS All patients were evaluated at admission and at discharge. Treatments were adapted to each patient's difficulties and their severity, as well as to the patient's age. Families received individual and group therapy. RESULTS Older age was associated with better cognitive recovery and shorter duration of treatment. Different conditions show differential impact on intelligence quotient and developmental quotient scores at the beginning of treatment, with hypoxia and encephalitis being associated with greatest severity. Intelligence quotient and developmental quotient scores and visual memory and attention scores at discharge improved significantly after the faceted neuropsychological treatment with respect to scores registered at admission. CONCLUSIONS The care of patients with ABI should include neuropsychological rehabilitation programmes and provide emotional support to the family so that they may actively participate in the recovery of the child or adolescent.
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Affiliation(s)
- S Cámara Barrio
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, España.
| | - B Esteso Orduña
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, España
| | - M T Vara Arias
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, España
| | - S Rodríguez Palero
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, España
| | - M C Fournier Del Castillo
- Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, España
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Şahin S, Kaya Kara Ö, Köse B, Kara K. Investigation on participation, supports and barriers of children with specific learning disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 101:103639. [PMID: 32259721 DOI: 10.1016/j.ridd.2020.103639] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 02/19/2020] [Accepted: 03/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Children with specific learning disabilities (SLD) have been observed to face participation restrictions in their daily life. AIMS This study aims to examine the participation and environmental features of children with SLD compared to non-disabled children. METHODS AND PROCEDURES This study was designed as a case-controlled study. Parents of children between 5 and 17 years of age with SLD (n = 90) and those who are non-disabled (n = 88) were included in this study to do the Participation and Environment Measure for Children and Youth (PEM-CY). RESULTS Differences between groups were found statistically significant in home, school, and community settings between both participation and environmental features (p < 0.05). Children with SLD participated less frequently in school settings and were less involved in activities in home and school settings. Parents of children with SLD desired more change in their child's participation in all settings. Environmental factors were significantly more likely to be identified as barriers in the participation of children with SLD. CONCLUSION AND IMPLICATIONS This study provides information about participation patterns and environmental factors for many children with SLD. The results provide insights into a rehabilitation program that may improve the participation of children with SLD, and on where greater efforts are needed to support participation and environmental features for children with SLD.
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Affiliation(s)
- Sedef Şahin
- Hacettepe University, Faculty of Health Sciences, Occupational Therapy Department, Turkey.
| | - Özgün Kaya Kara
- Akdeniz University, Faculty of Health Sciences, Physical Therapy and Rehabilitation Department, Turkey
| | - Barkın Köse
- Hacettepe University, Faculty of Health Sciences, Occupational Therapy Department, Turkey
| | - Koray Kara
- Health Science University, Antalya Education and Research Hospital, Department of Child and Adolescent Psychiatry, Turkey
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Activities and Participation in the First 6 Months After Mild Traumatic Brain Injury in Children and Adolescents. J Head Trauma Rehabil 2020; 35:E501-E512. [PMID: 32472841 DOI: 10.1097/htr.0000000000000584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the natural course of activities and participation of children up to 6 months after a mild traumatic brain injury (mTBI). METHODS A prospective longitudinal cohort study with complete data sets of 231 children diagnosed with mTBI and their caregivers. MAIN MEASURES Activities and participation assessed with the Child and Adolescent Scale of Participation (CASP) and the Children's Assessment of Participation and Enjoyment (CAPE) measured at 2 weeks, 3 months, and 6 months post-mTBI. Because of a ceiling effect, the primary outcome measure (CASP) was divided into deviant (not maximum score) or full functioning. RESULTS Friedman's, Cochran's Q, and McNemar's tests (CASP) and repeated-measures analyses of variance (CAPE) showed significant increases in activities and participation between 2 weeks and 3 and 6 months after mTBI. Based on the parents' perspective, 67% of the children returned to full functioning at 6 months postinjury, with only 38% of the children describing themselves as functioning at their premorbid level. DISCUSSION Findings indicate that most children return to maximum level of activities and participation over time after mTBI. In a substantial number of children, however, the level of activities and participation at 6 months postinjury is evaluated as lower than that of peers. The importance of investigating predictors for child and caregiver perspectives is emphasized.
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Effectiveness of the Brains Ahead! Intervention: 6 Months Results of a Randomized Controlled Trial in School-Aged Children With Mild Traumatic Brain Injury. J Head Trauma Rehabil 2020; 35:E490-E500. [DOI: 10.1097/htr.0000000000000583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Resch C, Van Kruijsbergen M, Ketelaar M, Hurks P, Adair B, Imms C, De Kloet A, Piskur B, Van Heugten C. Assessing participation of children with acquired brain injury and cerebral palsy: a systematic review of measurement properties. Dev Med Child Neurol 2020; 62:434-444. [PMID: 31975385 PMCID: PMC7079076 DOI: 10.1111/dmcn.14465] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 12/24/2022]
Abstract
AIM To examine which instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) align with attendance and/or involvement constructs of participation; and to systematically review measurement properties of these instruments in children with ABI or CP, to guide instrument selection. METHOD Five databases were searched. Instruments that quantified 'attendance' and/or 'involvement' aspects of participation according to the family of participation-related constructs were selected. Data on measurement properties were extracted and methodological quality of the studies assessed. RESULTS Thirty-seven instruments were used to assess participation in children with ABI or CP. Of those, 12 measured attendance and/or involvement. The reliability, validity, and responsiveness of eight of these instruments were examined in 14 studies with children with ABI or CP. Sufficient measurement properties were reported for most of the measures, but no instrument had been assessed on all relevant properties. Moreover, most psychometric studies have marked methodological limitations. INTERPRETATION Instruments to assess participation of children with ABI or CP should be selected carefully, as many available measures do not align with attendance and/or involvement. Evidence for measurement properties is limited, mainly caused by low methodological study quality. Future studies should follow recommended methodological guidelines. WHAT THIS PAPER ADDS Twelve instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) aligned with attendance/involvement. Seven instruments have some psychometric evidence supporting their use with children with CP. For children with ABI, only the Child and Adolescent Scale of Participation has shown preliminary evidence of measurement properties.
