The Importance of Identifying Children With Brain Injury in Schools: Speech-Language Pathologists as Crucial Partners.

PURPOSE: The purpose of this article is to describe the importance of and strategies to identify traumatic brain injury (TBI) and associated cognitive-communication disorders (CCDs) in children, a priority identified by the attendees at the Fourth International Cognitive-Communication Disorders Conference. Childhood TBI is associated with a range of difficulties, including CCDs, that can adversely impact functioning and participation into adulthood. Identifying a history of TBI in children in schools is the crucial first step to then monitor, assess, and provide evidence-based intervention and accommodations in collaboration with families and medical and educational professionals. CONCLUSION: Given that CCDs are treatable, effective identification, assessment, and management of students with TBI and resulting CCDs can reduce adverse outcomes in adult survivors of childhood TBI. Speech-language pathologists must be aware of their expertise in assessing and treating CCDs in children with TBI and advocate for programmatic and policy changes to better identify and support children with TBI.

Speech-Language Pathology Treatment of Cognitive-Communication Deficits in School-Aged Children With Traumatic Brain Injury: A Scoping Review.

PURPOSE: The purpose of this scoping review was to synthesize the current evidence-based treatment practices used with school-aged children with any severity of traumatic brain injury (TBI) that could benefit the practice of speech-language pathologists (SLPs). METHOD: A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Included studies were assigned thematic labels based on a modified version of the Rehabilitation Treatment Specification System. RESULTS: A total of 27 articles that covered 16 different treatment approaches met inclusion criteria for this study. Most studies included adolescent or teenage participants with moderate-severe TBIs. Treatment targets included executive functioning (n = 15), social competence (n = 6), postconcussive symptoms (n = 5), behavior (n = 3), family functioning (n = 1), and health-related quality of life (n = 1). The majority of current interventions for school-aged children with TBI include a multidisciplinary approach and components of family involvement education. CONCLUSIONS: Further research is needed on interventions that are specifically implemented by SLPs as well as protocols that include more heterogeneous samples (e.g., varied sociodemographic factors and injury severity) to allow for the development and testing of ecologically valid intervention practice. SLPs can use the results of this scoping review to individualize treatment based on the child's areas of need while considering individual characteristics and to provide person-centered intervention for children with school-aged TBI.

Factors impacting educational outcomes for students with traumatic brain injury in BrainSTEPS.

Purpose: To describe child pre-injury and injury factors impacting post-injury educational outcomes for students with traumatic brain injury (TBI) participating in a state-wide, school-based, school re-entry consultation program, BrainSTEPS in Pennsylvania.Method: Retrospective analysis of a BrainSTEPS annual follow-up survey.Result: A total of 296 parent surveys were completed. Analysis revealed a significant difference between levels of severity of TBI and current educational placement (p < 0.001), receipt of current therapy (p < 0.05) and need for additional consult (p < 0.05). Severity of TBI was not related to other examined educational outcome variables (i.e. school performance, current symptoms). History of TBI, symptoms and treatment were not found to be associated with educational outcomes.Conclusion: These results both support findings from previous studies, and extend previous work by highlighting ongoing needs, including continued, individualised support, of children who sustain a moderate-severe TBI during childhood, and are currently in the chronic stages of injury, with consideration of pre- and post- injury factors. Programs such as BrainSTEPS provide identification of educational needs and provide needed services and supports for children with TBI. Sensitive, validated measures are needed to further understand the role of pre-injury and injury factors on educational outcomes, particularly in programs like BrainSTEPS.

The Influence of the Family Functioning and Social Relationships on Child Participation After Traumatic Brain Injury.

PURPOSE: To describe the relationship amongst child and family characteristics (e.g. social relationships, family functioning) and child participation after traumatic brain injury (TBI) an average of 2.65 years post-TBI (SD = 2.12). METHOD: Cross-sectional, secondary analysis of data collected as part of a larger research project. RESULTS: N = 44 children with TBI. Analysis revealed statistically significant correlations between child participation, family functioning, and child characteristics. CONCLUSIONS: School-aged children with TBI might experience chronic participation restrictions, associated with challenges in family functioning. Professionals can support children with TBI and their families through follow-up services that include a focus on family-based interventions to better support long-term outcomes for this population.

Speech-Language Pathology Assessment of School-Age Children With Traumatic Brain Injury: A Scoping Review.

PURPOSE: The purpose of this study was to describe evidenced-based assessment practices for school-age children with any severity of traumatic brain injury (TBI) that could inform the practice of speech-language pathologists (SLPs). METHOD: A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Included studies were assigned thematic labels related to the International Classification of Functioning, Disability and Health framework. RESULTS: A total of 30 articles met inclusion criteria for this study. Most studies included adolescent or teenage participants with mild TBIs in the acute stages of recovery. Twenty-two different assessments were reported on for children with TBI addressing body structure/function (n = 19 assessments), activities and participation (n = 1 assessment), and contextual factors (n = 3 assessments). CONCLUSIONS: Current assessments have a clear focus on body structure/function for adolescents after childhood TBI, with little research evidence to address activities and participation or contextual factors. The limited amount of functional assessments directly related to the SLP scope of practice stresses the need for additional research on ecologically valid and comprehensive assessment approaches for school-age children with TBI. The results of this review could be utilized as a resource in providing theoretical, evidence-based, and person-centered evaluation methods for children with TBI. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20422170.