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Kendrick D, Lindley R, Blackburn L, Roadevin C, Thompson E, Andrews I, Anwar F, Brooks A, Carlton E, Crouch R, Day F, Fallon S, Farrin A, Graham L, Hoffman K, Howell R, Holmes J, James M, Jones T, Kellezi B, Kettlewell J, Morriss R, das Nair R, Richardson D, Smith M, Timmons S, Wright-Hughes A, Radford K. Early vocational rehabilitation and psychological support for trauma patients to improve return to work (the ROWTATE trial): study protocol for an individually randomised controlled multicentre pragmatic trial. Trials 2024; 25:439. [PMID: 38956682 PMCID: PMC11221047 DOI: 10.1186/s13063-024-08183-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 05/17/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Moderately severe or major trauma (injury severity score (ISS) > 8) is common, often resulting in physical and psychological problems and leading to difficulties in returning to work. Vocational rehabilitation (VR) can improve return to work/education in some injuries (e.g. traumatic brain and spinal cord injury), but evidence is lacking for other moderately severe or major trauma. METHODS ROWTATE is an individually randomised controlled multicentre pragmatic trial of early VR and psychological support in trauma patients. It includes an internal pilot, economic evaluation, a process evaluation and an implementation study. Participants will be screened for eligibility and recruited within 12 weeks of admission to eight major trauma centres in England. A total of 722 participants with ISS > 8 will be randomised 1:1 to VR and psychological support (where needed, following psychological screening) plus usual care or to usual care alone. The ROWTATE VR intervention will be provided within 2 weeks of study recruitment by occupational therapists and where needed, by clinical psychologists. It will be individually tailored and provided for ≤ 12 months, dependent on participant need. Baseline assessment will collect data on demographics, injury details, work/education status, cognitive impairment, anxiety, depression, post-traumatic distress, disability, recovery expectations, financial stress and health-related quality of life. Participants will be followed up by postal/telephone/online questionnaires at 3, 6 and 12 months post-randomisation. The primary objective is to establish whether the ROWTATE VR intervention plus usual care is more effective than usual care alone for improving participants' self-reported return to work/education for at least 80% of pre-injury hours at 12 months post-randomisation. Secondary outcomes include other work outcomes (e.g. hours of work/education, time to return to work/education, sickness absence), depression, anxiety, post-traumatic distress, work self-efficacy, financial stress, purpose in life, health-related quality of life and healthcare/personal resource use. The process evaluation and implementation study will be described elsewhere. DISCUSSION This trial will provide robust evidence regarding a VR intervention for a major trauma population. Evidence of a clinically and cost-effective VR intervention will be important for commissioners and providers to enable adoption of VR services for this large and important group of patients within the NHS. TRIAL REGISTRATION ISRCTN: 43115471. Registered 27/07/2021.
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Affiliation(s)
- Denise Kendrick
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University Park, Nottingham, NG7 2RD, UK.
| | - Rebecca Lindley
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University Park, Nottingham, NG7 2RD, UK
| | - Lauren Blackburn
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - Cristina Roadevin
- Nottingham Clinical Trials Unit, University Park, Nottingham, NG7 2RD, UK
| | - Ellen Thompson
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Isabel Andrews
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University Park, Nottingham, NG7 2RD, UK
| | - Fahim Anwar
- Cambridge University Hospital NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Adam Brooks
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - Edd Carlton
- North Bristol NHS Trust Southmead Hospital, Southmead Road, Westbury-On-Trym, Bristol, BS10 5NB, UK
| | - Robert Crouch
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, UK
| | - Florence Day
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Steve Fallon
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University Park, Nottingham, NG7 2RD, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Laura Graham
- Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
| | - Karen Hoffman
- Centre for Trauma Sciences, Barts Health NHS Trust and Queen Mary University London, Blizard Institute, 4 Newark St, London, E1 2AT, UK
| | - Rebekah Howell
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Jain Holmes
- Centre for Rehabilitation & Ageing Research (CRAR), Injury, Recovery Sciences and Inflammation (IRIS), School of Medicine, Medical School, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Marilyn James
- Nottingham Clinical Trials Unit, University Park, Nottingham, NG7 2RD, UK
| | - Trevor Jones
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University Park, Nottingham, NG7 2RD, UK
| | - Blerina Kellezi
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Jade Kettlewell
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University Park, Nottingham, NG7 2RD, UK
| | - Richard Morriss
- Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | | | - Davina Richardson
- Imperial College Healthcare NHS Trust, The Bays, South Wharf Road, London, W2 1NY, UK
| | - Matthew Smith
- Academic Department of Rehabilitation Medicine, Leeds General Infirmary, Leeds, LS1 3EX, UK
| | - Stephen Timmons
- Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, Nottingham, NG8 1BB, UK
| | | | - Kathryn Radford
- Centre for Rehabilitation & Ageing Research (CRAR), Injury, Recovery Sciences and Inflammation (IRIS), School of Medicine, Medical School, University of Nottingham, Nottingham, NG7 2UH, UK
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Crépeau-Hubert F, Baril AC, Di Caprio S, Haddad D, Picq C, Poncet F. Cross-cultural adaptation and validation of the cooking task to the French-Canadian context: assessing the impact of executive function disorders through cooking activities. Disabil Rehabil 2024; 46:1640-1651. [PMID: 37154574 DOI: 10.1080/09638288.2023.2204248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Acquired brain injury (ABI) often leads to deficits in executive functioning (EF) which is responsible for severe and longstanding disabilities in activities of daily living. The "Cooking Task" (CT), an ecological test of EF involving multi-tasking, was developed in France and exhibits excellent psychometric properties but has not yet been adapted and validated for the French-Canadian context. OBJECTIVES Conduct a cross-cultural adaptation and validation of the CT for the French-Canadian context. METHODS The CT was translated and adapted by a committee of experts and was validated. RESULTS Adaptation-changes were made to the language (e.g., cartable vs classeur), the materials (e.g., measuring cup vs scale), and the measuring units (e.g., ml/cups vs grams). Validation-Preliminary analyses were conducted on 24 participants with an ABI and 17 controls. Construct convergent validity: The French-Canadian-CT discriminates between ABI and control total score on the CT and on most error type categories. Construct known-group validity: French-Canadian-CT scores correlated with another measure of EF deficits (Dysexecutive Questionnaire and Six Elements Task). Inter-rater reliability score for the total error was high (ICC= .84) and results were similar to those obtained for the France-CT. CONTRIBUTIONS This study will provide a new ecologically valid tool for clinicians in Canada.
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Affiliation(s)
- Frédérik Crépeau-Hubert
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Audrey Changya Baril
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Sofia Di Caprio
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Dahlia Haddad
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Christine Picq
- Service de Médecine Physique et de Réadaptation, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
- Lethbridge-Layton-Mackay Rehabilitation Centre, CIUSSS Centre Ouest-de-l'Ile-de-Montréal, Montreal, Canada
| | - Frédérique Poncet
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Lethbridge-Layton-Mackay Rehabilitation Centre, CIUSSS Centre Ouest-de-l'Ile-de-Montréal, Montreal, Canada
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3
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Drake M, Scratch SE, Jackman A, Scheinberg A, Wilson M, Knight S. Adapting TeachABI to the local needs of Australian educators - a critical step for successful implementation. BRAIN IMPAIR 2024; 25:IB23094. [PMID: 38566297 DOI: 10.1071/ib23094] [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: 08/30/2023] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
Background The present study is the foundational project of TeachABI-Australia , which aims to develop and implement an accessible, nation-wide digital resource for educators to address their unmet acquired brain injury (ABI)-related professional learning needs. The aim of the present study was to identify the adaptations required to improve the suitability and acceptability of the TeachABI professional development module within the Australian education system from the perspectives of Australian educators. Methods The research design employed an integrated knowledge translation approach and followed the ADAPT Guidance for undertaking adaptability research. A purposive sample of eight educators eligible to teach primary school in Australia provided feedback on the module through a quantitative post-module feedback questionnaire and a qualitative semi-structured interview. Results Participants rated the acceptability of the module as 'Completely Acceptable ' (Mdn = 5, IQR = 1), and reported 'only Minor' changes were required (Mdn = 2, IQR = 0.25) to improve the suitability to the Australian context. Qualitative analysis of transcripts revealed three broad categories: (1) the usefulness of TeachABI , (2) the local fit of TeachABI , and (3) pathways for implementing TeachABI in the local setting. Recommended adaptations to the module collated from participant feedback included changes to language, expansion of content, and inclusion of Australian resources, legislation, and videos. Conclusions TeachABI is acceptable to Australian educators but requires modifications to tailor the resource to align with the unique schooling systems, needs, and culture of the local setting. The systematic methodological approach to adaptation outlined in this study will serve as a guide for future international iterations of TeachABI .