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Affiliation(s)
- Christine Resch
- Department of Neuropsychology and PsychopharmacologyFaculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands,Limburg Brain Injury CenterMaastrichtthe Netherlands
| | - Mette Van Kruijsbergen
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center Utrecht, and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center Utrecht, and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Petra Hurks
- Department of Neuropsychology and PsychopharmacologyFaculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Brooke Adair
- Centre for Disability and Development ResearchAustralian Catholic UniversityMelbourneAustralia,Generation VictoriaMurdoch Children's Research InstituteParkvilleAustralia
| | - Christine Imms
- Centre for Disability and Development ResearchAustralian Catholic UniversityMelbourneAustralia
| | - Arend De Kloet
- Basalt Rehabilitationthe Haguethe Netherlands,The Hague University of Applied Sciencesthe Haguethe Netherlands
| | - Barbara Piskur
- Research Centre for Autonomy and Participation for People with Chronic IllnessesZuyd University of Applied SciencesHeerlenthe Netherlands
| | - Caroline Van Heugten
- Department of Neuropsychology and PsychopharmacologyFaculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands,Limburg Brain Injury CenterMaastrichtthe Netherlands,School for Mental Health and NeuroscienceFaculty of Health, Medicine and Life SciencesMaastricht University Medical CenterMaastrichtthe Netherlands
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Predictors of activities and participation six months after mild traumatic brain injury in children and adolescents. Eur J Paediatr Neurol 2020; 25:145-156. [PMID: 31831269 DOI: 10.1016/j.ejpn.2019.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/30/2019] [Accepted: 11/19/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study aimed to identify predictors of long-term consequences for activities and participation in children and adolescents with mild traumatic brain injury (mTBI). METHODS A multicentre prospective longitudinal cohort study was conducted. The primary outcome measure was activities and participation measured with the Child and Adolescent Scale of Participation - CASP and completed by children (N = 156) and caregivers (N = 231) six months post-mTBI. The CASP items were categorized into home, community, school, and environment. Predictors were categorized according to the International Classification of Functioning, Disability and Health for Children and Youth. Predictors included pre-injury personal- and environmental factors, injury-related factors, symptoms, and resumption of activities in the first two weeks after mTBI. Univariate and multivariate logistic regression analyses were used to determine the predictive value of these factors. RESULTS Results show that predictors differ across settings and perspectives (child or caregiver). Decreased activities and participation in children with mTBI can be predicted by adverse pre-injury behavioral functioning of the child (p < .000 - p = .038), adverse pre-injury family functioning (p = .001), lower parental SES (p = .038), more stress symptoms post-injury (p = .017 - p = .032), more post-concussive symptoms (p = .016 - p = .028) and less resumption of activities (p = .006 - p = .045). DISCUSSION Pre-injury factors, more symptoms post-injury and less resumption of activities should be considered when children are screened for unfavorable outcomes. Additional factors may add to the prediction, but injury-related factors do not. It is recommended that future research explores psychosocial factors, such as coping styles, emotion-regulation, personality traits, social support, and other comorbid problems of both children and caregivers.
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Analytis P, Warren N, Ponsford J. Supporting children and young people with an acquired brain injury (ABI) and their siblings: The experience of a camp for families with a child with an ABI. Neuropsychol Rehabil 2020; 31:797-813. [PMID: 32098596 DOI: 10.1080/09602011.2020.1731556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Paediatric acquired brain injury (ABI) is associated with long-term negative sequelae, and families must continually adapt to meet the needs of the child with ABI and family members. Condition-specific camps may support families in this process. This study explored the experience of camps for children with ABI and their families from the perspective of children and young people with ABI and their siblings. Semi-structured interviews were conducted with 10 people with ABI (Mage = 23.93, SD = 16.52 years) and 19 siblings of people with ABI (Mage = 14.53, SD = 5.73 years). Using reflexive thematic analysis, the central theme identified was "My safe space," supported by three further themes: "Having fun and relaxing," "Making friends," and "Enjoying choices." Camp was a space where the shared understanding and acceptance of ABI created a sense of safety. This was facilitated by enjoying activities, developing friendships with peers who shared the experience of ABI, and having a sense of control through choice availability. Thus, camps appear to offer opportunities to enjoy typical childhood experiences while restoring a sense of security, increasing understanding of ABI and validating attendees' experiences. Camps may, therefore, offer low-cost interventions to support children with ABI and their families.
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Affiliation(s)
- Penelope Analytis
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia.,Turner Institute for Brain and Mental Health, Brain Injury and Rehabilitation Theme, Monash University, Melbourne, Australia
| | - Narelle Warren
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia.,Turner Institute for Brain and Mental Health, Brain Injury and Rehabilitation Theme, Monash University, Melbourne, Australia
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25
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Vanclooster S, Van Hoeck K, Peremans L, Bilsen J, Van Der Werff Ten Bosch J, Laureys G, Paquier P, Jansen A. Reintegration into school of childhood brain tumor survivors: a qualitative study using the International Classification of Functioning, Disability and Health – Children and Youth framework. Disabil Rehabil 2020; 43:2610-2620. [DOI: 10.1080/09638288.2019.1708484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | | | - Lieve Peremans
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Johan Bilsen
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Geneviève Laureys
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Philippe Paquier
- Center for Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anna Jansen
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Pediatric Neurology Unit, UZ Brussel, Brussels, Belgium
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26
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Keetley R, Radford K, Manning JC. A scoping review of the needs of children and young people with acquired brain injuries and their families. Brain Inj 2019; 33:1117-1128. [DOI: 10.1080/02699052.2019.1637542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rachel Keetley
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Division of Rehabilitation and Ageing, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Kathryn Radford
- Division of Rehabilitation and Ageing, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Joseph C Manning
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- School of Health Sciences, The University of Nottingham, Nottingham, UK
- Centre for Innovative Research across a Life Course, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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27
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Re-engaging with places: Understanding bio-geo-graphical disruption and flow in adult brain injury survivors. Soc Sci Med 2019; 231:22-30. [DOI: 10.1016/j.socscimed.2018.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 11/23/2022]
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28
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Câmara-Costa H, Francillette L, Opatowski M, Toure H, Brugel D, Laurent-Vannier A, Meyer P, Dellatolas G, Watier L, Chevignard M. Participation seven years after severe childhood traumatic brain injury . Disabil Rehabil 2019; 42:2402-2411. [PMID: 30950661 DOI: 10.1080/09638288.2019.1594398] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Participation in home, school and community activities is considered as the ultimate aim of rehabilitation. The aims of this study were to examine participation seven years post-severe childhood traumatic brain injury and factors associated with participation.Materials and methods: Participants were enrolled in the Traumatisme Grave de l'Enfant (Severe Childhood Injury) cohort study following severe accidental childhood traumatic brain injury. Participation seven years post-injury, was examined using parent- and self-report forms of the Child and Adolescent Scale of Participation among 37 patients [62% males, mean age 15.4 years (SD = 4.4), mean length of coma 6.68 days (SD = 4.96)] and 33 matched controls.Results: Parent reports indicated significantly lower participation among patients compared to controls, but the self-reports did not. In the traumatic brain injury group, parent-reported participation was variable, with 22% of the patients clearly showing greater restrictions than controls. Participation restrictions were significantly associated with injury severity, poor functional outcome one-year post-injury, executive and behavioral difficulties and higher fatigue levels seven years post-injury, but not with pre-injury nor family factors.Conclusions: Several years after severe childhood traumatic brain injury, participation appears to depend more on injury-related factors than on environmental factors. In self-reports assessments of participation, it could be difficult for children and adolescents to distinguish capacity from performance.Implications for rehabilitationParticipation outcomes were highly variable in a sample of patients who sustained severe childhood traumatic brain injury.Participation should be assessed systematically following severe traumatic brain injury, both initially but also in the long-term, ideally using a combination of self- and proxy-report measures.Among patients with severe injuries, the influence of initial brain injury severity markers on participation seems much stronger than that of social/family environment factors.Children's and adolescents' self-reported participation assessed with the Child and Adolescent Scale of Participation may be difficult to interpret.
