We are delighted to announce that we now have a dedicated ABI Support Worker for brain injured children and young people. This is an exciting new development for the charity and is already having a positive effect on some of the children we work with. This innovative post has been part-funded by BBC Children in Need.
a) improve the mental health and well-being of brain injured young people by offering knowledgeable support and
b) support their ongoing recovery by providing tailored support that addresses a range of complex and often unrecognised needs post brain injury.
Cognitive skills start to develop soon after a baby is born and parents play a key role in this. As soon as they come into the world the baby begins to absorb and process information from their environment. They grow and develop rapidly in the first five years of life. As information is gathered and stored in their brains, children develop knowledge, understanding, physical, communication, cognitive, emotional and behavioural skills; including the ability to problem solve. However an acquired brain injury can change all that and these skills can be lost or impaired.
Following an acquired brain injury, cognitive problems are extremely common and can be more problematic in the longer term than physical problems. Research is showing that even a mild head injury can create long term problems.
The areas of the brain that have been damaged may determine the sort of problems a person might have; however neural pathways are complex structures so any number of neurological functions may be affected.
It is also important to consider that our brains continue to develop well into early adulthood; so the true impact of a brain injury sustained in childhood may not become apparent for several years.
Typically, difficulties only emerge in teenage years when there is another big surge in brain development and they fail to keep up with their peers. However some of our younger children in primary school are already behind their peers; meaning they are already on a different learning and development trajectory.
For families it is the cognitive, emotional and behavioural problems have the biggest negative impact on family life.
However, it is cognitive impairment that has the biggest impact on learning, development, employment, future earning potential, future life chances and social mobility.
It is assumed that neuro-rehabilitation activity happens in schools and colleges because these children and young people often need Special Education Needs Support or Specialist Teaching Support Services. Unfortunately from the lived experience perspective, we now know this to be untrue and this is also backed up by research and the poor life experiences of brain injured children and young people.
Experience has taught us that a child returning to school with cognitive impairments following an acquired brain injury; will leave with the same level of cognitive impairments. We are finding that brain injured young people are often unable to maintain employment as a result, meaning the impacts of a childhood acquired brain injury has life-long negative effects.
Problems with executive functions, memory, attention, coordination and perception, go on to affect: training, development and on-the-job learning; speed of learning; following instructions; and the ability to transfer learning into action in the workplace.
This can also leave them extremely vulnerable both in the community and in certain workplace environments; particularly where stringent health and safety practices are essential for ensuring their own wellbeing and that of others.
There is a growing knowledge base of the impact acquired brain injury has on the lives of brain injured children and young people.
Cognitive Rehabilitation Support is therefore essential to target these key skills and ensure better long-term outcomes for children and young people.
Cognitive Rehabilitation Therapy (CRT) is the process of re-learning cognitive skills that have been lost or altered as a result of damage to the brain. Cognitive skills are the core skills your brain uses to understand, think, read, learn, remember, reason and pay attention.
Working together, they take incoming information from sensory processes and move it into the store of knowledge you use in everyday life. These skills are not to do with intelligence but a deficit in any of them can affect your ability to learn.
Each cognitive skill plays an important part in processing new information. In order to grasp, retain and use any new information effectively, all your cognitive skills need to be working properly. Sadly this is not addressed by schools for children and young people.
CRT is a neuro-rehabilitation intervention that addresses a range of problems such as memory, attention, insight, coordination, information processing and communication (which includes comprehension, reading, writing, maths as well as speaking). All are key skills both for learning, day-to-day life and working life. If these skills are impaired, a child will often not do well at school; they may be repeatedly or permanently excluded; and they will continue to negatively affect their future life chances.
This then links to poor mental health and well-being; so it is essential that children and young people are effectively supported to re-develop cognitive skills as part of their ongoing recovery and to facilitate better long-term outcomes.
As parents we have already experience of doing this for our children, but their ability to help their child is often not recognised or understood.
The aims of CRT are to address a person’s problems if any of the cognitive skills are weak or damaged. CRT consists of 4 main areas:
1. Tutoring: Focus: To develop insight into self awareness
2. Process Training: Focus: Restoration of lost cognitive functions
3. Strategy Training: Focus: Compensation for the problem if it is not resolving effectively
4. Functional Activities Training: Focus: Real life improvements
Following a detailed assessment process to identify any cognitive impairments, our children and young people receive a written Support Plan and a detailed Home Programme.
Additionally, they receive 1-3 sessions per week of 1-1 CRT and emotional support, that is delivered in school, at home or another community venue; plus a range of homework tasks using a variety of resources.
You can download a copy of our Cognitive Rehabilitation Factsheet in Information.
"Positive and coordinated neuro-rehab interventions for children and young people is proven to bring health improvements; improve independence; reduces the need for sheltered living; decreases vulnerability; decreases drop-out rates in schools; decreases youth offending"
"We are medical practitioners. The real experts are the parents. Over the last 35 years they have taught me everything I know"
"Children and young people have poor social competence post brain injury due to reduced cognition, executive functions, and emotional control. As a result they are twice as likely to have mental health issues in the future"
"Different 'experts' involved in paediatric neuro-rehabilitation come from different organisational cultures which causes conflict and has a negative effect on the outcomes for the child."
"More play increases brain plasticity and makes for better recovery post brain injury"
"Our 10 year study proves that family-led home-based neuro-rehab interventions deliver the best outcomes for children and young people"
"Taking brain injured children home causes high stress for families. Disjointed services exacerbate family stress levels."
"Pediatric neuro-rehabilitation cannot be delivered in isolation. The needs of the child have to be looked at both holistically and within the context of the family unit. Parents need to be empowered to be parents in post-acute pediatric neuro-rehabilitation following brain injury"
"When different organisations assess different aspects of a child's neuro-rehabilitation needs, everyone looks at things from a different perspective and have conflicting priorities"
"Case management for children and young people post acquired brain injury is 'pivotal' to successful outcomes and must be local"