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Affiliation(s)
- Marnie Drake
- Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia; and Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Shannon E Scratch
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada; and Bloorview Research Institute, Toronto, ON, Canada; and Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; and Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Angela Jackman
- Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia
| | - Adam Scheinberg
- 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
| | - Meg Wilson
- Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Sarah Knight
- Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia; and 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
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Jimenez N, Harner V, Oliva MA, Lozano L, Fuentes M. The role of social determinants of health in the receipt of school services after\\ traumatic brain injury: A focus review on underserved pediatric populations. NeuroRehabilitation 2023:NRE220210. [PMID: 37125571 DOI: 10.3233/nre-220210] [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: 05/02/2023]
Abstract
BACKGROUND Return to school is key for community re-integration after a traumatic brain injury (TBI). School support facilitates and ensure a successful transition back to school. However, access to school services is not uniform among U.S. children. OBJECTIVE To describe school services for children with TBI from minoritized backgrounds and highlight population-specific risk factors and facilitators for accessing services. METHODS Narrative review of the literature including studies on return to school after a mild-complicated, moderate, or severe TBI, among children enrolled in the U.S. school system. We describe receipt of services, enabling and risk factors, and outcomes, for minority children. RESULTS There is a gap in knowledge regarding return to school among minoritized children with TBIs. Studies have few participants from racial and ethnic minority backgrounds, or low income or rural communities. Transgender and non-binary youth are not represented in present research efforts. Studies highlight larger barriers to receipt of school services among minority children and additional barriers associated with their minority status. CONCLUSION Diversity in the U.S pediatric population is increasing. Minoritized populations are at increased risk for TBI and poor outcomes. Research focused on the needs of these populations is required to optimize school return after TBI hospitalization and overall post-discharge care.
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Affiliation(s)
- Nathalia Jimenez
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Vern Harner
- School of Social Work and Criminal Justice, University of Washington-Tacoma, Tacoma, WI, USA
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
| | - Maria Andrea Oliva
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Lorena Lozano
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Molly Fuentes
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Kemp AM, O'Brien KH, Wallace T. Reconceptualizing Recovery After Concussion: A Phenomenological Exploration of College Student Experiences. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:867-882. [PMID: 36108288 DOI: 10.1044/2022_ajslp-22-00076] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Typical measures of recovery from concussion-such as symptom scales, neurocognitive testing, or exertion measures-may not capture individualized experiences of concussion. This report examines how college students with concussion interact with and consider their recovery. METHOD Sixteen college students who sustained concussions while in college completed 40- to 75-min semistructured interviews. All were enrolling to become mentors in a peer mentoring program for students with concussion. Questions addressed experiences as a college student with concussion, life changes following concussion, and role of peers in recovery. Using phenomenological reduction, analysis focused on the phenomenon of recovery and motivation for participation in a mentoring program. RESULTS Two main themes were found: (a) What Recovery Looks Like and (b) Gaining Perspective, Learning to Cope and Adapting to Change. Thirteen participants denied the label of "recovered" even though all had been deemed recovered and discharged from medical care. Instead, two subthemes emerged within What Recovery Looks Like: Ongoing Recovery and Reconceptualizing Recovery. Perceptions of recovery were influenced by effort, capacity, and resilience. In the second theme, students described strategies, resources, and supports used to cope with their injuries; most commonly used was emotion-focused coping. CONCLUSIONS College students with concussion consider recovery as an ongoing process rather than a dichotomized condition. Student experiences may not be reflected in commonly used symptom scales or objective assessments. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21084925.
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Affiliation(s)
- Amy M Kemp
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Tracey Wallace
- SHARE Military Initiative at Shepherd Center, Crawford Research Institute, Complex Concussion Clinic, Atlanta, GA
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Norman A, Curro V, Holloway M, Percuklievska N, Ferrario H. Experiences of individuals with acquired brain injury and their families interacting with community services: a systematic scoping review. Disabil Rehabil 2023; 45:739-751. [PMID: 35244507 DOI: 10.1080/09638288.2022.2043465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This scoping review aims to (1) synthesise the research findings on the experiences of individuals with acquired brain injuries, and their families, when interacting with, or accessing, community-based services and (2) identify where gaps in service provision may exist and their cause. METHODS A systematic search strategy was employed across multiple databases to identify all studies relating to the experiences of individuals with acquired brain injuries and their families when interacting with, or accessing, community-based services. Inclusion was assessed by at least two reviewers at each stage and data extraction was completed by one researcher and validity checked by another. A narrative synthesis was employed. RESULTS A total of 101 papers met the inclusion criteria with the narrative synthesis identifying three main themes of (1) unmet needs, (2) types of access, and (3) barriers to access. CONCLUSIONS The results identify that those with acquired brain injuries, and their families, experience significant difficulties interacting with community-based services and often do not receive appropriate access. Many barriers to access were identified including a lack of knowledge of the long-term effects of acquired brain injury amongst professionals working in health and social care services.Implications for rehabilitationBrain injury is a leading cause of disability worldwide with a range of physical, cognitive, emotional, and behavioural difficulties.It is important that service users and families are given appropriate information about the long-term difficulties associated with ABI so they are better informed about the types of support they may need upon discharge from hospital.Rehabilitation professionals need to ensure they have good level of knowledge of the difficulties associated with ABI to ensure appropriate access to services for individuals and their families.Understanding more about unmet needs allows community rehabilitation services to be tailored and person-centred.
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Affiliation(s)
- Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, UK
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Cavazzoni E, Boakye T. A 12-Year Audit of Neurological Outcomes Associated with Core Body Temperature >37.5°C in Children with Severe Traumatic Brain Injury. Ther Hypothermia Temp Manag 2022. [PMID: 36355047 DOI: 10.1089/ther.2022.0026] [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: 11/11/2022] Open
Abstract
Hyperthermia exposure is associated with poor neurological outcomes in patients with severe traumatic brain injury (TBI). Our aim was to describe fever in children with severe TBI admitted to a pediatric intensive care unit (PICU) for at least 72 hours and to evaluate associations between fever using a novel approach to describe thermal exposure and neurobehavioral outcomes. The cohort included children from birth to 17 years of age admitted to the PICU between 2000 and 2012 for at least 72 hours who had severe TBI with intracranial pressure monitoring. Patients with non-accidental TBI or pre-existing developmental delays were excluded. Hyperthermia was defined as a core temperature >37.5°C. Hourly temperature measurements were used to calculate the area under the curve (AUC) using the linear trapezoidal rule. Each participant was followed up at the Brain Injury Clinic 6 and 18 months postinjury. Neurobehavioral outcome scores were analyzed against AUC using standard statistical methods. Ninety-eight patients admitted with severe TBI met the study inclusion criteria. Hyperthermia/fever was common (89.7%), and patients remained hyperthermic for a median of 9.4 hours. However, no statistically significant association was found between AUC and abnormal neurological outcomes. The follow-up rates were good at 6 (86.7%) and 18 months (83.7%). The neurological deficit improved with time, with "favorable outcomes" increasing from 72% to 94% at the respective follow-up months. Our study used a novel method to describe patients' fever, providing a different indicator of thermal exposure than that previously reported. In addition, the AUC was well correlated with the maximum temperature recorded and the proportion of time >37.5°C, indicating that it is a good surrogate for thermal exposure. Interestingly, the neurological disabilities of the patients improved over time.