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Affiliation(s)
- Hugo Câmara-Costa
- Paris-Saclay University, Paris-Sud University, UVSQ, CESP, INSERM, Paris, France.,Sorbonne University, Laboratory of Biomedical Imaging (LIB), Paris, France
| | - Leila Francillette
- Sorbonne University, Laboratory of Biomedical Imaging (LIB), Paris, France
| | - Marion Opatowski
- Department of Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - Hanna Toure
- Rehabilitation Department for Children with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France
| | - Dominique Brugel
- Rehabilitation Department for Children with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France.,Outreach team for Children and Adolescents with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France
| | - Anne Laurent-Vannier
- Rehabilitation Department for Children with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France.,Outreach team for Children and Adolescents with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France
| | - Philippe Meyer
- Department of Paediatric Anesthesiology, Hôpital Necker Enfants Malades, Paris, France.,Faculty of Medicine René Descartes, Paris 5 University, Paris, France
| | - Georges Dellatolas
- Paris-Saclay University, Paris-Sud University, UVSQ, CESP, INSERM, Paris, France
| | - Laurence Watier
- Department of Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - Mathilde Chevignard
- Sorbonne University, Laboratory of Biomedical Imaging (LIB), Paris, France.,Rehabilitation Department for Children with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France.,Outreach team for Children and Adolescents with Acquired Brain Injury, Hôpitaux de Saint Maurice, Saint Maurice, France.,Clinical Research Group of Cognitive Handicap and Rehabilitation (HanCRe), Sorbonne University, Paris, France
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29
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Dooley B, Stagnitti K, Galvin J. An investigation of the pretend play abilities of children with an acquired brain injury. Br J Occup Ther 2019. [DOI: 10.1177/0308022619836941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Bridget Dooley
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Karen Stagnitti
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Jane Galvin
- Victorian Paediatric Rehabilitation Service, Melbourne, Victoria, Australia
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Resch C, Anderson VA, Beauchamp MH, Crossley L, Hearps SJC, van Heugten CM, Hurks PPM, Ryan NP, Catroppa C. Age-dependent differences in the impact of paediatric traumatic brain injury on executive functions: A prospective study using susceptibility-weighted imaging. Neuropsychologia 2018; 124:236-245. [PMID: 30528585 DOI: 10.1016/j.neuropsychologia.2018.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/12/2018] [Accepted: 12/05/2018] [Indexed: 12/17/2022]
Abstract
Childhood and adolescence represent sensitive developmental periods for brain networks implicated in a range of complex skills, including executive functions (EF; inhibitory control, working memory, and cognitive flexibility). As a consequence, these skills may be particularly vulnerable to injuries sustained during these sensitive developmental periods. The present study investigated 1) whether age at injury differentially affects EF 6 months and 2 years after TBI in children aged 5-15 years, and 2) whether the association between brain lesions and EF depend on age at injury. Children with TBI (n = 105) were categorized into four age-at-injury groups based on previous studies and proposed timing of cerebral maturational spurts: early childhood (5-6 years, n = 14), middle childhood (7-9 years, n = 24), late childhood (10-12 years, n = 52), and adolescence (13-15 years, n = 15). EF were assessed with performance-based tasks and a parent-report of everyday EF. TBI patients' EF scores 6 months and 2 years post-injury were compared to those of typically developing (TD) controls (n = 42). Brain lesions were identified using susceptibility weighted imaging (SWI). Results indicated that inhibitory control performance 2 years post-injury was differentially affected by the impact of TBI depending on age at injury. Follow-up analyses did not reveal significant differences within the age groups, preventing drawing strong conclusions regarding the contribution of age at injury to EF outcome after TBI. Tentatively, large effect sizes suggest that vulnerability is most apparent in early childhood and adolescence. Everyday inhibitory control behaviour was worse for children with TBI than TD children across childhood and adolescence at the 2-year assessment. There was no evidence for impairment in working memory or cognitive flexibility after TBI at the group level. Given small group sizes, findings from analyses into correlations between EF and SWI lesions should be interpreted with caution. Extent, number and volume of brain lesions correlated with adolescent everyday EF behaviour 6 months post-injury. Taken together, the results emphasize the need for long-term follow-up after paediatric TBI during sensitive developmental periods given negative outcomes 2-year post injury. Inhibitory control seems to be particular vulnerable to the impact of TBI. Findings of associations between EF and SWI lesions need to be replicated with larger samples.
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Affiliation(s)
- Christine Resch
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia.
| | - Vicki A Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia; Department of Psychology, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Pavillon Marie-Victorin, Department de Psychologie, C.P. 6128 Succursale Centre-Ville, Montreal, Quebec, Canada H3C 317; Ste-Justine Research Center, Montreal, Quebec, Canada.
| | - Louise Crossley
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia.
| | - Stephen J C Hearps
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia.
| | - Caroline M van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Petra P M Hurks
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia; Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, 3052 Melbourne, Victoria, Australia; Department of Psychology, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
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31
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Lambregts SAM, Van Markus-Doornbosch F, Catsman-Berrevoets CE, Berger MAM, De Kloet AJ, Hilberink SR, Roebroeck ME. Neurological outcome in children and youth with acquired brain injury 2-year post-injury. Dev Neurorehabil 2018; 21:465-474. [PMID: 29652209 DOI: 10.1080/17518423.2018.1460770] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine neurological outcome in children and youth with acquired brain injury (ABI) and explore associated factors. DESIGN Cross-sectional study, two-years post-injury. PATIENTS Hospital-based sample (n=112) aged 6-22 years. METHODS Neurological outcome and participation were assessed with a multidimensional neurological examination and the Child and Adolescent Scale of Participation. Logistic regression analyses were used to explore the relationships. RESULTS Both sensorimotor and cognitive deficits were found in 30-31%, language deficits and behavioural deficits in 10-17%. Non-traumatic injury had a negative impact on neurological outcome, specifically regarding sensorimotor and language deficits. Lower education level showed a significantly poorer neurological outcome. High levels of age-expected participation were reported, with a significant relation between deficits and participation restrictions, especially at school. CONCLUSION One out of three have a poor neurological outcome, related to type of injury and lower level of education. The amount of deficits is associated with participation restrictions.
