摘要:

Objectives:To document causes, course of acute care, and outcomes in a large sample of children and adolescents (N=24,021) hospitalized for traumatic brain injury. Special focus is given to patterns of referral to rehabilitation and educational services at the time of discharge from acute care. Design: Descriptive statistics applied to a multicenter data collection on pediatric trauma. Setting: Seventy-six pediatric trauma centers or children's hospitals in the United States that reported to the National Pediatric Trauma Registry between October 1988 and April 1996. Data Set: Demographics, cause of injury, time and place of occurrence, severity of injury, utilization of resources during acute care, in hospital death rate, functional limitations, discharge disposition, and discharge recommendation for children who sustained a traumatic brain injury associated or not with injury to other body region. Results: Two thirds of the children were male and 77.8% were one to 14 years of age. Injuries occurred mostly between noon and midnight (67.7%) and on the road (50.0%) or at home (32.0%). Nearly all injuries (90%) were unintentional, most children (63.6%) sustained injuries to other body regions, and the anatomical severity of the injuries was ten times higher than in children without traumatic brain injury. Over A0% of the children were in the intensive care unit, 20% had one or more surgical intervention, the average length of stay was six days, the median two days. The in hospital death rate was 6.1% and 22.2% of the children developed functional limitations from the injury. At the time of discharge from acute care, most children returned home. In the group with four to nine limitations, half of the children were discharged to a rehabilitation facility. Of the children with functional limitations who returned home, physical therapy was recommended In 23.7% of the cases, occupational therapy in 13.2% of the cases, and speech therapy in 10.1% of the cases. Of those of school age discharged home with functional limitations, 1.8% were referred to special education. Conclusion: The majority of children with traumatic brain injury and functional limitations due to the injury return home at time of discharge from acute care with limited referral to potentially beneficial services. To correct these deficiencies, more research is needed to identify nonmedical factors affecting referrals.

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This article explores the development of service delivery systems in rehabilitation and education for school-age children with TBI. Historical relationships between rehabilitation services and special education services are examined in terms of what the future may hold for these systems within a changing health care world. Examples of critical changes in these delivery systems and the development of program models that merge rehabilitation and special education services for children are profiled.

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

When children with brain injury enter the education system, educators and health care professionals are challenged to design and provide school programs that will help youngsters achieve their greatest potential. To comply with state and national regulations for providing education to children with disabilities, school systems across the country have identified various paradigms that can result in effective service delivery for children with learning problems, regardless of the etiology. Those “best practice” guidelines are applicable and appropriate for youngsters who experience learning problems as a result of brain injuries. This article discusses several of the challenges that educators, health care providers, families, and students face and illustrates how these challenges can be met. Specific strategies suggested include building a strong team, acquiring needed knowledge, and developing a philosophical orientation. Challenges addressed include team building, offering alternative options for services, preparing the student for transitions, adapting the curriculum to meet the student's needs, and developing a comprehensive educational plan.

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:Three boys, ages 8,11, and 13, who experienced social isolation as a result of traumatic brain injury, were studied to investigate the effectiveness of a school-based, educator-mediated intervention aimed at increasing the social networks of students with traumatic brain injury. A four-phase problemsolving process was instituted in which a student-centered school team identified goals and strategies for increasing the student's social opportunities and then met frequently to review progress toward the goals. Main Outcome Measures: Frequency of students' social contacts with nondisabled peers, parent and educator social validation ratings, and participant observations. Results: The number of social contacts for each student increased over baseline levels and was maintained over the course of the study. Parents, teachers, and students were generally satisfied with the process and with the concomitant increases in students degree of social integration. Anecdotal follow-up reports indicated that these results were not maintained over time. Conclusions: The study's findings raise important questions about the varying perspectives on the importance of social integration, the degree to which educators can serve as change agents in students' social experiences, and the type of follow-up support required to maintain increases in students' social interactions.

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:A total of 149 persons involved in 20 community-based vocational rehabilitation programs located throughout the United States that serve persons with traumatic brain injury (TBI) participated in a study to examine the structure and content of a vocational assessment process and functional abilities rating instruments. These are applicable for educators to use when examining work-related skills of students with TBI transitioning from school to work.Measures:Nine rating instruments that constitute the Vocational Assessment Protocol (VAP) were used, including two demographic profiles, three clinical profiles, and four vocational profiles. Data from case records and input from service providers, examinees, and significant others were used to complete the nine profiles.Results:Data collected with the VAP identified a high incidence rate of common barriers to employment. Barriers involving social and adaptive skills, physical demands, emotional behaviors, and cognitive skills were common.Conclusions:The data presented underscore the need for educators to examine and develop work-related skills of youth in school-to-work transition.

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:A study was performed to determine (1) the nature of services provided for students with traumatic brain injury (TBI) by offices of disability services (ODSs) in colleges and universities across the state of Ohio and (2) these offices' awareness of such students.Design:A telephone survey was used to obtain data from 74 public, private, and community colleges in Ohio. Subjects and Main Outcome Measures: ODS counselors and other office personnel provided information on ODS service manuals, identification of students with TBI, support services, course requirements, and graduation rates. Conclusions: Findings suggest that (1) provision of services is largely dependent on student self-identification, (2) academic and psychological supports are needed most, and (3) few ODS offices include TBI in pamphlets detailing their services.

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1997

数据来源: OVID