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Affiliation(s)
- Elena Cavazzoni
- Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Westmead, Australia
| | - Thomas Boakye
- Children's Critical Care Unit, Gold Coast University Hospital, Gold Coast, Australia
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8
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Ahonle ZJ, Tucker M, Degeneffe CE, Romero S, Dillahunt-Aspillaga C. Return to School Outcomes among Adults with TBI One Year After Rehabilitation Discharge: A TBIMS Study. Brain Inj 2022; 36:1000-1009. [PMID: 35916683 DOI: 10.1080/02699052.2022.2105952] [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: 11/02/2022]
Abstract
OBJECTIVE To examine return to school outcomes 1 year after traumatic brain injury (TBI) rehabilitation discharge. DESIGN Longitudinal observational study using Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) data at 1-year post-TBI. SETTING Inpatient rehabilitation centers using follow-up telephone calls. INDIVIDUALS Individuals (n = 237) enrolled in the TBIMS-NDB since 2001 between the ages of 18 and 59 years who were engaged in postsecondary education (full or part-time) before recorded TBI. MAIN MEASURES Return to school, categorized as in a postsecondary setting at first follow-up (reported hours in school greater than zero at one-year follow-up). RESULTS Using an alpha level of 0.05 binary logistic regression analysis identified four predictive variables. Significant predictors of return to school include being of lower age, possessing a higher level of functioning at discharge, reporting lower ratings of disability at discharge, and being able to use a vehicle independently for transportation. CONCLUSION Pursuit of higher education is a viable means of community reintegration after TBI. Some individuals with TBI face a myriad of barriers and challenges when returning to school. Study findings may facilitate understanding of how TBI affects return to school and community reintegration outcomes.
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Affiliation(s)
- Zaccheus James Ahonle
- Department of Occupational Therapy, College of Public Health & Health Professions, University of Florida, Florida, US.,Veteran Rural Health Resource Center, Gainesville (VRHRC-GNV), Florida, US.,Rehabilitation Counseling Program, Department of Counseling, Educational Psychology & Foundations, Mississippi State University, Starkville, MS, US
| | - Mark Tucker
- Rehabilitation Counseling Program, Department of Administration, Rehabilitation, and Postsecondary Education, San Diego State University, San Diego, California, US
| | - Charles Edmund Degeneffe
- Rehabilitation Counseling Program, Department of Administration, Rehabilitation, and Postsecondary Education, San Diego State University, San Diego, California, US
| | - Sergio Romero
- Department of Occupational Therapy, College of Public Health & Health Professions, University of Florida, Florida, US.,Veteran Rural Health Resource Center, Gainesville (VRHRC-GNV), Florida, US
| | - Christina Dillahunt-Aspillaga
- Rehabilitation & Mental Health Counseling Program, Child & Family Studies, University of South Florida, Tampa, Florida, US
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Kakonge L, Charron VP, Vedder J, Wormald K, Turkstra LS. A mapping review of adolescent identity after TBI: what clinicians need to know. Neuropsychol Rehabil 2022; 32:1868-1903. [PMID: 35604405 DOI: 10.1080/09602011.2022.2071299] [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: 10/18/2022]
Abstract
ABSTRACTAdolescence is a critical period for developing a sense of identity, an iterative process that relies on the development of skills such as self-reflection and self-appraisal. Outcomes of identity development include personal ethics, knowledge of one's strengths and challenges, and, ultimately, independence. Traumatic brain injury (TBI) affects these outcomes in adults, when identity has been established and may need to be redefined; but what happens when an injury occurs while identity is being formed? To answer this question, we used mapping review methodology to explore TBI effects on adolescent identity formation, mapping the evidence onto a biopsychosocial framework for rehabilitation. We reviewed studies on identity in adolescents with mild to severe TBI ages 13-18 years, published from inception to 2021, with a focus on outpatient rehabilitation settings. Key findings of the mapping review noted adolescents post-TBI are likely to: (1) question their identity considering dissonance between the current self and their pre-injury self; and (2) seek to establish new, adaptive meanings and identities. All studies drew conclusions regarding identity and participation of adolescents post-TBI. Results provided insight into the importance of considering individualized rehabilitation interventions for adolescents, given their unique developmental path towards identity formation.
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Affiliation(s)
- Lisa Kakonge
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Victoria P Charron
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Janelle Vedder
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Kendra Wormald
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Lyn S Turkstra
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
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10
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Tarnai K, Marcopulos B. Developing a model of return to school: A Traumatic Brain Injury Model Systems study. Brain Inj 2022; 36:544-552. [PMID: 35380490 DOI: 10.1080/02699052.2022.2051739] [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: 11/02/2022]
Abstract
OBJECTIVE A common goal for those recovering from moderate to severe brain injury is to reengage in education or employment. There is significant overlap between the skills relevant for successful job and academic performance in high school and college, and many deficits reported after brain injury are consistent across young adults and adults. This study utilized a return to work (RTW) model framework to develop a model of return to school (RTS). METHOD Days of post-traumatic amnesia (PTA), length of stay (LOS), rehabilitation discharge Disability Rating Scale (DRS) scores, presence of pre-injury learning limitation, and educational level were used to predict RTS one-year post-injury in a student sample (N = 158, 58.8% white, 69.6% male) within the Traumatic Brain Injury Model Systems National Database. RESULTS The overall RTS rate for this sample was 62%. Logistic regression indicated that lower DRS discharge scores and being in high school pre-injury resulted in the best outcome. CONCLUSION Results showed partial support for the translation of RTW factors to a student sample; however, results may also favor the conceptual distinction in RTS versus RTW, which are elaborated. More outreach for college students may improve awareness of disability services, thereby heightening the future return rate.
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Affiliation(s)
- Kathryn Tarnai
- Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia, USA
| | - Bernice Marcopulos
- Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia, USA.,Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
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11
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Gilbert C, Mooradian G, Citorik A, Gilmore N, Kiran S. Multi-level outcomes for young adults with acquired brain injury through a remote intensive cognitive rehabilitation approach: a pilot intervention study. Brain Inj 2022; 36:206-220. [PMID: 35188029 PMCID: PMC9124694 DOI: 10.1080/02699052.2022.2034961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To investigate the effects of the Intensive Cognitive and Communication Rehabilitation (ICCR) program for young adults with acquired brain injury (ABI) using a quasi-experimental pilot intervention study design while transitioning to remote implementation. METHOD Twelve young adults with chronic ABI (treatment n = 7; control n = 5) participated in ICCR (i.e., lectures, seminars, individual cognitive rehabilitation (CR), technology training) for six hours/day, four days/week, for one or two 12-week semesters. Outcomes included classroom metrics, individual therapy performance, including Goal Attainment Scaling (GAS), standardized cognitive-linguistic assessments, and participation and health-related quality of life (QOL) measures. RESULTS In the first semester (in-person and remote), treatment participants significantly improved in classroom exams; individual therapy (i.e., memory, writing, GAS); executive function and participation measures, but not QOL. In the second semester (remote), treatment participants significantly improved in classroom exams; essay writing; individual therapy (i.e., writing and GAS); and memory assessment, but not in participation or QOL. Treatment participants enrolled in consecutive semesters significantly improved in classroom exams, individual therapy (i.e., memory), participation and QOL, but not on standardized cognitive assessments. Controls demonstrated no significant group-level gains. CONCLUSION These preliminary results highlight the benefit of intensive, integrated, and contextualized CR for this population and show promise for its remote delivery.
