Brain Injuries in Children
Brain injuries in children occur in large numbers each year and are the biggest cause of child deaths and disabilities. Each year, thousands of young children and teenagers suffer injuries from falls, vehicle accidents, sports injuries, and physical abuse. In some cases, a brain injury is not immediately detectable after an accident occurred. There are times when a trauma only begins to make itself known once the child has entered school (in young children) or when learning a new task as in the case of older children.
Assessing a Brain Injury
Since brain injuries are considered the leading cause of death and disability in young children and teens each year, it is important that an assessment is done to make sure it is a brain trauma they are suffering from and not some other medical issue. An injury can range from moderate to severe, but it is important that each case is evaluated separately and not given a blanket diagnosis.
A common method used to test for damage to the brain and the severity of it is the Glasgow Coma Score (GCS). The test checks three areas (verbal responses, motor responses, and eye opening). The result of the score shows how much damage has been received. A score of 13 to 15 is indicative of a mild injury, 9 to 12 is a moderate injury and 3 to 8 indicates a severe trauma has been sustained.
Once the level of severity is determined, the Glasgow Outcome Scale (GOS) is used as a method to further clarify neurologic outcomes. A score of 5 indicates a good chance of recovery, 4 is an indication of moderate disability, and three means the child is severely disabled. If the score is 2, it is indicative of a vegetative state, and a score of 1, unfortunately, is an indication the child will die from the trauma.
The type of rehabilitation for a child with a brain injury will depend on the severity of the trauma. Cognitive Rehabilitation Therapy (CRT) means that a child will relearn the cognitive skills that were altered or lost as the result of the injury. In the event that the skills cannot be relearned, new skills will be taught to remunerate for the ones lost. In other words, rehabilitation is tailored to reinforce, strengthen, and re-establish behaviors and activities learned before. If behaviors cannot be relearned, new skills will be taught to make up for the ones lost that will allow the child to function accordingly.
Cognitive Rehabilitation Therapy consists of four areas:
- Awareness – Learning about weaknesses and strengths and becoming knowledgeable about the problem.
- Process Training – Developing skills by practicing or retraining in the skills that have been lost to correct the issues.
- Strategy Training – Using environmental, external and internal methods to remunerate the issue instead of solving it.
- Functional Activities Training – The other three steps are used in methods of daily life to bring real improvements to the lives of children affected by brain injuries.
Cognitive Rehabilitation Therapy is just one method of rehabilitation that can be used on children that have sustained brain injuries. Of course, it should be noted that the type of treatment will depend greatly on how severe the injury is and whether or not a recovery can be made. Only a physician can diagnose the severity of the injury and the best methods for rehabilitation.