TBI in children
Traumatic brain injury in children is an unfortunate event which can affect every aspect of the child’s functioning. The leading cause is motor vehicle accident, but it can also be caused by a head injury from a fall or a blow. Because of the wide ranging array of symptoms that result from TBI, a team of professionals consisting of a physiotherapist, occupational therapist, speech language pathologist and psychologist may be engaged to assist in the child’s recovery.
Treatment from a physiotherapy standpoint will focus on gait training, transfers, strengthening of the lower extremities and training in the use of assistive devices. Occupational therapy will address ADL training, positioning, bed mobility and transfers. The child may also be trained in the use of adaptive devices for bathing, dressing and feeding. Speech therapy focuses on swallowing difficulties and language, while psychology looks at behaviour and cognitive problems.
Many parents expect their child to return to prior level of functioning, but this is not always the case. Impairment in gait, muscle weakness, posture and coordination, speech and behaviour is sometimes permanent. Therapists will ask questions about the child’s likes and dislikes and his/her activities prior to injury in order to provide sensory stimulation based on the child’s interests.
Baseline evaluations help establish realistic goals for the child. A home visit may be necessary before goals and a treatment program are drawn up. The child’s mobility needs will be assessed, as well as safety in getting around the home. The family will also be educated in caring for the child at home. Older children may be taken on field trips to the malls and other places in order to assess his/her readiness to get around the community.
Treating a child with TBI can be very challenging, but the rewards can be great when the child is able to adjust to his new circumstances and function well within her/his disability.
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