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Affiliation(s)
| | - Grace Mooradian
- Aphasia Research Laboratory, Boston University, Boston, Massachusetts, USA
| | - Anne Citorik
- Aphasia Research Laboratory, Boston University, Boston, Massachusetts, USA
| | - Natalie Gilmore
- Aphasia Research Laboratory, Boston University, Boston, Massachusetts, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Boston University, Boston, Massachusetts, USA
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12
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What About the Little Ones? Systematic Review of Cognitive and Behavioral Outcomes Following Early TBI. Neuropsychol Rev 2022; 32:906-936. [PMID: 34994947 DOI: 10.1007/s11065-021-09517-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 06/07/2021] [Indexed: 10/19/2022]
Abstract
There is increasing empirical focus on the effects of early traumatic brain injuries (TBI; i.e., before the age of six years) on child development, but this literature has never been synthetized comprehensively. This systematic review aimed to document the cognitive, academic, behavioral, socio-affective, and adaptive consequences of early TBI. Four databases (Medline, PsycNET, CINAHL, PubMed) were systematically searched from 1990 to 2019 using key terms pertaining to TBI and early childhood. Of 12, 153 articles identified in the initial search, 43 were included. Children who sustain early TBI are at-risk for a range of difficulties, which are generally worse when injury is sustained at a younger age, injury severity is moderate to severe, and injury mechanisms are non-accidental. Early childhood is a sensitive period for the emergence and development of new skills and behaviors, and brain disruption during this time is not benign. Research, clinical management, intervention, and prevention efforts should be further developed with consideration of the unique characteristics of the early childhood period.
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13
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Gilmore N, Katz DI, Kiran S. Acquired Brain Injury in Adults: A Review of Pathophysiology, Recovery, and Rehabilitation. ACTA ACUST UNITED AC 2021; 6:714-727. [PMID: 34746412 DOI: 10.1044/2021_persp-21-00013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose To summarize existing literature from a range of fields (i.e., neurology, neuropsychology, neuroscience, neuroimaging, rehabilitation, speech-language pathology) that is relevant to the development and/or revision of cognitive rehabilitation programs for individuals with acquired brain injury (ABI) and in particular, for young adults. Method This paper reviews a range of ABI-associated topics including: 1) mechanisms of injury; 2) biological, individual-specific, and behavioral drivers of recovery; and 3) current methods of cognitive rehabilitation. It then narrows focus to young adults, a frequently affected and growing population to sustain ABI. The paper concludes by providing: 1) suggestions for key components of cognitive rehabilitation for young adults with ABI; 2) an example from our own research providing intensive academically-focused cognitive rehabilitation for young adults with ABI pursuing college; and 3) recommendations for future behavioral and neuroimaging studies in this area. Conclusions ABI is on the rise in the United States. Young adults have been sustaining ABI at higher rates over the past several decades. These injuries occur when they would otherwise be advancing their academic and career goals, making the cognitive deficits that often accompany ABI especially devastating for this group. Review of existing literature suggests cognitive rehabilitation programs that combine aspects of restorative, comprehensive, and contextualized approaches could promote recovery for young adults with ABI. Future intervention studies may benefit from including both behavioral and neural outcomes to best understand how principles of neuroplasticity- naturally embedded within many cognitive rehabilitation approaches-could be manipulated to promote cognitive recovery and long-lasting brain reorganization in this group.
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Affiliation(s)
- Natalie Gilmore
- Speech, Language and Hearing Sciences, Boston University, Boston, USA
| | - Douglas I Katz
- Neurology, Boston University School of Medicine, Boston, USA
| | - Swathi Kiran
- Speech, Language and Hearing Sciences, Boston University, Boston, USA
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14
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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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15
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Tarconish E, Lombardi A, Madaus J, Taconet A, Coelho C. Available supports and resources for postsecondary students with traumatic brain injury: A systematic review of the literature. JOURNAL OF VOCATIONAL REHABILITATION 2021. [DOI: 10.3233/jvr-211143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Postsecondary students with traumatic brain injuries (TBI) are a rapidly growing population, encompassing those who sustained injuries prior to attending postsecondary education and those who endure injuries during their postsecondary studies. Not only do these individuals face a broad range of symptoms, all of which can affect academic achievement, but they also do not achieve comparable academic outcomes to their peers without disabilities. OBJECTIVE: There is a need to develop and examine the effectiveness of available supports and resources to meet the needs of these students. METHODS: Twenty-three articles were systematically reviewed to illustrate what supports are currently described in the literature for postsecondary students with TBI and what research methods were used to assess the effectiveness of these supports. RESULTS: Three categories of supports emerged, including concussion management protocols, typical study/learning strategies and accommodations, and interventions developed specifically for this population. Findings also indicated a lack of rigorous research methods used to assess these interventions’ effects. CONCLUSIONS: Implications for future research include a need for additional study of all supports and resources described in this review, and assessment of whether or not education professionals, including postsecondary disability services professionals, are aware of and using the tools and strategies addressed in this review.
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16
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O'Brien KH, Wallace T, Kemp A. Student Perspectives on the Role of Peer Support Following Concussion: Development of the SUCCESS Peer Mentoring Program. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:933-948. [PMID: 33556263 DOI: 10.1044/2020_ajslp-20-00076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose College students with concussion are often ill-equipped to manage their health and learning needs, and college campuses are slow to react. We present the development of a peer mentoring program for college students with concussion: Success in College after Concussion with Effective Student Supports (SUCCESS), focusing on the process by which student needs and preferences drove development of the program for testing. Method Principles of person-centered design were used to guide program development, engaging stakeholders at each stage of development and resulting in the intervention package presented to student participants here. A series of interviews and focus groups with 11 students with concussion addressed student needs after concussion, student perceptions of the role of peers in recovery, and feedback on program development. Results Findings indicate students have limited knowledge about concussion, and concussion impacts extend beyond school, although students are most concerned about their studies. Students reported struggling to communicate with professors and find resources on campus to aid in their reentry to learning. Regarding peer mentoring, students report benefiting from hearing about other's successes and sharing personal narratives of injury and recovery. Students reported high acceptability of a peer mentoring program, both for psychosocial support and access to resources. Conclusions College students with concussion have unmet needs as they return to learn. The SUCCESS peer mentoring program is highly acceptable to students, who report that they would expect such a program to be engaging and to meet their needs. The program's impact on student academic and psychosocial outcomes should be investigated through comparative efficacy trials.
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Affiliation(s)
- Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Tracey Wallace
- Complex Concussion Clinic, Crawford Research Institute, Shepherd Center, Atlanta, GA
| | - Amy Kemp
- Department of Communication Sciences and Special Education, University of Georgia, Athens
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17
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Mealings M, Douglas PJ, Olver PJ. The student journey: Living and learning following traumatic brain injury. Brain Inj 2021; 35:315-334. [PMID: 33405962 DOI: 10.1080/02699052.2020.1863466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Primary objective: In this research we set out to gain further understanding of the experiences of students participating in secondary and tertiary education following TBI: exploring academic and non-academic factors, as well as changes in experiences over time.Methods and procedures: A longitudinal, qualitative investigation was completed. 12 students (17-32 years) completed up to three in-depth interviews over a period of 4-15 months, capturing atotal of 30 time points. Data were analyzed using grounded theory methods.Main outcomes and results: Students' participation experiences were unique and varied with different timelines and outcomes, however they shared many similar critical points. We interpreted their experiences as a student journey traveling through four significant landscapes, "Choosing to study", "Studying", "Deciding what to do", "Making the next step." Journeys involved complex processes of living and learning. Moving along the pathway was not always smooth or straightforward.Conclusions: Students' experiences of returning to study following TBI can be interpreted as a complex journey of living and learning. Four important stages of the journey provide clinicians and educators with landscape features that can provide a structure for exploring supports to address both academic and non-academic factors to assist students in their study journey.