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Affiliation(s)
- Suzanne A M Lambregts
- a Department of Rehabilitation Medicine , Erasmus MC University Medical Centre, Rotterdam , The Netherlands.,b Department of Pediatric Rehabilitation , Revant Rehabilitation Centres , Breda , The Netherlands
| | | | | | - Monique A M Berger
- e Department of Acquired Brain Injury Rehabilitation , The Hague University of applied sciences, Expert Group Rehabilitation , The Hague , The Netherlands
| | - Arend J De Kloet
- c Department of Pediatric and Youth Rehabilitation , Sophia Rehabilitation Centre , The Hague , The Netherlands.,e Department of Acquired Brain Injury Rehabilitation , The Hague University of applied sciences, Expert Group Rehabilitation , The Hague , The Netherlands
| | - Sander R Hilberink
- a Department of Rehabilitation Medicine , Erasmus MC University Medical Centre, Rotterdam , The Netherlands
| | - Marij E Roebroeck
- a Department of Rehabilitation Medicine , Erasmus MC University Medical Centre, Rotterdam , The Netherlands.,f Department of Rehabilitation Medicine , Rijndam Rehabilitation Institute , Rotterdam , The Netherlands
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32
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Golos A, Bedell G. Responsiveness and discriminant validity of the Child and Adolescent Scale of Participation across three years for children and youth with traumatic brain injury. Dev Neurorehabil 2018; 21:431-438. [PMID: 28692352 DOI: 10.1080/17518423.2017.1342711] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine responsiveness and discriminant validity of the Child and Adolescent Scale of Participation (CASP) across three years. METHODS Examined longitudinal data on 515 children and youth with TBI and arm injuries. Repeated measures analyses of variance were used to examine CASP scores (pre-injury; 3, 12, 24, 36 months post-injury). RESULTS Scores decreased from pre-injury to 3 months, but significantly only for moderate and severe TBI groups. Scores gradually increased post-injury for all groups except severe TBI. Scores were consistently lowest for severe TBI, followed by moderate TBI, mild TBI, and arm injury across time. Severe TBI scores were significantly lower than scores for mild TBI and arm injury, but not moderate TBI. CONCLUSIONS CASP scores were responsive to change over time at most measurements and differentiated between groups, particularly severe TBI. Further research is needed with a larger sample of children with moderate/severe TBI as they were underrepresented in this study.
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Affiliation(s)
- Anat Golos
- a School of Occupational Therapy of Hadassah and the Hebrew University , Jerusalem , Israel
| | - Gary Bedell
- b Department of Occupational Therapy , Tufts University , Medford , MA , USA
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33
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Hill E, Claessen M, Whitworth A, Boyes M, Ward R. Discourse and cognition in speakers with acquired brain injury (ABI): a systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:689-717. [PMID: 29781173 DOI: 10.1111/1460-6984.12394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/13/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Cognitive impairment, particularly of executive functioning, has been implicated in deficits in spoken discourse production following acquired brain injury (ABI). However, due to variation in the methodologies and heterogeneity of findings across studies, the nature and extent of this association is not well understood. AIMS This review aims to synthesize the literature investigating associations between cognitive deficits and discourse impairment after ABI. It is reported in accordance with guidelines of The Preferred Reporting Items of Systematic Reviews and Meta-Analyses. DATA SOURCES Searches were conducted of a variety of databases including Medline, PsycINFO, EMBASE, CINAHL, ProQuest, Cochrane and ERIC. Additional studies were identified via reference harvesting. ELIGIBILITY CRITERIA Studies were included if they reported data on participants with ABI, assessed spoken discourse production and cognitive function, and performed statistical analyses to determine the association between discourse and cognitive variables. This review excluded non-English sources and those not published in peer-reviewed journals. Meta-analyses were not conducted due to variability across tools and terminology used to describe participant injury- and non-injury-related characteristics and outcomes. RESULTS Twenty-five observational studies were included in the review. Findings revealed significant associations between multiple cognitive functions and discourse across micro-linguistic to super-structural measures. Methodological and terminological inconsistencies were identified across studies, which limited systematic comparison of the results. CONCLUSIONS This review revealed present, yet heterogeneous, relationships between cognitive and discourse deficits in speakers with ABI. Associations were interpreted in light of a well-established model of discourse processing. Greater comparison across studies would have been facilitated by a standard nomenclature in relation to cognitive constructs and standardized discourse assessment. Future research should explore the influence of injury- and participant-related factors on discourse-cognitive relationships. The lack of information on conversational discourse and paediatric ABI limits the generalizability of this review to daily interaction following ABI. While applicable across the lifespan, in-depth investigation of discourse following ABI in childhood and adolescence is a priority due to complex changes in language and cognition, and the potential for impairments profoundly impact social, emotional and academic progression into adulthood. Given the centrality of remediating cognitive-communication difficulties in ABI, the interrelationships between discourse and cognition should retain a critical focus of research. This will inform clinical management and future research with this population. Findings have implications for our theoretical understanding of discourse and the nature of its breakdown in ABI.
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Affiliation(s)
- Elizabeth Hill
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University
| | - Mary Claessen
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University
| | - Anne Whitworth
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University
| | - Mark Boyes
- School of Psychology, Curtin University, Perth, WA, Australia
| | - Roslyn Ward
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University
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Resch C, Rosema S, Hurks P, de Kloet A, van Heugten C. Searching for effective components of cognitive rehabilitation for children and adolescents with acquired brain injury: A systematic review. Brain Inj 2018; 32:679-692. [PMID: 29621405 DOI: 10.1080/02699052.2018.1458335] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM Cognitive rehabilitation is of interest after paediatric acquired brain injury (ABI). The present systematic review examined studies investigating cognitive rehabilitation interventions for children with ABI, while focusing on identifying effective components. Components were categorized as (1) metacognition and/or strategy use, (2) (computerized) drill-based exercises, and (3) external aids. METHODS The databases PubMed (including MEDLINE), PsycInfo, and CINAHL were searched until 22nd June 2017. Additionally, studies were identified through cross-referencing and by consulting experts in the field. RESULTS A total of 20 articles describing 19 studies were included. Metacognition/strategy use trainings (five studies) mainly improved psychosocial functioning. Drill-based interventions (six studies) improved performance on tasks similar to training tasks. Interventions combining these two components (six studies) benefited cognitive and psychosocial functioning. External aids (two studies) improved everyday memory. No studies combined external aids with drill-based interventions or all three components. CONCLUSION Available evidence suggests that multi-component rehabilitation, e.g. combining metacognition/strategy use and drill-based training is most promising, as it can lead to improvements in both cognitive and psychosocial functioning of children with ABI. Intervention setting and duration may play a role. Conclusions remain tentative due to small sample sizes of included studies heterogeneity regarding outcome measures, intervention and therapist variables, and patient characteristics.
