Journal of Pediatric Rehabilitation Medicine - Volume 3, issue 4
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Journal of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach is an international journal designed to parallel the multi-disciplinary team approach of caring for a child with an acute or chronic disease. The issues will primarily be themed and broad in scope including, but not be limited to cerebral palsy, traumatic brain injury, spinal cord injury, spina-bifida, amputation, muscular dystrophies of all types, stroke, cancer, mental retardation, developmental delays, and others.
The aim is to include a wide range of experts who care for children with the above diagnosis. Authorship by two different disciplines is requested though not required to encourage an interdisciplinary and collaborative approach. The goal is for the reader to obtain not just the medical perspective, but also nursing, occupational, physical and speech therapy, psychology, home care, etc., in providing the most comprehensive care for children. Manuscripts will be blinded and peer reviewed with appropriate feedback. Statistical analysis will be reviewed by the biostatistician. Readers are encouraged to submit and or suggest case reviews, commentaries, editorials, original research, conference schedules, or reviews.
Abstract: Objective: The purpose of this study was to focus on two linguistic abilities, word retrieval (expressive language) and comprehension of vocabulary and grammar (receptive language), as well as to investigate to what extent long-term problems exist in these areas in children following traumatic brain injury. Methods: Two groups of children were studied retrospectively: twenty-four children with traumatic brain injury (TBI) and twenty-one children diagnosed with brain tumour. All children had been referred to the…rehabilitation team for assessment. The children were between four and seventeen years old when assessed, with the assessments performed at least one year after the injury or brain tumour diagnosis. An established set of tests regarding word retrieval and comprehension of vocabulary and grammar was used, and the results were compared with normative test data. Results: In both clinical groups, significantly more children scored lower than the designated "normal" score than in the normative sample on tests measuring confrontation naming and phonological word retrieval. In addition, in the brain tumour group, more children demonstrated significantly lower results than normal performance on a test for semantic word retrieval. In the TBI group, significantly more children scored below the normal value on tests of word and grammatical comprehension when compared to the normative sample. Conclusions: This study confirms that word retrieval is an area of deficit in many children with acquired brain injuries one year or more after the injury occurred. The study also indicates that children with TBI may have persistent deficits in comprehension of both vocabulary and grammar.
Keywords: Traumatic brain injury, acquired brain injury, brain tumour, word retrieval, language comprehension, language disorders
Abstract: Objective: To investigate the use of medical equipment by children with disabilities, the reasons for use, and prescribers of equipment. Methods: A convenience sample. Setting: Referral clinic for children with developmental conditions. Participants: Caregivers of children with motor disabilities completed an interview survey for children 0–21 years. Results: 108 parents/caregivers reported 467 (mean=4.3 per patient) pieces of owned equipment. The mean age of children was 7.1 years (± 5.0), and 49% were…female. The most common diagnoses were cerebral palsy (45%), 'Other' diagnoses including intellectual disability (19%), genetic abnormality (13%), spina bifida (13%), and neuromuscular diseases (7%). Survey participants described use of the following types of equipment: orthotics (82%), bath chair (37%), seating device (34%), stander (19%), augmentative communication devices (17%), walker (14%), and gait trainer (10%). Reasons for "non-use" of equipment included: outgrown (19%), not useful (14%), and child refusal (15%). Physicians were the sole prescriber for 15% of families, whereas physical or occupational therapists most commonly recommended new equipment (76%). Conclusion: Based on parental report, children with neuromuscular disabilities use most equipment that is medically recommended. The majority of equipment needs are identified by therapists. Pediatricians can benefit from additional expertise in the provision of medical equipment for children.
Keywords: Medical equipment, children with disabilities, assistive technology, use of medical equipment, cerebral palsy
Abstract: Children and youth who sustain a traumatic brain injury (TBI) and/or spinal cord injury (SCI) may have temporary or permanent disabilities that affect their speech, language and communication abilities. Having a way to communicate can help reduce children's confusion and anxiety, as well as enable them to participate more actively in the rehabilitation process and thus, recover from their injuries. In addition, effective communication with family, care staff, peers, teachers and friends is essential to long-term…recovery and positive outcomes for children with TBI and SCI as they are integrated back into their communities. This article describes how rehabilitation teams can use augmentative and alternative communication (AAC) and assistive technologies (AT) to support the communication of children recovering from TBI and SCI over time.