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Affiliation(s)
- Margaret Mealings
- School of Allied Health, La Trobe University, Bundoora, Australia.,Epworth Rehabilitation, Epworth Healthcare, Richmond, Australia
| | - Professor Jacinta Douglas
- School of Allied Health, La Trobe University, Bundoora, Australia.,Research and Innovation Unit, Summer Foundation, Box Hill, Australia
| | - Professor John Olver
- Epworth Rehabilitation, Epworth Healthcare, Richmond, Australia.,Epworth Monash Rehabilitation Medicine Unit, Richmond, Australia
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18
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Anderson D, Gau JM, Beck L, Unruh D, Gioia G, McCart M, Davies SC, Slocumb J, Gomez D, Glang AE. Management of Return to School Following Brain Injury: An Evaluation Model. INTERNATIONAL JOURNAL OF EDUCATIONAL RESEARCH 2021; 108:10.1016/j.ijer.2021.101773. [PMID: 33927471 PMCID: PMC8076871 DOI: 10.1016/j.ijer.2021.101773] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Traumatic brain injury (TBI) affects children's ability to succeed at school. Few educators have the necessary training and knowledge needed to adequately monitor and treat students with a TBI, despite schools regularly serving as the long-term service provider. In this article, we describe a return to school model used in Oregon that implements best practices indicated by the extant literature, as well as our research protocol for evaluating this model. We discuss project aims and our planned procedures, including the measures used, our quasi-experimental design using matched controls, statistical power, and impact analyses. This project will provide the evidential base for implementation of a return to school model at scale.
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Affiliation(s)
| | - Jeff M. Gau
- University of Oregon, Eugene, 97403-5252, USA
| | - Laura Beck
- University of Oregon, Eugene, 97403-5252, USA
| | | | - Gerard Gioia
- Children’s National Health System, 111 Michigan
Avenue NW, Washington, DC, 20010
| | | | - Susan C Davies
- University of Dayton, University of Dayton, 300 College
Park Dayton, Ohio 45469, USA
| | | | - Doug Gomez
- University of Oregon, Eugene, 97403-5252, USA
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19
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Harvey J, Farquharson K, Schneider-Cline W, Bush E, Pelatti CY. Describing the Composition of Individualized Education Plans for Students With Traumatic Brain Injury. Lang Speech Hear Serv Sch 2020; 51:839-851. [PMID: 32492357 DOI: 10.1044/2020_lshss-19-00074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The purpose of this study was to explore and describe the features of Individualized Education Plans (IEPs) for a cohort of students with traumatic brain injury (TBI) to help elucidate current special education practices for students with TBI. Method We obtained permission from administrators of a local school district of 41,000 students in a Midwestern state to review de-identified IEP records of students verified with TBI. We examined demographic information (i.e., cause and age at time of injury), IEP services and intensity, IEP goal categories, and previous verification status. Results Descriptive results support that intervention services were more intense for students with TBI with greater lengths of time postinjury. Target behaviors within goals were more often related to math and reading than to the cognitive processes that govern these skills, such as attention, memory, and executive functioning. Finally, more than a third of our sample had been verified with a disability and were receiving special education services via an IEP prior to their TBI. Conclusions This work represents an important first step in understanding the special education services for students with TBI. Future research should explore interventions that are ecologically valid for school-based settings and are developed to address the idiosyncratic deficits of students with TBI, particularly interventions that focus on the underlying cognitive processes experienced by these students.
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Affiliation(s)
- Judy Harvey
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln
| | - Kelly Farquharson
- School of Communication Science and Disorders, Florida State University, Tallahassee
| | | | - Erin Bush
- Department of Communication Disorders, University of Wyoming, Laramie
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20
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A Service User Perspective Informing the Role of Occupational Therapy in School Transition Practice for High School Learners with TBI: An African Perspective. Occup Ther Int 2019; 2019:1201689. [PMID: 31467499 PMCID: PMC6701279 DOI: 10.1155/2019/1201689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/10/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
Background In the South African context, there are no specific guidelines regarding how to prepare and support adolescents for the transition from a health care to a high school setting post TBI. This raises questions about the relevance and responsiveness of the current transition practices in occupational therapy in terms of adequately preparing and supporting these adolescents to participate in school and hence exercise their right to a quality education. Method This study explored adolescents and other key role players' perspectives on and experiences of the high school transition (i.e., school reentry and continued school participation) post TBI. It was anticipated that this would provide an increased understanding of the enablers and barriers to high school reentry and participation post TBI. This served as a basis to explore the main aim of this study which was to help occupational therapists identify where efforts in terms of service delivery are needed. This study was situated in the interpretivist qualitative paradigm and used a multicase study design, which included semistructured interviews with eight adolescent learners with TBI, their primary caregivers, teachers, and principals as well as observations and documentation review. Results This paper will focus on a central theme in the research, namely, the nature and extent of support needed to facilitate the high school transition of adolescents with TBI within a developing context. Similar to the findings of studies conducted in developed contexts, participants highlighted that they felt that adolescents need support at various stages of the school transition. Participants further alluded to support that should be collaborative, coordinated, flexible, and monitored to ensure it is relevant and responsive to these adolescents' changing needs. Conclusion The study findings conclude that occupational therapists have a crucial role in fostering an enabling environment (directly and indirectly) through fulfilling various roles including that of a facilitator, intermediary, coach, collaborator, supporter, and advocator.
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21
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Kucheria P, Sohlberg MM, Prideaux J, Fickas S. Read, Understand, Learn, & Excel: Development and Testing of an Automated Reading Strategy Detection Algorithm for Postsecondary Students. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1257-1267. [PMID: 31170349 DOI: 10.1044/2019_ajslp-18-0181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose An important predictor of postsecondary academic success is an individual's reading comprehension skills. Postsecondary readers apply a wide range of behavioral strategies to process text for learning purposes. Currently, no tools exist to detect a reader's use of strategies. The primary aim of this study was to develop Read, Understand, Learn, & Excel, an automated tool designed to detect reading strategy use and explore its accuracy in detecting strategies when students read digital, expository text. Method An iterative design was used to develop the computer algorithm for detecting 9 reading strategies. Twelve undergraduate students read 2 expository texts that were equated for length and complexity. A human observer documented the strategies employed by each reader, whereas the computer used digital sequences to detect the same strategies. Data were then coded and analyzed to determine agreement between the 2 sources of strategy detection (i.e., the computer and the observer). Results Agreement between the computer- and human-coded strategies was 75% or higher for 6 out of the 9 strategies. Only 3 out of the 9 strategies-previewing content, evaluating amount of remaining text, and periodic review and/or iterative summarizing-had less than 60% agreement. Conclusion Read, Understand, Learn, & Excel provides proof of concept that a reader's approach to engaging with academic text can be objectively and automatically captured. Clinical implications and suggestions to improve the sensitivity of the code are discussed. Supplemental Material https://doi.org/10.23641/asha.8204786.
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Affiliation(s)
- Priya Kucheria
- Department of Communication Disorders and Sciences, University of Oregon, Eugene
| | - McKay Moore Sohlberg
- Department of Communication Disorders and Sciences, University of Oregon, Eugene
| | - Jason Prideaux
- Department of Computer and Information Science, University of Oregon, Eugene
| | - Stephen Fickas
- Department of Computer and Information Science, University of Oregon, Eugene
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22
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Mah K, Gladstone B, King G, Reed N, Hartman LR. Researching experiences of childhood brain injury: co-constructing knowledge with children through arts-based research methods. Disabil Rehabil 2019; 42:2967-2976. [PMID: 30973787 DOI: 10.1080/09638288.2019.1574916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: In the knowledge base examining experiences of childhood brain injury, the perspectives of children with brain injury are notably lacking. This failure to represent the voices of pediatric clients has resulted in an incomplete knowledge base from which to inform evidence-based rehabilitation practice. In this paper, we examine why the perspectives of children with brain injury are rarely sought and propose a new way forward.Methods: We draw upon current evidence and practices in related fields and present an exemplar from an in-progress qualitative arts-based research project with children with brain injury.Results: Assumptions ingrained in research practices, particularly those surrounding the capacity of 'doubly vulnerable' children with brain injury to produce knowledge, have resulted in the relative exclusion of this group from research that concerns them. For the field to evolve, research practices must value children's first-hand accounts, engage them in co-constructing knowledge about their lives, and invite methods that meet their interests and abilities.Conclusion: By reframing how we think about the capacities of children with disabilities and shifting our research practices to include children with brain injury as knowledgeable participants, it becomes possible to expand the knowledge base upon which clinical rehabilitation practices are built.Implications for RehabilitationCurrent research practices preclude 'doubly vulnerable' pediatric populations, including children with brain injury, from actively contributing to research that concerns them.As a result, the perspectives of children with brain injury are virtually absent from research, rendering the evidence base upon which rehabilitative practices are built incomplete.Reframing how we think about the capacities of children with brain injury can shift how we engage with them, both in research and clinic, and may subsequently impact the knowledge available to us.Implications for client-centred rehabilitation are discussed, including the need to understand children as capable of insight into their own experience, as able to contribute to a more complete understanding of the health phenomena that affect them, and as invaluable and active participants in research and clinical care.