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Affiliation(s)
- Christine Resch
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands.,b Limburg Brain Injury Center , Maastricht , The Netherlands
| | - Stefanie Rosema
- c Sophia Rehabilitation , The Hague , The Netherlands.,d Department of Complex Behavioral Disorders and Forensic Psychiatry , De Bascule, Academic Center for Child- and Adolescent Psychiatry , Amsterdam , The Netherlands.,e Department of Child- and Adolescent Psychiatry , VU University Medical Center , Amsterdam , The Netherlands
| | - Petra Hurks
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands
| | - Arend de Kloet
- c Sophia Rehabilitation , The Hague , The Netherlands.,f The Hague University of Applied Sciences , the Hague , The Netherlands
| | - Caroline van Heugten
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands.,b Limburg Brain Injury Center , Maastricht , The Netherlands.,g School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences , Maastricht University Medical Center , Maastricht , The Netherlands
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35
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Lee T, Norton A, Hayes S, Adamson K, Schwellnus H, Evans C. Exploring Parents' Perceptions and How Physiotherapy Supports Transition from Rehabilitation to School for Youth with an ABI. Phys Occup Ther Pediatr 2017; 37:444-455. [PMID: 28121255 DOI: 10.1080/01942638.2016.1261980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS To explore parents' perceptions of their youth's transition from rehabilitation to school following an Acquired Brain Injury (ABI) and how physiotherapy influenced the youth's participation and physical function during the transition. METHODS The study utilized phenomenological qualitative methodology using semi-structured interviews with 11 parents of youth 10 to 18 years of age recruited from one pediatric rehabilitation hospital in Ontario. Each interview was audiotaped, transcribed verbatim, and thematically analyzed. RESULTS Parents valued physiotherapy and highlighted potential areas of improved service delivery to promote participation in an active lifestyle during this transition. In addition to being parents, they had to assume new roles and responsibilities in order to motivate their youth to continue with therapy and physical activity and had to facilitate their participation in school, recreational and social activities. CONCLUSION For youth following an ABI, the transition back to school is complex and strategies should be supportive and responsive. Implications for physiotherapists include improved collaboration with community partners to motivate youth and promote physical activity; engage youth with their peers early in the rehabilitation process; and ongoing support for parents.
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Affiliation(s)
- Tracy Lee
- a Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Andrea Norton
- a Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Sue Hayes
- a Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Keith Adamson
- a Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada.,b Bloorview Research Institute , Toronto , Ontario , Canada.,c Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Heidi Schwellnus
- a Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada.,b Bloorview Research Institute , Toronto , Ontario , Canada.,d School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Cathy Evans
- e Department of Physical Therapy , University of Toronto , Toronto , Ontario , Canada
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36
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Validity of Accelerometry to Measure Physical Activity Intensity in Children With an Acquired Brain Injury. Pediatr Phys Ther 2017; 29:322-329. [PMID: 28953176 DOI: 10.1097/pep.0000000000000439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the validity of the ActiGraph accelerometer (AG) to differentiate between standardized, physical activity tasks using oxygen consumption ((Equation is included in full-text article.)O2) as the criterion measure in children and adolescents with an acquired brain injury; to determine vector magnitude activity intensity cut-points; to compare performance of cut-points to previously published cut-points. METHODS Twenty-seven children performed standardized walking and stepping activities wearing a portable indirect calorimeter, AG, and heart rate monitor. Differences in (Equation is included in full-text article.)O2 and AG vector magnitude activity counts were measured during activities. Receiver operating characteristic curves were determined for intensity cut-points. RESULTS (Equation is included in full-text article.)O2 and AG activity counts significantly increased as walking speed increased. Discrimination of the newly derived cut-points was excellent and demonstrated greater agreement compared with the previously published cut-points. CONCLUSION Output from accelerometers can differentiate physical activity intensity in children with an acquired brain injury. Future studies can apply these cut-points to evaluate physical activity performance.
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Chen WC, Bedell GM, Yen CF, Liou TH, Kang LJ, Liao HF, Hwang AW. Psychometric properties of the Chinese version of the child and adolescent factors inventory (CAFI-C). RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:111-121. [PMID: 28753452 DOI: 10.1016/j.ridd.2017.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 06/26/2017] [Accepted: 07/12/2017] [Indexed: 06/07/2023]
Abstract
The Child and Adolescent Factors Inventory (CAFI) is a parent-report measure that assesses type and severity of impairments experienced by children and youth with a range of disabling conditions. The CAFI was translated from English into Traditional Chinese (CAFI-C) and has been used in the Disability Evaluation System (DES) in Taiwan. The aim of this study was to validate the use of the CAFI-C in the DES. Participants included 18,119 children and youth with disabilities between the ages of 6.0-17.9 (Mean=11.6; SD=3.46). The factor structure, internal consistency, convergent validity, and discriminant (known groups) validity were examined. The results indicated that the CAFI-C had a two-factor structure (Mental/speech and Physical/sensory impairment) that explained 54.3% of the variance, and had adequate internal consistency (α=0.80-0.90). Children and youth with higher CAFI-C scores had significantly more participation restrictions and environment barriers. CAFI-C scores were significantly different among children and youth with different disability types and of four severity levels (mild, moderate, severe, and profound) rated by physicians. These findings support the internal consistency and validity of the CAFI-C for assessing type and severity of impairment in children and youth with disabilities in Chinese-speaking population.
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Affiliation(s)
- Wei-Chang Chen
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - Gary M Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - Chia-Feng Yen
- Department of Public Health, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Tsan-Hon Liou
- Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Lin-Ju Kang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan
| | - Hua-Fang Liao
- The School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan.
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Kocher Stalder C, Kottorp A, Steinlin M, Hemmingsson H. Children's and teachers' perspectives on adjustments needed in school settings after acquired brain injury. Scand J Occup Ther 2017; 25:233-242. [PMID: 28494632 DOI: 10.1080/11038128.2017.1325932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Children with acquired brain injury (ABI) often present with functional deficits that influence their societal participation and well-being. Successful reintegration into school calls for individual support to meet each child's adjustment needs. The adjustment needs of children with ABI in school settings have not previously been explored. AIM The objectives of the present study were (a) to describe adjustment needs in school settings for children with ABI and (b) to explore differences and similarities between reports from the children and their teachers. METHODS In this cross-sectional study, 20 children with ABI (mean age 12.8 ± 3.4 years; class grade 1-10) and their teachers were interviewed individually, using the School Setting Interview (SSI). Data were analyzed with descriptive and with non-parametric statistics. RESULTS (a) In the overall group, children rated that 55.6% of the 16 activities in the SSI needed no adjustment. The corresponding percentage for teachers was 48.4%. (b) In the child-teacher pairs, there was a positive relationship between teachers' and children's responses only in 3 out of 16 school activities and agreement varied strongly according to the activity in question. CONCLUSIONS AND SIGNIFICANCE It is important for occupational therapists and other professionals to specifically consider adjustment needs relating to school activities from various perspectives when aiming to provide individualized interventions.
