Telehealth in Pediatric Rehabilitation.

Pediatric rehabilitation focuses on optimizing function and quality of life of children through a holistic and transdisciplinary patient-centered team approach. This article describes the incorporation of telehealth in pediatric rehabilitation and its growth over the past decade. It also reviews the experience of practitioners using telehealth by necessity during the 2020 COVID-19 pandemic. Evidence suggests many applications where telehealth can appropriately substitute for traditional in-person visits, and there are many potential applications of telehealth to be explored as a means to enhance connectivity of the interdisciplinary rehabilitation team and the outreach to patients in remote and underserved areas.

Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic.

Purpose Mild traumatic brain injury (mTBI) is common among children and is associated with a range of symptomatology and clinical presentations. This study uses data from a paediatric outpatient TBI clinic to (1) investigate characteristics associated with more severe post-concussive symptoms and (2) examine differences in the proportion of individuals endorsing specific post-concussion symptoms based on group (e.g., sex, type of injury, and psychiatric history). Methods Data from the Children's Hospital of Richmond's TBI outpatient programme were analysed (N = 157). Results Gender and sports injury were associated with severity of symptoms. In addition, females endorsed a greater number of overall symptoms than males. A number of specific symptoms were found to be endorsed to a greater extent based on psychiatric history and type of injury; however, overall total number of symptoms endorsed did not differ based on these characteristics. Conclusions Findings from this study provide further evidence that mTBI affects a wide range of youth and that associated symptomatology can indeed be varied. Moreover, results revealed differences in endorsement of specific symptoms and symptom severity based on patient and injury characteristics which have implications for concussion assessment and treatment. Implications for Rehabilitation Symptoms following mild traumatic brain injury (mTBI) in children and adolescents can have varied presentation, ranging from minimal to severe. Females and those with non-sports-related injuries are more likely to endorse greater symptoms following concussion. Symptom evaluation is an essential component of the concussion assessment and treatment of paediatric patients following mTBI, and clinicians should be aware of patient characteristics associated with increased symptoms, especially when baseline symptom data are not available.

Traumatic brain injury: a comparison of inpatient functional outcomes between children and adults.

OBJECTIVES: To examine age-related differences in functional outcomes following traumatic brain injury. PARTICIPANTS AND PROCEDURE: Seventy-six patients admitted to a pediatric acute rehabilitation hospital were compared with 2548 adult patients in the National Institute on Disability and Rehabilitation Research-funded traumatic brain injury model systems national database. MAIN OUTCOME MEASURES: Functional Independence Measure totals during inpatient rehabilitation. RESULTS: Increasing age was significantly associated with improved outcome in children and with poorer outcome in adults. CONCLUSION: The relationship between age and functional outcome is different within different age groups (pediatric vs adult), and the effect of moderating variables differs by age group.

Workplace discrimination and missing limbs: the national EEOC ADA research project.

Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with missing limbs is documented. Researchers compare and contrast the key dimensions of workplace discrimination involving Americans with missing limbs and persons with back and other non-paralytic orthopedic impairments. Specifically, the researchers examine demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom complaints are filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcome or resolution of these complaints. Findings indicate that persons with missing limbs were more likely to encounter discrimination if they were male, under 20 or over 65 years of age, and White or Native American. They were also more likely to encounter more frequent discrimination when they worked for employers in the Southern United States, those with 200 or fewer employers, or whose industry designation involved manufacturing, construction, or transportation. Finally, the nature of job discrimination experienced by Americans with missing limbs is more likely to involve hiring, promotion, or job training than other issues. Implications for policy and advocacy are addressed.