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Affiliation(s)
- Katie Mah
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Brenda Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Canada
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Laura R Hartman
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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23
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Factors Associated with Difficulty in Returning to School in Students After Traumatic Brain Injury. J UOEH 2019; 40:299-305. [PMID: 30568081 DOI: 10.7888/juoeh.40.299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Traumatic brain injury (TBI) often causes behavioral problems and difficulties with school work, but the specific factors associated with difficulty in returning to school after TBI still remain unclear. The purpose of this study was to investigate factors associated with difficulty in returning to school within 1 year of injury in students with traumatic brain injury. This study is a secondary analysis of existing data sets. We recruited patients aged 16 years in the United States with a primary rehabilitation diagnosis of TBI registered in the Traumatic Brain Injury Model Systems National Database. We compared variables between the students who returned to school and those who did not return to school. In addition, subgroup analyses were performed focused on traumatic brain injury severity. We excluded those were received <10 years of schooling, and 309 eligible students were identified for the analysis. Of these, 246 (80%) did not return to school within 1 year of injury. There were fewer cases of severe TBI in the group of students who returned to school than in the group who did not return to school (29% vs 44%, P = 0.03). The duration of rehabilitation was significantly longer in the group who returned to school than in the group who did not return to school (mean days 40 vs 29, P = 0.001), and a subgroup analysis showed in the severe traumatic brain injury group (mean days 46 vs 29; P = 0.02) and the non-severe traumatic brain injury group (mean days 37 vs 26; P = 0.02) similar results. Insufficient amount of rehabilitation was associated with difficulty in returning to school in students after TBI, regardless of the severity of the injury.
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24
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Douglas J. Loss of friendship following traumatic brain injury: A model grounded in the experience of adults with severe injury. Neuropsychol Rehabil 2019; 30:1277-1302. [PMID: 30755079 DOI: 10.1080/09602011.2019.1574589] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Relationships make important contributions to wellbeing and maintenance of self-worth. For those who sustain traumatic brain injury (TBI), life is frequently characterized by declining interpersonal relationships. The aim of this study was to understand the post-injury experience of friendship from the perspective of adults with severe TBI. Participants were 23 adults who had sustained severe TBI on average 10 years earlier; the majority was between 25 and 45 years old. The experience of friendship was explored using a convergent mixed methods design (quantitative self-report measures and in-depth interviews). Qualitative analysis of interview transcripts employed open and focussed coding to reveal themes and categories. Participants nominated on average 3.35 (SD 2.19) friends. When paid carers and family members were excluded, the mean dropped to 1.52 (SD 1.38). Exploratory correlations between number of friends and quality of life, depression and strong-tie support revealed significant associations of moderate to large effects. The post-injury experience of friendship was broadly conceptualized as "going downhill" with four overlapping phases: losing contact, being misunderstood, wanting to share and hanging on. Participants' stories illustrated how rehabilitation can focus on friendship by supporting established relationships and facilitating access to activities that afford interpersonal encounters and opportunities to share experiences.
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Affiliation(s)
- Jacinta Douglas
- Living with Disability Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia.,NHMRC Centre of Research Excellence in Traumatic Brain Injury Psychosocial Rehabilitation, Canberra, Australia
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25
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Mealings M, Douglas J, Olver J. Is it me or the injury: Students’ perspectives on adjusting to life after traumatic brain injury through participation in study. Neuropsychol Rehabil 2019; 30:1255-1276. [DOI: 10.1080/09602011.2019.1574231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Margaret Mealings
- La Trobe University College of Science Health and Engineering, Bundoora, Australia
- Epworth Healthcare, Richmond, Australia
| | - Jacinta Douglas
- La Trobe University College of Science Health and Engineering, Bundoora, Australia
- Summer Foundation, Box Hill, Australia
| | - John Olver
- Epworth Healthcare, Richmond, Australia
- Epworth Monash Rehabilitation Medicine Unit, Richmond, Australia
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26
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Minney MJ, Roberts RM, Mathias JL, Raftos J, Kochar A. Service and support needs following pediatric brain injury: perspectives of children with mild traumatic brain injury and their parents. Brain Inj 2018; 33:168-182. [PMID: 30396278 DOI: 10.1080/02699052.2018.1540794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To provide a qualitative examination of the service and support needs of children who have had a mild traumatic brain injury (mTBI), and their parents, in order to improve clinical services. METHODS Semi-structured interviews were conducted with 9 children (8-12 years; M = 10.6 years, SD = 0.8) and their parents (n = 9) 29-55 days (M = 34 days; SD = 9.3) after presenting to an Australian Paediatric Emergency Department (PED) for mTBI. Children's post-concussive symptoms (PCS) were additionally measured using the Post-Concussive Symptom Inventory (PCSI). Audio recordings were transcribed, and a thematic analysis was conducted. RESULTS Post-injury needs were reflected in four main themes: Communication; Family Burden; Continuity of Care; and Social and Community Support. These themes reflected children's and parents' needs for information, emotional/social/community support, and follow-up care. Both the children's and parents' needs, and the extent to which they were met, appeared to be related to the severity and duration of the child's PCS. CONCLUSIONS Dedicated pediatric mTBI follow-up services that build on family's resources and meet their individual needs for information, emotional support, and referral may assist in optimizing post-injury outcomes.
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Affiliation(s)
- M J Minney
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - R M Roberts
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - J L Mathias
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - J Raftos
- b Pediatric Emergency Department , Women's & Children's Hospital , North Adelaide , Australia
| | - A Kochar
- b Pediatric Emergency Department , Women's & Children's Hospital , North Adelaide , Australia
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Rockswold SB, Burton PC, Chang A, McNally N, Grant A, Rockswold GL, Low WC, Eberly LE, Yacoub E, Lenglet C. Functional Magnetic Resonance Imaging and Oculomotor Dysfunction in Mild Traumatic Brain Injury. J Neurotrauma 2018; 36:1099-1105. [PMID: 30014758 DOI: 10.1089/neu.2018.5796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is a significant cause of disability, especially when symptoms become chronic. This chronicity is often linked to oculomotor dysfunction (OMD). To our knowledge, this is the first prospective study to localize aberrations in brain function between mTBI cohorts, by comparing patients with mTBI with OMD with an mTBI control group without OMD, using task and resting-state functional magnetic resonance imaging (fMRI). Ten subjects with mTBI who had OMD (OMD group) were compared with nine subjects with mTBI who had no findings of OMD (control group). These groups were determined by a developmental optometrist using objective testing for OMD. The (convergence) task fMRI data demonstrated significantly decreased brain activity, measured as decreases in the blood oxygen level dependent (BOLD) signal, in the OMD group compared with the control group in three brain regions: the left posterior lingual gyrus, the bilateral anterior lingual gyrus and cuneus, and the parahippocampal gyrus. When doing a seed-based resting state fMRI analysis in the lingual/parahippocampal region, a large cluster covering the left middle frontal gyrus and the dorsolateral pre-frontal cortex (Brodmann areas 9 and 10), with decreased functional correlation in the OMD group, was identified. Together these observations provide evidence for neural networks of interactions involving the control of eye movement for visual processing, reading comprehension, spatial localization and navigation, and spatial working memory that appear to be decreased in mTBI patients with OMD compared with mTBI patients without OMD. The clinical symptomatology associated with post-traumatic OMD correlates well with these MRI findings.