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Affiliation(s)
- Cornelia Kocher Stalder
- a Institute of Occupational Therapy at Zurich University of Applied Sciences , Winterthur , Switzerland.,b Neuropaediatrics , University Children's Hospital Bern , Bern , Switzerland
| | - Anders Kottorp
- c Karolinksa Institutet , University Stockholm , Stockholm , Sweden.,d Department of Occupational Therapy , University of Illinois at Chicago , Chicago , USA
| | - Maja Steinlin
- b Neuropaediatrics , University Children's Hospital Bern , Bern , Switzerland
| | - Helena Hemmingsson
- e Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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Catroppa C, Hearps S, Crossley L, Yeates K, Beauchamp M, Fusella J, Anderson V. Social and Behavioral Outcomes following Childhood Traumatic Brain Injury: What Predicts Outcome at 12 Months Post-Insult? J Neurotrauma 2016; 34:1439-1447. [PMID: 27809667 DOI: 10.1089/neu.2016.4594] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study sought to investigate social and behavioral outcomes 12 months following childhood traumatic brain injury (TBI) and to identify predictors of these outcomes. The study also compared rates of impairment in social and behavioral outcomes at 12 months post-injury between children with TBI and a typically developing (TD) control group. The study comprised 114 children ages 5.5 to 16.0 years, 79 with mild, moderate, or severe TBI and 35 TD children, group-matched for age, sex and socio-economic status. Children with TBI were recruited via consecutive hospital admissions and TD children from the community. Social and behavioral outcomes were measured via parent-rated questionnaires. Analysis of covariance models identified a significant mean difference between the mild and moderate groups for social problems only, but the moderate and severe TBI groups showed a higher rate of impairment, particularly in externalizing problems. Pre-injury function, injury severity, parent mental health, and child self-esteem all contributed significantly to predicting social and behavioral outcomes. Both injury and non-injury factors should be considered when identifying children at risk for long-term difficulties in social and behavioral domains.
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Affiliation(s)
- Cathy Catroppa
- 1 Murdoch Children's Research Institute , Victoria, Australia
| | - Stephen Hearps
- 1 Murdoch Children's Research Institute , Victoria, Australia
| | - Louise Crossley
- 1 Murdoch Children's Research Institute , Victoria, Australia
| | - Keith Yeates
- 2 Yeates, Keith; Alberta Children's Hospital Research Institute , Calgary, Alberta, Canada
| | - Miriam Beauchamp
- 3 Department of Psychology, University of Montreal , Montreal, Quebec, Canada
| | | | - Vicki Anderson
- 1 Murdoch Children's Research Institute , Victoria, Australia .,5 Department of Psychology, Royal Children's Hospital , Melbourne, Australia .,6 Department of Psychological Sciences and Pediatrics, University of Melbourne , Melbourne, Australia
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Baque E, Barber L, Sakzewski L, Boyd RN. Reproducibility in measuring physical activity in children and adolescents with an acquired brain injury. Brain Inj 2016; 30:1692-1698. [DOI: 10.1080/02699052.2016.1201594] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Emmah Baque
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Roslyn N. Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
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Bedell G, McDougall J. The Child and Adolescent Scale of Environment (CASE): Further validation with youth who have chronic conditions. Dev Neurorehabil 2016; 18:375-82. [PMID: 24304145 DOI: 10.3109/17518423.2013.855273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To further validate the Child and Adolescent Scale of Environment (CASE). METHODS Baseline data (n = 430) were analyzed from a longitudinal study on quality of life for youth with chronic conditions ages 11-17 in Ontario, Canada. Internal consistency and structure, and convergent and discriminant validity were examined via Cronbach's alpha (α), exploratory factor analyses, correlation analyses and ANOVA. RESULTS The CASE had high internal consistency (α = 0.89). A three-factor solution was produced with 55% variance explained: (1) Community/Home Resources, (2) School Resources and (3) Physical Design/Access). CASE total and factor scores were significantly correlated with scores from measures of impairment and participation (i.e. youth with more problematic environments had more severe impairment and more restricted participation). Significant differences in CASE scores existed for primary condition and impairment severity, but not for age or gender. CONCLUSION Results provide additional CASE validation evidence. Further testing is needed with more diverse and representative samples.
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Affiliation(s)
- Gary Bedell
- a Department of Occupational Therapy , Tufts University , Medford , Massachusetts , United States and
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de Kloet AJ, Berger MAM, Bedell GM, Catsman-Berrevoets CE, van Markus-Doornbosch F, Vliet Vlieland TPM. Psychometric evaluation of the Dutch language version of the Child and Family Follow-up Survey. Dev Neurorehabil 2016; 18:357-64. [PMID: 24304040 DOI: 10.3109/17518423.2013.850749] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The Child and Family Follow-up Survey (CFFS) is developed to monitor long-term outcomes of children and youth with acquired brain injury (ABI). The aim of this study was to translate and adapt it into the Dutch language and to evaluate its reliability and validity. METHODS The CFFS includes the Child and Adolescent Scale of Participation (CASP), the Child and Adolescent Factors Inventory (CAFI) and the Child and Adolescent Scale of Environment (CASE). The CFFS was translated into Dutch following international guidelines and adapted. The internal consistency, validity and test-retest reliability were examined among two groups of patients (n = 140 and n = 27) in the age of 5-22 years with ABI and their parents. RESULTS The translation and adaptation resulted in the CFFS-DLV, Dutch language version. The CASP-DLV, CAFI-DLV and CASE-DLV had a good internal consistency, with Cronbach's alpha being 0.95, 0.89 and 0.83, respectively. There were statistically significant correlations among the three CFFS subscale scores. These scores were also significantly correlated with the total scores of the Pediatric Quality of Life Inventory (PedsQL, parent) and the Pediatric Stroke Outcome Measure, but not with the domain scores of the Children's Assessment of Participation and Enjoyment (CAPE). The test-retest reliability was good to moderate, with the intra-class correlation coefficients being 0.90 for the CASP-DLV, 0.95 for the CAFI-DLV and 0.81 for the CASE-DLV. CONCLUSIONS The CFFS-DLV, as translation and adaptation of the CFFS into Dutch, proved to be a promising instrument to measure long-term outcomes of children and youth with ABI. Further research is needed to examine its responsiveness to change and potential in other patient groups.
