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.
Service Aims – to:
a) improve the mental health and well-being of brain injured young people and
b) support their ongoing recovery by providing tailored support that addresses a range of complex needs post brain injury.
In our experience it is cognitive impairment that has the biggest impact on learning, development, employment, earning potential and future life chances.
How do we develop Cognitive Skills?
Cognitive skills start to develop soon after a baby is born. 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, skills and the ability to problem solve.
Loss of Cognitive skills
Following an acquired brain injury, cognitive problems are extremely common and can be more problematic in the longer term than physical problems. The areas of the brain that have been damaged can determine the sort of problems a person might have. 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.
What is Cognitive Rehabilitation Therapy?
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 think, read, learn, remember, reason and pay attention. Working together, they take incoming information 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.
CRT is a neuro-rehabilitation therapeutic intervention that addresses a range of problems such as memory, attention, insight, coordination, communication, information processing, all of which are key skills both for learning, 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. It is therefore 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.
The impacts of not doing Cognitive Rehabilitation Therapy
It is assumed that neuro-rehabilitation happens in schools and colleges and is delivered by the Special Education Needs Support Services. Unfortunately we now know this to be untrue. Experience has taught us that a child returning to school with cognitive impairments following an acquired brain injury; will leave with cognitive impairments. We are finding that brain injured young people are often unable to maintain employment as a result.
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 in certain workplace environments; particularly where stringent health and safety practices are essential for ensuring their own wellbeing and that of others. Cognitive Rehabilitation Therapy is therefore essential to target these key skills and ensure better long-term outcomes.
Aims of Cognitive Rehabilitation Therapy
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
2. Process Training: Focus: Restoration of lost functions
3. Strategy Training: Focus: Compensation for the problem if it is not resolving effectively
4. Functional Activities Training: Focus: Real life improvements
How is CRT delivered?
Following a detailed assessment process to identify any cognitive impairments, our children and young people receive a written Therapy Plan and a detailed Home Programme.
Additionally, they receive 1-3 sessions per week of 1-1 CRT and emotional support, that can be delivered in school, at home or another community venue; plus a range of homework tasks.
You can download a copy of our Cognitive Rehabilitation Factsheet in Information.
"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"
"Restoration of anatomical functions and relationships must be done within 2 months of brain injury"
"Participation in teen sports and normal activities leads to improved quality of life for children and young people post brain injury and helps to maximise outcomes"
"Often families don't have the financial capability to access services. We need to rethink how we deliver neuro-rehab services to children and young people"
"New parenting support intervention showed how parenting style is related to executive dysfunction in children and young people post brain injury. With support parents cope better so the child has a better recovery"
"We need to harness the power of brain plasticity for treating children and young people with brain injury. Stressful experiences alter brain development of a child, especially at the key ages of 0-3 and at ages 10-16"
"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"
"Our 10 year study proves that family-led home-based neuro-rehab interventions deliver the best outcomes for children and young people"
"Case management for children and young people post acquired brain injury is 'pivotal' to successful outcomes and must be local"
"Parent-supported interventions after pediatric ABI bring reductions to the cost to society"