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Affiliation(s)
- Sarah B Rockswold
- 1 Department of Physical Medicine and Rehabilitation, Hennepin County Medical Center, Minneapolis, Minnesota.,2 Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, Minnesota
| | - Philip C Burton
- 3 Department of Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Amy Chang
- 1 Department of Physical Medicine and Rehabilitation, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Nova McNally
- 1 Department of Physical Medicine and Rehabilitation, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Andrea Grant
- 3 Department of Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Gaylan L Rockswold
- 4 Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota.,5 Division of Neurosurgery, Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Walter C Low
- 4 Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
| | - Lynn E Eberly
- 6 Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Essa Yacoub
- 3 Department of Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Christophe Lenglet
- 3 Department of Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
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Stakeholders’ Perspectives on Communication and Collaboration Following School Reintegration of a Seriously Ill Child: A Literature Review. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9443-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Peebles P, Cruz S. A primer on traumatic brain injury for nursing faculty. J Prof Nurs 2018; 34:488-493. [PMID: 30527698 DOI: 10.1016/j.profnurs.2018.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 12/21/2017] [Accepted: 01/10/2018] [Indexed: 11/29/2022]
Abstract
Incidence of traumatic brain injury (TBI) is increasing on campuses. Despite growing media attention and athletic program protocols to address the issue, many are unaware of the potential effects such an injury can cause. This may be true for nursing faculty who teach or advise students recovering from TBI. This article will examine relevant aspects of injury and recovery, as well as ways faculty can advocate for and support students who struggle during what can be a protracted period of recovery. Students' symptoms while recovering from TBI may diminish cognitive, emotional, and physical resources. Because individual responses to similar injuries may vary significantly, an individualized plan of academic support is important. A key component to academic support for students with TBI is integrated communication between athletic department staff, students, faculty, and administration.
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Affiliation(s)
- Patricia Peebles
- Goshen College School of Nursing, 1700 S. Main St. Goshen, IN 46526, United States.
| | - Sydney Cruz
- Goshen College School of Nursing, 1700 S. Main St. Goshen, IN 46526, United States
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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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Mealings M, Douglas J, Olver J. Beyond academic performance: Practice implications for working with students following traumatic brain injury. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:441-453. [PMID: 27778519 DOI: 10.1080/17549507.2016.1221453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 07/29/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Speech-language pathologists (SLPs) have a key role in supporting educational participation for secondary and tertiary students with traumatic brain injury (TBI). This article aims to (i) explore issues identified by students with TBI that affect educational participation beyond their academic performance, (ii) offer a framework based on research evidence to guide the practice of SLPs and (iii) explore strategies that may expand the traditional roles of SLPs to support students beyond academic performance. METHOD Data were drawn from an earlier qualitative research project in which three adolescent males were interviewed about their experiences of returning to education after severe TBI. Interviews were recorded, transcribed verbatim and analysed using a grounded theory approach. RESULT Six themes were identified that had a substantial impact beyond academic performance: poor community awareness of TBI, the invisible nature of TBI, getting back to everyday life, planning to return to education, being accepted and adjusting to long-term changes. Incorporating these factors, a clinical framework is put forward to guide SLPs in developing strategies for promoting positive educational participation. CONCLUSION By considering factors beyond academic performance and addressing these in intervention, SLPs may significantly improve the overall educational success and wellbeing of students living with TBI.
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Affiliation(s)
- Margaret Mealings
- a Department of Community and Clinical Allied Health, La Trobe University , Bundoora , Australia
- b Epworth Rehabilitation, Epworth Healtchare , Richmond , Australia
| | - Jacinta Douglas
- a Department of Community and Clinical Allied Health, La Trobe University , Bundoora , Australia
- c Summer Foundation , Box Hill , Australia , and
| | - John Olver
- b Epworth Rehabilitation, Epworth Healtchare , Richmond , Australia
- d Epworth Monash Rehabilitation Medicine Unit , Richmond , Australia
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Roessler RT, Rumrill PD, Rumrill SP, Minton DL, Hendricks DJ, Sampson E, Stauffer C, Scherer MJ, Nardone A, Leopold A, Jacobs K, Elias E. Qualitative case studies of professional-level workers with traumatic brain injuries: A contextual approach to job accommodation and retention. Work 2017; 58:3-14. [PMID: 28922180 DOI: 10.3233/wor-162601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a multi-systemic disability that causes a wide range of difficulties with personal and social functioning. METHODS Four individuals with TBI participated in an evaluation of barriers to their continued employment following graduation from college. A trained interviewer completed the Work Experience Survey (WES) in teleconsultation sessions with each participant. RESULTS Researchers applied a qualitative case study research design. Participants reported a wide range of difficulties in performing essential functions of their jobs (3 to 24) that have the potential to significantly affect their productivity. Career mastery problems reflected outcomes associated with TBI such as 'believing that others think I do a good job' and 'having the resources (e.g., knowledge, tools, supplies, and equipment) needed to do the job.' Indicative of their wish to continue their current employment, participants reported high levels of job satisfaction. CONCLUSIONS The WES is a cost-effective needs assessment tool to aid health and rehabilitation professionals in providing on-the-job supports to workers with TBI.
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Hamilton C, Maw A, Gill A, Brahmbhatt M, Phaal R, Pickard J. Paediatric neurorehabilitation: finding and filling the gaps through the use of the Institute for Manufacturing strategic roadmapping method. ACTA ACUST UNITED AC 2017. [DOI: 10.1136/bmjinnov-2017-000202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IntroductionAcquired brain injury (ABI) is a major cause of morbidity and mortality in childhood. Specialist rehabilitation services are often situated far from families and local services may be non-standardised and fragmented. A strategic level of understanding is needed to improve patient care and outcomes. Roadmapping techniques are commonly used in industry settings to discover and present a systematic understanding of structures; however, they are rarely used in the healthcare setting. With continuing pressures on healthcare systems worldwide, they provide an effective method for examining services.MethodsThe Institute for Manufacturing (IfM) strategic roadmapping method was used to identify areas of difficulty and opportunities in paediatric neurorehabilitation. Participants included stakeholders from a wide range of professions and sectors who have input with children after ABI.ResultsDelegates identified a range of ‘layers’ covering trends, drivers, current experience and unmet needs. From these layers, four priorities were identified and further expanded.These included: ‘access to medical and therapy expertise close(r) to home’, ‘shared understanding across family, school and health’, ‘family and professional awareness of resources and support’ and ‘establishing a centre for rehabilitation technology evaluation, advice and co-ordination of services and research’.ConclusionThe IfM strategic roadmapping method identified and developed key areas for development in the field of paediatric neurological rehabilitation. Healthcare professionals looking at strategic level difficulties should strongly consider the use of such systematic tools when evaluating areas of practice.
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Case Management for Children and Adolescents with Acquired Brain Injury in Community Settings: A Scoping Review. BRAIN IMPAIR 2017. [DOI: 10.1017/brimp.2017.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Acquired brain injury is the leading cause of death and disability in children after infancy. Childhood brain injury has long-term consequences for children and parents, including challenges with returning to school, ongoing health and behaviour concerns, family functioning and demands on carers. Community-based case management interventions are a vital contribution to community supports.Aims: This scoping study aims to scope and map the literature on case management, to identify how case management is described in the literature for children and adolescents with acquired brain injury (0–17 years).Methods: A scoping review was completed of published articles on case management from four major databases (CINAHL, MEDLINE, PUBMed and Embase) between 2005 and 2015. Articles were selected against inclusion criteria and reviewed.Results: Eight articles of 2688 records met the inclusion criteria and were reviewed. Case management was provided by case managers and other health professionals. The case management interventions described were mapped to the International Classification of Health Interventions and the Brain Injury Case Management Taxonomy (BICM-T). Case management addressed a range of needs including return to school, family issues and ongoing medical needs. There were anecdotal reports of effectiveness of case management during the return to school process.Conclusion: This scoping study reveals a lack of information on this topic. Improved reporting of case management interventions and more research on case management is needed for children and adolescents with brain injury.