Abstract: This article introduces the roles of parents and rehabilitation professionals in the provision of communication supports for children who cannot meet their communication needs through natural speech alone, also referred to as individuals with complex communication needs (CCN). The authors present a personnel framework, introduce intervention models of augmentative and alternative communication (AAC) services, and address issues parents face in preparing to provide communication supports to children with CCN using AAC and…assistive technology (AT).
Keywords: Augmentative and alternative communication, rehabilitation, pediatrics, children
Abstract: Children in pediatric intensive care units (PICUs) may experience a broad range of motor, sensory, cognitive, and linguistic difficulties that make it difficult for them to communicate effectively. Being unable to communicate is emotionally frightening for children and can lead to an increase in sentinel events, medical errors and extended lengths of stay. Implementation of augmentative and alternative communication (AAC) tools and strategies can address the communication needs of children in the PICU by enabling them…to communicate their wants, needs and feelings to healthcare providers and family members and participate in their own care more productively. Hospitals around the world are increasingly recognizing and addressing patients' needs for communication access and have begun to implement communication screenings and assessments and interventions at admission and throughout the hospital stay. New standards for all American hospitals, in fact, mandate efforts to improve patient communication. When patient-provider communication improves, treatment success goes up, hospital-caused errors decrease and patient and family satisfaction improve. This article describes three phases of intervention for communication vulnerable children in the PICU and provides examples of treatment approaches that ensure communication access as their medical condition changes.
Keywords: Children, augmentative and alternative communication, AAC, communication, assistive technology, pediatric intensive care unit, pediatric, hospital, communication vulnerable, sentinel events
Abstract: Children with complex communication needs (CCN) who require augmentative and alternative communication (AAC) are at considerable risk in many aspects of their development: (a) functional communication skills, (b) speech development, (c) language development, (d) cognitive/conceptual development, (e) literacy development, (f) social participation, (g) access to education, and (h) overall quality of life. Early intervention is critical to address these areas and provide successful and functional outcomes. AAC offers the potential to enhance…communication, language, and learning for children with significant communication disabilities. This paper provides an overview of the effects of AAC interventions on communication, behavior, language, and speech outcomes for young children with CCN for pediatricians and other medical and rehabilitation professionals. Future research directions to maximize the communication development of young children with CCN are also discussed.
Keywords: Young children, AAC, language, communication, assistive technology
Abstract: Pediatric rehabilitation specialists have key roles to play in preparing young people with complex communication needs (CCN) to participate in the adult health care system. As adults, individuals with CCN are responsible for describing their health needs, scheduling services, and self-advocating with health care specialists so they can access habilitation and rehabilitation services and technologies and have their health concerns addressed. Pediatric rehabilitation specialists can help adolescents with CCN (and their support…teams) acquire both an understanding of how adult services are organized, as well as the health literacy, communication, and collaboration skills they will need to ensure successful health outcomes.
Keywords: Health literacy, transition, adolescent, communication, complex communication needs
Abstract: The Communication Matrix  is an assessment instrument that is designed to evaluate the expressive communication skills of children with severe and multiple disabilities. It accommodates any type of communicative behavior, including forms of augmentative and alternative communication (AAC) such as picture systems, electronic devices, sign language and 3-dimensional symbols; pre-symbolic communication such as gestures, body movements, sounds, eye gaze and facial expressions; as well as the typical forms of communication such…as speech and writing. It covers seven levels of communication observed in typically developing infants during the first two years of life. The instrument, which is widely used to assess children with severe acquired and congenital disorders in community and school settings, is appropriate for both inpatient and outpatient pediatric rehabilitation. Data from an associated database demonstrating the value of this tool for clinical service and research are presented.
Keywords: Assessment, communication skills, online tool