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Affiliation(s)
- Arend J de Kloet
- a Sophia Rehabilitation , The Hague , The Netherlands .,b Department of Research & Development , The Hague University of Applied Sciences , The Hague , The Netherlands
| | - Monique A M Berger
- b Department of Research & Development , The Hague University of Applied Sciences , The Hague , The Netherlands
| | - Gary M Bedell
- c Department of Occupational Therapy , Tufts University , Medford , MA , USA
| | - Coriene E Catsman-Berrevoets
- d Department of Paediatric Neurology , Sophia Children's Hospital, Erasmus University Hospital , Rotterdam , The Netherlands , and
| | | | - Thea P M Vliet Vlieland
- a Sophia Rehabilitation , The Hague , The Netherlands .,e Department of Orthopaedics , Leiden University Medical Centre , Leiden , The Netherlands
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Thompson M, Elliott C, Willis C, Ward R, Falkmer M, Falkmer T, Gubbay A, Girdler S. Can, Want and Try: Parents' Viewpoints Regarding the Participation of Their Child with an Acquired Brain Injury. PLoS One 2016; 11:e0157951. [PMID: 27367231 PMCID: PMC4930177 DOI: 10.1371/journal.pone.0157951] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acquired brain injury (ABI) is a leading cause of permanent disability, currently affecting 20,000 Australian children. Community participation is essential for childhood development and enjoyment, yet children with ABI can often experience barriers to participation. The factors which act as barriers and facilitators to community participation for children with an ABI are not well understood. AIM To identify the viewpoints of parents of children with an ABI, regarding the barriers and facilitators most pertinent to community participation for their child. METHODS Using Q-method, 41 parents of children with moderate/severe ABI sorted 37 statements regarding barriers and facilitators to community participation. Factor analysis identified three viewpoints. RESULTS This study identified three distinct viewpoints, with the perceived ability to participate decreasing with a stepwise trend from parents who felt their child and family "can" participate in viewpoint one, to "want" in viewpoint two and "try" in viewpoint three. CONCLUSIONS Findings indicated good participation outcomes for most children and families, however some families who were motivated to participate experienced significant barriers. The most significant facilitators included child motivation, supportive relationships from immediate family and friends, and supportive community attitudes. The lack of supportive relationships and attitudes was perceived as a fundamental barrier to community participation. SIGNIFICANCE This research begins to address the paucity of information regarding those factors that impact upon the participation of children with an ABI in Australia. Findings have implications for therapists, service providers and community organisations.
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Affiliation(s)
- Melanie Thompson
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Catherine Elliott
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Claire Willis
- School of Sport Science, Exercise and Health, University of Western Australia, Perth, Western Australia, Australia
| | - Roslyn Ward
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Marita Falkmer
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Torbjӧrn Falkmer
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Anna Gubbay
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Sonya Girdler
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
- * E-mail:
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Kissane AL, Eldridge BJ, Kelly S, Vidmar S, Galea MP, Williams GP. High-level mobility skills in children and adolescents with traumatic brain injury. Brain Inj 2015; 29:1711-6. [DOI: 10.3109/02699052.2015.1075174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Boyd RN, Baque E, Piovesana A, Ross S, Ziviani J, Sakzewski L, Barber L, Lloyd O, McKinlay L, Whittingham K, Smith AC, Rose S, Fiori S, Cunnington R, Ware R, Lewis M, Comans TA, Scuffham PA. Mitii™ ABI: study protocol of a randomised controlled trial of a web-based multi-modal training program for children and adolescents with an Acquired Brain Injury (ABI). BMC Neurol 2015; 15:140. [PMID: 26286324 PMCID: PMC4544804 DOI: 10.1186/s12883-015-0381-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 07/14/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Acquired brain injury (ABI) refers to multiple disabilities arising from damage to the brain acquired after birth. Children with an ABI may experience physical, cognitive, social and emotional-behavioural impairments which can impact their ability to participate in activities of daily living (ADL). Recent developments in technology have led to the emergence of internet-delivered therapy programs. "Move it to improve it" (Mitii™) is a web-based multi-modal therapy that comprises upper limb (UL) and cognitive training within the context of meaningful physical activity. The proposed study aims to compare the efficacy of Mitii™ to usual care to improve ADL motor and processing skills, gross motor capacity, UL and executive functioning in a randomised waitlist controlled trial. METHODS/DESIGN Sixty independently ambulant children (30 in each group) at least 12 months post ABI will be recruited to participate in this trial. Children will be matched in pairs at baseline and randomly allocated to receive either 20 weeks of Mitii™ training (30 min per day, six days a week, with a potential total dose of 60 h) immediately, or be waitlisted for 20 weeks. Outcomes will be assessed at baseline, immediately post-intervention and at 20 weeks post-intervention. The primary outcomes will be the Assessment of Motor and Process Skills and 30 s repetition maximum of functional strength exercises (sit-to-stand, step-ups and half kneel to stand). Measures of body structure and functions, activity, participation and quality of life will assess the efficacy of Mitii™ across all domains of the International Classification of Functioning, Disability and Health framework. A subset of children will undertake three tesla (3T) magnetic resonance imaging scans to evaluate functional neurovascular changes, structural imaging, diffusion imaging and resting state functional connectivity before and after intervention. DISCUSSION Mitii™ provides an alternative approach to deliver intensive therapy for children with an ABI in the convenience of the home environment. If Mitii™ is found to be effective, it may offer an accessible and inexpensive intervention option to increase therapy dose. TRIAL REGISTRATION ANZCTR12613000403730.
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Affiliation(s)
- Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Emmah Baque
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Adina Piovesana
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Stephanie Ross
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Jenny Ziviani
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Owen Lloyd
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
| | - Lynne McKinlay
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia.
| | - Stephen Rose
- CSIRO, ICT - Australian e-Health Research Centre, Royal Brisbane and Women's Hospital Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.
| | - Ross Cunnington
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
| | - Robert Ware
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia.
- School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Melinda Lewis
- Children's Allied Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
| | - Tracy A Comans
- Griffith Health Institute and School of Medicine, Griffith University, Brisbane, Queensland, Australia.
| | - Paul A Scuffham
- Griffith Health Institute and School of Medicine, Griffith University, Brisbane, Queensland, Australia.