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Andersson K, Bellon M, Walker R. Parents’ experiences of their child’s return to school following acquired brain injury (ABI): A systematic review of qualitative studies. Brain Inj 2016; 30:829-38. [DOI: 10.3109/02699052.2016.1146963] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kerstin Andersson
- Disability and Community Inclusion, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Michelle Bellon
- Disability and Community Inclusion, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Ruth Walker
- Disability and Community Inclusion, School of Health Sciences, Flinders University, Adelaide, Australia
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Hartman LR, Tibbles A, Paniccia A, Lindsay S. A Qualitative Synthesis of Families' and Students' Hospital-to-School Transition Experiences Following Acquired Brain Injury. Glob Qual Nurs Res 2015; 2:2333393615614307. [PMID: 28462322 PMCID: PMC5342636 DOI: 10.1177/2333393615614307] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 11/17/2022] Open
Abstract
Acquired brain injury (ABI) is one of the greatest causes of death and disability among children in Canada. Following ABI, children are required to transition back to school and adapt to the physical, cognitive, behavioral, social, and emotional demands of the school environment. We conducted a qualitative systematic review of students' and parents' experiences of the transition back to school following ABI. We identified 20 articles that met our inclusion criteria. Six themes emerged: (a) lack of ABI-specific education for families and professionals, (b) communication-related factors as a facilitator and/or barrier to transition, (c) emotional focus, (d) peer relationships, (e) supports, and (f) ABI sequelae in the classroom. Students' and families' personal motivations and abilities and the support they receive in their environment affect their experiences of transitioning back to school and the disrupted occupations they face.
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Affiliation(s)
- Laura R Hartman
- Bloovreiw Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Alana Tibbles
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Alicia Paniccia
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Sally Lindsay
- Bloovreiw Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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Hartman LR, Duncanson M, Farahat SM, Lindsay S. Clinician and educator experiences of facilitating students’ transition back to school following acquired brain injury: A qualitative systematic review. Brain Inj 2015; 29:1387-99. [DOI: 10.3109/02699052.2015.1071431] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kirk S, Fallon D, Fraser C, Robinson G, Vassallo G. Supporting parents following childhood traumatic brain injury: a qualitative study to examine information and emotional support needs across key care transitions. Child Care Health Dev 2015; 41:303-13. [PMID: 25039833 DOI: 10.1111/cch.12173] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Traumatic brain injury (TBI) is the leading cause of death and acquired disability in childhood. Research has demonstrated that TBI can lead to long-term physical, cognitive, emotional and behavioural difficulties for children and parental stress. Less is known about how parents experience a childhood brain injury and their information and support needs. This study aimed to examine parents' experiences and support needs following a childhood TBI from the time of the accident to their child's discharge home. METHODS Qualitative semi-structured interviews were conducted with 29 parents/carers of children who had experienced a severe TBI. Participants were recruited from one children's tertiary centre in the UK. Data were analysed using the Framework approach. RESULTS Parents had unmet information and emotional support needs across the care trajectory from the time of the accident to their child's return home. Information needs related to the impact of the TBI on their child; current and future treatment/rehabilitation plans; helping their child and managing their behaviour; accessing services/support. They lacked information and support for care transitions. In different settings parents faced particular barriers to having their information needs met. Parents' felt they needed emotional support in coming to terms with witnessing the accident and the loss of their former child. Lack of community support related not only to service availability but to a general lack of understanding of the impact of TBI on children, particularly when this was invisible. Overall parents felt unsupported in coping with children's behavioural and psychological difficulties. DISCUSSION Taking a holistic approach to examining parents' experiences and support needs has enabled their changing needs to be highlighted across key care transitions within hospital and community settings and the service implications identified. Improvements in care co-ordination across care transitions are needed to ensure continuity of care and integration of support.
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Affiliation(s)
- S Kirk
- School of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK
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Abstract
Concussion is one of the most hotly debated topics in sports medicine today. Research surrounding concussion has experienced significant growth recently, especially in the areas of incidence, assessment, and recovery. However, there is limited research on the most effective rehabilitation approaches for this injury. This review evaluates the current literature for evidence for and against physical and cognitive rest and the emerging areas targeting vestibular, oculomotor, and pharmacologic interventions for the rehabilitation of sport-related concussion.
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Kennedy MRT, Krause MO, O’Brien KH. Psychometric properties of the college survey for students with brain injury: Individuals with and without traumatic brain injury. Brain Inj 2014; 28:1748-57. [DOI: 10.3109/02699052.2014.955883] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Gabbe BJ, Brooks C, Demmler JC, Macey S, Hyatt MA, Lyons RA. The association between hospitalisation for childhood head injury and academic performance: evidence from a population e-cohort study. J Epidemiol Community Health 2014; 68:466-70. [PMID: 24419234 PMCID: PMC3995280 DOI: 10.1136/jech-2013-203427] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Childhood head injury has the potential for lifelong disability and burden. This study aimed to establish the association between admission to hospital for childhood head injury and early academic performance. METHODS The Wales Electronic Cohort for Children (WECC) study is comprised of record-linked routinely collected data, on all children born or residing in Wales. Anonymous linking fields are used to link child and maternal health, environment and education records. Data from WECC were extracted for children born between September 1998 and August 2001. A Generalised Estimating Equation model, adjusted for clustering based on the maternal identifier as well as other key confounders, was used to establish the association between childhood head injury and performance on the Key Stage 1 (KS1) National Curriculum assessment administered to children aged 5-7 years. Head injury was defined as an emergency admission for >24 h for concussion, skull fracture or intracranial injury prior to KS1 assessment. RESULTS Of the 101 892 eligible children, KS1 results were available for 90 661 (89%), and 290 had sustained a head injury. Children who sustained an intracranial injury demonstrated significantly lower adjusted odds of achieving a satisfactory KS1 result than children who had not been admitted to hospital for head injury (adjusted OR 0.46, 95% CI 0.30 to 0.72). CONCLUSIONS The findings of this population e-cohort study quantify the impact of head injury on academic performance, highlighting the need for enhanced head injury prevention strategies. The results have implications for the care and rehabilitation of children admitted to hospital with head injury.
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Moving Ahead: A New Centre of Research Excellence in Brain Recovery, Focusing on Psychosocial Reintegration Following Traumatic Brain Injury. BRAIN IMPAIR 2012. [DOI: 10.1017/brimp.2012.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Severe traumatic brain injury (TBI) is the most common cause of brain injury in the Western world and leads to physical, cognitive and emotional deficits that reduce independence. Changes to psychosocial function are the most disruptive, resulting in vocational difficulties, family stress and deteriorating relationships, and are a major target for remediation. But rehabilitation is expensive and its evidence base is limited. Thus, new collaborative initiatives are needed. This article details the development of ‘Moving Ahead’, a model for a Centre of Research Excellence (CRE) for Traumatic Brain Injury Rehabilitation. This CRE offers several major innovations. First, it provides an integrated, multi-faceted approach to addressing psychosocial difficulties embracing different clinical standpoints (e.g., psychological, speech pathology, occupational therapy) and levels of investigation (e.g., basic science to community function) across the lifespan. It is based upon a close relationship with clinicians to ensure transfer of research to practice and, conversely, to ensure that research is clinically meaningful. It provides an integrated platform with which to support and train new researchers in the field via scholarships, postdoctoral fellowships, websites, meetings, mentoring and across-site training, and thus build workforce capacity for individuals with TBI and their families. It has input from the international community to contextualise research more broadly and ensure scientific rigour. Finally, it provides collaboration across sites to facilitate research and data collection.
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