Bridging gaps in care for children with acquired brain injury: Perceptions of medical and educational service providers.

PURPOSE: Significant gaps in service delivery for children with acquired brain injury exist between healthcare and educational systems, such as the lack of coordinated efforts to transfer rehabilitation strategies to school settings. This paper attempts to address these issues and offer recommendations to bridge these gaps in care. METHODS: The American Congress of Rehabilitation Medicine (ACRM), Brain Injury-Interdisciplinary Special Interest Group (BI-ISIG), Pediatric-Adolescent Task Force constructed and disseminated a survey to medical rehabilitation (N= 44) and education professionals (N= 40). Responses were analyzed quantitatively and qualitatively, achieving > 85% inter-coder reliability. RESULTS: Results highlighted differences between groups in methods for seeking new information, opinions on advocacy needs, and differing priorities given to various resources. CONCLUSIONS: These discrepancies have important implications for improved collaboration needed for assuring an appropriate continuum of service for this population. Recommendations include: 1) providing education and training regarding brain injury in the most cost-effective ways utilizing technology that crosses the barriers identified and reaches people in multiple settings; 2) direct and active communication between medical and educational professionals; and 3) developing an interdisciplinary Community of Practice to help bridge medical rehabilitation and school systems.

A call for implementing preferred practices for brain injury screening in youth to improve transition.

BACKGROUND: It is vital to engage in systematic screening to identify and serve children who may have sustained an acquired brain injury (ABI) - either traumatic or non-traumatic, so they can be successfully transitioned between environments and life stages. This is particularly important for children and adolescents given the impact an ABI can have on learning and social functioning over the course of the neurodevelopmental process. A pattern of repeated, undiagnosed mild brain injuries may lead to mood or behavior disorders, learning problems. Despite increasing awareness of brain injury as a public health issue, there has not been implementation of systematic screening practices in schools or other public health settings similar to other conditions (e.g., vision disorders, Autism Spectrum Disorders). OBJECTIVES: What is needed to address this lack of systematic screening for ABI is a rationale for systematic screening for ABI in children and adolescents, including examining successful models of screening for other disorders and conditions. METHODS: A review was conducted of available ABI screening methods, including a description of the available screening tools for pediatric ABI, along with supporting research findings. RESULTS: A comparison was made of these pediatric ABI screening tools, looking at the purpose of the tool, the populations and settings in which the tool can be used, the time and cost for administering the tool, the evidence basis in the literature supporting the tool, and the types of outcomes that can be attained from using the tool. CONCLUSION: Recommendations are made for procedures for systematically implementing ABI screening in pediatric settings including schools, primary care providers, mental health, and juvenile justice systems to improve the access to brain injury services and affording more successful transition of adolescents into the adult roles.

Examining a Statewide Educational Consulting Program for Pediatric Brain Injury.

This study describes characteristics of students with acquired brain injury enrolled in a statewide educational consultation program and the program's support activities. Utilizing deidentified data from a statewide brain injury school consultation program, descriptive analyses of demographic and injury characteristics, including medical diagnosis (concussion/mild traumatic brain injury [TBI], moderate-severe TBI, and non-TBI), referral characteristics, educational placement, and the types of program activities were undertaken. 70% of students were referred for concussions/mild TBI and students were infrequently referred by medical professionals. Most students with concussion/mild TBI experienced recreational injuries (59%), while students with moderate/severe TBI commonly experienced road traffic injuries (48%). The greatest proportion of program team members' time was spent in consultation with school personnel (24%), communication with families (20%), and communication with school personnel (16%). Results suggest that the program addresses important communication and coordination needs among families, medical professionals, and educators and identifies opportunities to enhance program utilization.