Children and adolescents who have sustained a traumatic brain injury (TBI) may be left with multiple deficits and impairments that can impact adversely their abilities to return to premorbid functioning in the home, school and community. Early rehabilitation has been shown to improve functional outcome; the rehabilitation programme itself has to be based on real-world demands and experiences. Rehabilitation has to be continued beyond the post-acute stage in order to promote neuronal re-organisation, monitor the child’s development as well as identify and manage new issues that may appear with growth, development and maturation. The availability of relevant research data and findings for children is much less than those for adults. It is not always appropriate to apply data for adults to the younger persons due to important differences in the 2 groups and these are discussed in more detail in the article. Multiple factors have been found to affect recovery and functional outcome. Apart from age and developmental stage at injury, other variables can be grouped as injury-related, patient-related and treatment-related factors. The goals and components of the rehabilitation process are examined for the various stages of recovery and the last section of the article describes the paediatric rehabilitation scene in Singapore.
Traumatic injury to the brain (TBI) can lead to multiple medical, cognitive and functional issues, both in the acute care setting as well as over the much longer term. Much knowledge has been gained from relevant research in this area for adults, and the goals, guidelines and outcome for the practice of brain injury rehabilitation in the adult population is well-established. This is not so for younger persons. Meticulously performed research in children and adolescents with acquired brain injury is still relatively scarce. Oftentimes, data obtained from work done in adults is extrapolated to the younger age groups. However, they may not always be applicable due to several important differences between children and adults,1 as will be explained in the following sections of the article.
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