Neuro-rehabilitation Support

What does neuro-rehabilitation do?

‘Rehabilitation aims to reduce the impact of (brain) injury by the restoration of damaged function, or compensation for lost function, within the limitations of underlying disease, to optimise physical, cognitive, psychological and social function.’      (Seeley & Hutchinson, 2006)

What do we know?

In our lived-experience and from extensive research, ‘optimisation’ does not happen in the UK, because the necessary ongoing practical support to help them to recover is not provided for children and young people. This means families are left to cope on their own with very little knowledge and understanding of what they are facing and brain injured children are subsequently lost in mental health services. 

The real life impact of these decades of failures are now being evidenced in research reports which highlight some shocking statistics across the child population within education, youth offending and the prison population, homelessness, youth unemployment, mental health services, drug and alcohol abuse and domestic violence.

Yet we know that ongoing good quality neuro-rehabilitation support is associated with

• better long-term outcomes for children and young people, and  *
• it decreases levels of distress of carers  *

* This is is the main focus of our charitable work and where we add value to existing provision by filling a distinct gap.

Additionally, professionals states that the outcome of a paediatric acquired brain injury is related to family function, economic factors and social support.  When families are left without the information and support they need – they are simply set up to fail – which then increases family stress!  

Our charity operates in an area of high deprivation, and research highlights that there is a direct link between poverty and poor socio-economic resources and poor long term outcomes post brain injury.  

Neuro-rehabilitation is therefore not just about physiotherapy, occupational therapy, speech and language therapy and psychological assessments etc. to facilitate self-care and activities of daily living (ADL’s), it must be an intensive multi faceted approach that also addresses sensory and cognitive needs, education, employment, housing, social care, socio-economic problems as well as state benefits and welfare support. 

Children, young people and their families need lots of ongoing support during the lengthy recovery journey; and for long after any NHS interventions have ended.  Single parents families also need additional support to help them to cope and share the burden and battles they often face alone.

What does work?

Our own research shows a child’s ongoing recovery is most effective if their recovery needs are addressed holistically, which it seems is far more complex than even medical professionals are aware of.  To have a positive life-long impact rehabilitation will only ever be successful if: 

• It is delivered by a coordinated and diverse community-based team, who have a sound understanding of acquired brain injury and it’s impact on a child’s developing brain as well as day-to-day life.  (Not necessarily professionals)
• Detailed background information is gathered from a range of sources to compile a full case history
• There is a detailed assessment to identify changes, strengths and support needs – which are often missed
• Appropriate goals support identified needs and are agreed with the child and the family
• There is a knowledgeable Key Worker to communicate and provide advocacy for the child and the family – (not necessarily professionals with limited knowledge, skills or understanding. This often exacerbates family stress and impedes any potential recovery for the child or young person )
• Support is individually tailored to a clearly identified need – not an assumed need based on a child’s presentation
• It is aspirational, meaningful and continuous. (Children do not ‘plateau’ after a few weeks or months of treatment. Improvements can continue up to the age of 25 – the point at which their brain stops growing )
• Appropriate levels of non-clinical interventions are provided using tools and approaches that are familiar to children and young people
• Access to knowledgeable and specialist restorative support in education, which is the difference between success or failure in their recovery journey and in life. SEN support is not restorative! 
• Psychological well-being needs are supported and addressed by knowledgeable people who understand – counselling and child mental health services are not the answer
• It involves and supports the family; particularly single parents

Sadly, we know from our own experiences and those of our families that this is not provided to the majority of brain injured children and young people in our area.  Community professionals often have little or no understanding of the effects of an acquired brain injury on a child’s developing brain and how their emerging difficulties impact on learning and everyday life; which is extremely frustrating for parents. Even worse it has a negative impact on child, adolescent and young people’s physical, psychological and social well-being.

Post discharge Support

Less than 10% of all brain injured children that attend A&E are admitted to hospital.  The majority are discharged with time limited or no follow-up because they are presumed to be ‘ok’.  However it may be months or years later before the problems start to emerge. It is therefore in the community where these very vulnerable children are most at risk of not receiving the help and support they need.  

Sadly there still exists a huge lack of understanding of acquired brain injury as a hidden disability across a range of professional fields; despite it being the biggest cause of death and disability in children and young people in the UK.  (Currently estimated to be close to 1/3 of the child/young person population and estimated to affect 1 in 5 children in every classroom, in every school, across the UK!   

Unfortunately, brain injured children and young people are often referred to the wrong services, mis-diagnosed as being on the Autism Spectrum or having ADHD, and subsequently treated for the wrong thing – which in some cases has caused serious complications. 

Upon their return to school, brain injured children and young people quickly fall behind their peers and when assessed using standard psychological assessment methods, are often diagnosed as having ‘low intellectual ability’ which is often incorrect. This diagnosis appears to create negative mindsets within educational professionals who then lower targets and academic expectations – often assuming ‘they can’t do it anymore’. ‘Strategies’ are then implemented, which do not help the child to recover and by the time they leave school, they still have the same hidden disabilities that continue to affect their day-to-day life and limit their future employment prospects!

Our Approach

Wherever possible, we work in partnership with the child, parents and professionals, to ensure their ongoing and often changing needs continue to be recognised as part of their hidden disability.

We:

• Assess and identify need
• Providing practical restorative support
• Coordinate access to the correct service and
• Advocate for the ongoing needs of brain injured children and young people across a range of statutory and community organisations.

Without Matrix, this does not happen and the needs of this vulnerable cohort continue to be unrecognised and unsupported.