NeuroRehabilitation - Volume 19, issue 3

Authors: Lash, Marilyn

Article Type: Introduction

DOI: 10.3233/NRE-2004-19301

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 173-174, 2004

Authors: Hooper, Stephen R. | Alexander, Joshua | Moore, Daniel | Sasser, Howell C. | Laurent, Sherry | King, Jennifer | Bartel, Sheri | Callahan, Beth

Article Type: Research Article

Abstract: This study describes the common symptoms in children and adolescents following a traumatic brain injury (TBI) as reported by their primary caregivers. Utilizing data from a large-scale state demonstration project, 681 children who had sustained a TBI were ascertained from both Hospital Emergency Departments (n = 409) and Pediatric Inpatient settings (n = 272). The sample ranged in age from infancy to 18 years, was largely male (59.7%), and had equal numbers of Caucasian and minority patients. Most of the participants experienced a mild TBI (83%), with about 5.1% being moderate and 12% severe. Caregivers described …the presence of current symptoms (neurological, neurocognitive, behavioral, school problems) using a series of dichotomous questions regarding their child via a structured telephone interview at 1, 4, and 10 months post-injury. Inpatient children were described as manifesting more symptoms at each of the follow-up time points than their ED counterparts. At 1 month inpatients were described as having more symptoms across all 4 domains. At 4 and 10 months, the inpatients were described as having more neurocognitive symptoms and as not returning to school on a full-time basis, with behavior problems approaching significance at the 10-month point. A large number of individuals from both groups also reported persistent symptoms 10 months post-injury including headaches, attention and memory problems, low frustration tolerance, sleep problems, personality changes, and new school problems. Practical implications of these findings for the ongoing management of these children are discussed. Show more

Keywords: pediatric traumatic brain injury, TBI symptoms, symptom complaints, TBI follow-up

DOI: 10.3233/NRE-2004-19302

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 175-189, 2004

Authors: Bedell, Gary M.

Article Type: Research Article

Abstract: Objective: To describe the development and content of a follow-up survey designed to monitor needs and outcomes of children and youth with acquired brain injuries (ABI) and their families after discharge from inpatient rehabilitation. Preliminary findings pertaining to the core measure of the survey that focused on participation in home, school and community life will be presented as well. Methods: The follow-up survey was completed by sixty caregivers of children with ABI discharged from one pediatric inpatient rehabilitation program in the Northeast, USA. Time since discharge ranged from 4 months to 6.5 years. Children's ages at discharge ranged …from 4 months to 21 years and at follow-up ranged from 3 to 27 years. Results: Preliminary evidence of reliability, internal consistency and criterion-related validity was demonstrated for the participation measure. Results from exploratory factor analyses and Rasch analyses suggest that the participation measure may be measuring essentially one construct that may encompass two dimensions: Participation in movement-related activities and participation in communication and school-based social activities. Age, activity performance and child and environmental factors were associated with children's overall extent of participation. Conclusions: The results presented are preliminary yet promising. The follow-up survey is being further developed and tested. Future research also will investigate clinical utility, differences in scores among children and youth with different diagnostic conditions, and feasibility of creating separate versions of the participation measure for different age groups. Show more

Keywords: pediatric rehabilitation, outcome measurement, International Classification of Functioning

DOI: 10.3233/NRE-2004-19303

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 191-205, 2004

Authors: Gillett, Jane

Article Type: Research Article

Abstract: The Pediatric Acquired Brain Injury Community Outreach Program – an innovative, comprehensive model of care for children and youth with an acquired brain injury is described. The background to the formation of the idea is delineated and the current function of the model given. Future directions are discussed. The program addresses the needs and issues of children and youth with an acquired brain injury and their families. Subsequent literature supports the concept of care that this program espouses.

Keywords: acquired brain injury, pediatrics, community, models of care

DOI: 10.3233/NRE-2004-19304

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 207-218, 2004

Authors: Glang, Ann | Tyler, Janet | Pearson, Sue | Todis, Bonnie | Morvant, Martha