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Abstract
OBJECTIVE To assess the parental view on the impact of pediatric traumatic brain injury (TBI) and nontraumatic brain injury (NTBI) on the family and its determinants. METHODS Follow-up study including parents of children with a hospital-based diagnosis of acquired brain injury (ABI) aged 4-20 years at onset of ABI. Parents completed the Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM), which measures Parent Health-Related Quality of Life, Family Functioning, Communication, and Worry. Additional assessments included the Pediatric Stroke Outcome Measure (PSOM), the Child & Family Follow-up Survey (CFFS), PedsQL General Core and Multiple Fatigue Scales, and sociodemographic and disease characteristics. RESULTS Parents of 108 patients, median age 13 years (range 5-22), completed the questionnaires 24-30 months after diagnosis. There were 81 patients with TBI of whom 11 (14%) with moderate/severe TBI and 27 patients with NTBI of whom 5 (19%) with moderate/severe NTBI. The median PedsQL FIM Total Scale was 80.4 (SD 16.1). The PedsQL FIM Total Scale and 4 out of 5 Subscale Scores were statistically significantly better in the TBI group than in the NTBI group and in patients with severe NTBI than with mild/moderate NTBI. Moreover, in the total group, there were significant univariate associations between the FIM Total Scale and/or one or more Subscale Scores and age, preinjury patient health problems, and the PSOM, CFFS, PedsQL General Core, and Multiple Fatigue Scales. In the multivariable analysis, the FIM Total Scale was significantly associated with type and severity of injury and preinjury patient health problems. CONCLUSIONS Two years after onset, the parent-reported that impact of ABI on the family as measured by the PedsQL FIM was considerable especially in patients with moderate/severe NTBI.
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de Kloet AJ, Gijzen R, Braga LW, Meesters JJL, Schoones JW, Vliet Vlieland TPM. Determinants of participation of youth with acquired brain injury: A systematic review. Brain Inj 2015; 29:1135-1145. [DOI: 10.3109/02699052.2015.1034178] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hwang AW, Yen CF, Liou TH, Simeonsson RJ, Chi WC, Lollar DJ, Liao HF, Kang LJ, Wu TF, Teng SW, Chiu WT. Participation of Children with Disabilities in Taiwan: The Gap between Independence and Frequency. PLoS One 2015; 10:e0126693. [PMID: 25962175 PMCID: PMC4427311 DOI: 10.1371/journal.pone.0126693] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 04/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Independence and frequency are two distinct dimensions of participation in daily life. The gap between independence and frequency may reflect the role of the environment on participation, but this distinction has not been fully explored. METHODS A total of 18,119 parents or primary caregivers of children with disabilities aged 6.0-17.9 years were interviewed in a cross-sectional nationwide survey with the Functioning Scale of the Disability Evaluation System - Child version (FUNDES-Child). A section consisting of 20 items measured the children's daily participation in 4 environmental settings: home, neighborhood/community, school, and home/community. Higher independence and frequency restriction scores indicated greater limitation of participation in daily activities. Scores for independence, frequency and independence-frequency gaps were examined across ages along with trend analysis. ANOVA was used to compare the gaps across settings and diagnoses for children with mild levels of severity of impairment. FINDINGS A negative independence-frequency gap (restriction of frequency was greater than that of independence) was found for children with mild to severe levels of impairment. A positive gap (restriction of independence was greater than that of frequency) was found for children with profound levels of severity. The gaps became wider with age in most settings of children with mild impairment and different diagnoses. Widest negative gaps were found for the neighborhood/community settings than for the other three settings for children with mild to severe impairment. CONCLUSIONS Children's participation and independence-frequency gaps depend not only on the severity of their impairments or diagnoses, but also on their age, the setting and the support provided by their environment. In Taiwan, more frequency restrictions than ability restrictions were found for children with mild to moderate severity, especially in the neighborhood/community setting, and increased with age. Further identification of environmental opportunities that positively impact frequency of participation is needed.
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Affiliation(s)
- Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Chia-Feng Yen
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Tsan-Hon Liou
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Rune J. Simeonsson
- School Psychology Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- School of Education and Communication, Jönköping University, Jönköping, Sweden
| | - Wen-Chou Chi
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Donald J. Lollar
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Hua-Fang Liao
- The School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
| | - Lin-Ju Kang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Ting-Fang Wu
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
| | | | - Wen-Ta Chiu
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
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Catroppa C, Crossley L, Hearps SJC, Yeates KO, Beauchamp M, Rogers K, Anderson V. Social and behavioral outcomes: pre-injury to six months following childhood traumatic brain injury. J Neurotrauma 2014; 32:109-15. [PMID: 24773028 DOI: 10.1089/neu.2013.3276] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study aimed to extend the limited research investigating social and behavioral outcomes following childhood traumatic brain injury (TBI). The study compared pre-and post-injury measures of these skills and investigated the role of pre-injury child status and pre-injury family functioning in the prediction of outcome at six months post-injury. A secondary aim was to compare rates of impairment at six months post-injury between children post-TBI and a typically developing (TD) control group. This study comprised 140 children, 97 survivors of TBI (67 males) and 43 TD children (24 males), matched for age, sex, and socio-economic status. All participants were ascertained between 2007 and 2010, and were between ages 5.5 and 15.0 years. Children with TBI represented consecutive hospital admissions and were recruited at time of injury into a longitudinal study. TD children were recruited from the community, through local schools chosen to provide a range of socio-economic backgrounds. Findings indicated a deterioration of social participation skills post-injury, particularly for those sustaining a more severe injury, and a consistently higher rate of impairment in social and behavioral outcomes in the TBI group. Pre-injury function, injury severity and restrictions to social participation (e.g., reduced sport activities) as recommended by clinicians contributed significantly to outcome. Difficulties are evident in the short-term post-childhood TBI in social and behavioral domains. It is essential to monitor children long-term, particularly as societal expectations and demands increase.
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Affiliation(s)
- Cathy Catroppa
- 1 Murdoch Childrens Research Institute , Melbourne, Australia
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Tonkin BL, Ogilvie BD, Greenwood SA, Law MC, Anaby DR. The participation of children and youth with disabilities in activities outside of school: A scoping review. The Canadian Journal of Occupational Therapy 2014; 81:226-236. [DOI: 10.1177/0008417414550998] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Participation in occupations is vital for learning and development. Children with disabilities are at risk for decreased participation. Purpose. The purpose of this study is to examine peer-reviewed literature about the participation-based experiences of children and youth with disabilities in activities outside of formal preschool and school academics. Method. A scoping review was conducted to examine research studies published between 1990 and 2012. Studies included participants from 2 to 18 years who had at least one physical or intellectual/cognitive disability. Findings. Forty-nine articles discussing 32 studies and three systematic reviews met the inclusion criteria. Perceptions of and influences on participation were important emerging themes about direct impacts on patterns of participation. A child or youth’s level of functioning, activity level, level of enjoyment, and contextual factors were found to influence their level of successful participation. Implications. Occupational therapists can use the findings from this review to consider supports and barriers within interventions to enhance participation in meaningful life situations.
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