The Rubik’s Cube of Childhood Brain Injury

The Children’s Trust Conference - The Rubik’s Cube of Childhood Brain Injury

20 June 2018

Royal Society of Medicine London 

Did you know that childhood stroke is a rare condition presenting an incidence of 1.6 per 100,000 in children? This was one of many insights obtained from The Children’s Trust annual conference. Dalton Leong, Chief Executive of the organisation, stated that the aim of this year’s conference was to consider the ‘puzzling complexities and challenges of acquired brain injury in children’. The speakers for the day covered a broad range of topics, including a review of evidence-based interventions for children with a neurological diagnosis, rehabilitation outcomes and long-term prognosis.

The focus of the day was the importance of family, especially family participation and early inclusion within the rehabilitation process. We explored how rehabilitation clinicians, and neuro Occupational Therapists (OTs) should support families to become experts in their child’s care and explored the essential role of parents in nurturing and bringing up their child. It was discussed that traumatic injury or brain trauma can impact on this natural relationship and it was essential for professionals to give the family back its natural role. This isan area where I feel neuro OTs excel. Central to our profession is the importance of considering roles of the individual and the part that each family member plays in the care of their child. We do this at the same time as recognising the needs of the individual, as well as considering the impact of living with lifelong disability, now and into the future.

Therapeutic strategies were discussed including how clinicians can help a child to consider their ‘internal world’ to develop insights into individual goals and aspirations. Using a narrative approach helps young people to process trauma, and it is essential for neuro OTs to consider psychological adjustment as part of their role. It is essential to help children and young people to reflect on who they are now and who they want to be as part of the rehabilitation process. This is essential for individuals who are transitioning to adulthood, including the importance of developing a sound sense of self to ensure the traumatic brain injury does not remain the ‘enduring headline story’. 

Another theme close to the heart of neuro OTs was the importance of participation in activities. This topic was explored briefly by Dr Dunford, Lecturer in Occupational Therapy from Brunel University - https://www.brunel.ac.uk/people/carolyn-dunford   Whilst it was acknowledged that as a profession occupational therapy needs to work harder to develop an evidence-base relating to this key area, there are strong clinical outcomes to support family involvement. Involving the family in the rehabilitation process showed statistically significant changes in function compared to those receiving therapy in isolation. She also discussed how the aetiology of an injury can impact on outcomes, including the age at which the injury was sustained, with children younger than 7 years old generally presenting with poorer outcomes. In a nutshell, it is much easier to regain a skill you already have.

Overall, this was a very inspiring and informative day. A full review of the day can be found on The Children’s Trust website (link here)

The Children’s Trust is the UK’s leading charity for children with brain injury. Their focus is to give children with brain injury the opportunity to live the best life possible. To support the charity or to find further information, please visit their website.