Article Type: Research Article

Abstract: Since 1991, when Traumatic Brain Injury (TBI) was established as a disability category under IDEA, educators nationwide have become increasingly aware of the unique and complex challenges these students present. Yet professionals, advocates and family members share a growing concern that the instructional needs of these students are not being met. School personnel serving these students need systematic support that includes both information about specific aspects of the student's disability and access to expert technical assistance. The goal of the TBI Team model, as developed and implemented in Iowa, Kansas, and Oregon, is to make available to schools statewide a …group of well-trained peer consultants who can provide in-service training and ongoing consultation. The TBI Team model has four components: (a) needs assessment, (b) team recruitment, (c) team training, and (d) evaluation of both implementation and outcomes. Trained Team members provide in-service training, classroom consultation, and information and resources for school staff and parents. Team operations are maintained and supported through a central office at the Department of Education. Evaluation data suggest that the Team model is a cost effective and efficient approach to supporting teachers who work with students with TBI. Show more

Keywords: traumatic brain injury, pediatric TBI, students, training methods, teacher training, personnel training, staff development

DOI: 10.3233/NRE-2004-19305

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 219-231, 2004

Authors: Gillette, Yvonne | DePompei, Roberta

Article Type: Research Article

Abstract: Youths who have traumatic brain injury (TBI) or mental retardation and other developmental disabilities often experience cognitive challenges in using memory and organization for learning, managing daily routines, or conducting social interactions. This article presents the results of a survey of 53 youth-parent-teacher triads probing their views regarding the youth's relationship with technology. Since the sample is small, results should be viewed with caution, yet keeping in mind the study presents some of the only data available on the use of generic technologies with youths who have disabilities. Primary findings indicate: 1) youths use a variety of technologies and are …more likely to be exposed to computers than cell phones or personal data assistants respectively; 2) youths with finger, reading, and copying skills use more technologies; 3) youths value many varied features of technology, but rated most highly good technical support, simple learning requirements, capacity to store information, and long battery life. The data also indicated that the most common memory and organization strategy the youths used was "someone does it for me". Show more

Keywords: assistive technology, personal data assistants, cell phones, developmental disabilities, mental retardation, traumatic brain injury

DOI: 10.3233/NRE-2004-19306

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 233-243, 2004

Authors: Turkstra, Lyn S. | Dixon, Thomas M. | Baker, Kate K.

Article Type: Research Article

Abstract: Impairments in social performance are common consequences of TBI, yet the neuropsychological basis of these impairments is not well understood. This is particularly true for adolescents, who have the highest incidence of TBI and are at a critical stage of developing social and relationship skills. To address this, adolescents with TBI were compared to their typically developing peers on a social cognition task that included Theory of Mind (ToM) questions. As ToM may be necessary for the development of culture-specific social knowledge, the two groups also were compared in regard to their social beliefs. There were significant differences between injured …and uninjured adolescents in social cognition, with group differences increasing as a function of the requirement for ToM. There were few differences in self-reported social knowledge and social beliefs. The implication of this discrepancy for the rehabilitation of adolescents with TBI is discussed. Show more

Keywords: brain injury, adolescent, theory of mind, social

DOI: 10.3233/NRE-2004-19307

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 245-256, 2004

Authors: Strauss, David | Shavelle, Robert M. | DeVivo, Michael J. | Harrison-Felix, Cynthia | Whiteneck, Gale G.

Article Type: Letter

DOI: 10.3233/NRE-2004-19308

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 257-258, 2004

Authors: Shanmugham, Kalpana | Elliott, Timothy R. | Palmatier, Andrew

Article Type: Research Article

Abstract: Background/objectives: The relationship of social problem solving abilities, health locus of control beliefs, and psychosocial impairment were examined among individuals with spinal cord injuries who were hospitalized following surgical repair of severe pressure sores. Methods: Individuals were approached after surgical repair and completed measures of problem solving, health locus of control beliefs, and psychosocial impairment after admission to the rehabilitation hospital. Results: The sample reported greater psychosocial impairment than observed in comparative data, but they did not differ from another sample in terms of health locus of control beliefs. Correlational analyses revealed that a negative orientation …toward problem solving was significantly predictive of psychosocial impairment, consistent with prior research. However, a second study found persons assigned to a brief problem solving intervention did not differ on any measure from participants in a control group. Discussion: Implications of these results are discussed from theoretical and clinical perspectives. Although social problem solving abilities were predictive of psychosocial impairment in a predicted direction, the lack of effects for the intervention suggests greater precision is needed to understand individual needs and to develop individualized intervention protocols. Show more

Keywords: spinal cord injury, pressure sore, problem solving, locus of control

DOI: 10.3233/NRE-2004-19309

Citation: NeuroRehabilitation, vol. 19, no. 3, pp. 259-269, 2004