Basic Information
Why is the likelihood of the head being hit in trauma higher in peds than in adults?
children have larger heads than adults in relation to their body size
What factors can affect the signs and symptoms of TBI?
- vary based on the site and extent of injury to the brain
- the age at which the injury occurred
- the individual's premorbid abilities, the functional domains affected
What is the purpose of a screening conducted by SLPs for children who have experienced TBI?
- identify the need for further assessment and determine the possible areas of deficit resulting from the injury
- helps guide recommendations for screening, assessment or referrals
What are two main factors that intervention for children with TBI is based on?
child age, child language, child cultural values and norms, previous level of function, developmental status, functioning in related areas, preexisting cognitive deficits etc.
What is a key consideration when providing treatment to children from diverse backgrounds?
Treatment should be sensitive to linguistic and cultural diversity and conducted in the language used by individuals. Take special consideration to certain beliefs and practices shared in the culture, and ensure they are respected.
Who has a higher risk of injury, males or females?
Males
How does the functional impact differ between children and adults?
impact of TBI in children differs from that in adults because child's brain is still developing; effects may not appear immediately but can emerge overtime as the brain develops
What DOESN'T the screening by an SLP provide?
detailed information on the severity or characteristics of specific defecits.
Why is play-based intervention effective for young children with TBI?
- aligns with their developmental needs
- encourages skill development in a way that is natural and engaging
- the use of preferred items and developmental appropriateness
How does the treatment setting differ for children with mild TBI compared to those with moderate to severe TBI?
mild TBI/concussions: typically treated in school or community-based settings
moderate-severe TBI: initially receive care in medical settings and later transition to home or community-based programs.
What specific age range of children are more commonly injured?
Very young children (0-2 years)
Adolescents (15-18)
Identify at least three auditory or vestibular symptoms that may arise from a TBI affecting the temporal lobe or inner ear.
- central auditory dysfunction
- difficulty hearing speech sounds in noisy environments
- dizziness, vertigo, or imbalance
Impairments in body structure and function such as aphasia, motor speech disorders, dysphagia, and hearing or vestibular problems.
How do restorative and habilitative approaches differ in treating children with TBI?
Restorative approaches aim to restore lost functions, often through direct therapy.
While habilitative approaches help children learn or improve skills that had not yet developed before the TBI, which may be especially needed as developmental milestones are reached post-injury.
What is the role of early intervention for young children with TBI, and what type of environment is emphasized in this process?
Early intervention focuses on supporting the development of school readiness skills and addressing both the child's and family’s needs in their natural environment.
The leading cause of injury among youths ages 15 years and older is
motor vehicle crashes
Provide 2 examples of how TBI can affect pragmatic communication skills.
- difficulty initiating conversation or maintaining a topic
- inability to interpret or effectively use nonverbal communication (facial expressions/gestures)
Explain how the Pediatric Glasgow Coma Scale (pGCS) and Glasgow Coma Scale (GCS) are used in assessing TBI and how they differ from one another.
- pGCS used for 2years and younger; GCS used for older children
- both assess level of consciousness by measuring responses in: eye, motor, and verbal responses.
How can the compensatory strategy approach support children with TBI in academic settings? (think accommodations and modifications)
They help children adapt to deficits by using internal or external aids and making adjustments in the environment.
Accommodations might include note-takers or extra time on exams, allowing the child to participate without changing the task itself.
Modifications change the nature of the activity, such as reducing assignments or shortening the school day, to promote 'success'
- provide direct intervention, support reentry into school, educate school personnel and families about TBI, assess the educational environment to identify barriers, assist with implementing accommodations, and monitor long-term progress.
- may also identify previously undiagnosed cases of TBI and participate in prevention and advocacy programs.
Pediatric TBI injuries include:
skull fractures
intracranial injury (hematoma, hemorrhage, abusive head trauma, subdural fluid accumulation, contusions etc.)
Why is it challenging to identify TBI in young children?
Because some early signs (crying, clinginess, or changes in sleeping patterns) may resemble typical behaviors for certain developmental stages.
Define facilitator and barrier, and indicate how the environment/personal factors can act as either in TBI recovery
- Facilitators include the child’s ability and willingness to use compensatory strategies, support from family, teachers, and peers, and motivation to improve function.
For example, a supportive classroom environment with modified lighting or amplification devices can aid communication.
Barriers may include decreased confidence in communication abilities, cognitive deficits, visual or motor impairments, and a lack of awareness of their disability.
These barriers may hinder the child’s confidence and ability to participate in school and social interactions effectively.
What are some components that speech therapy of children with a TBI may focus on?
Individual speech subsystems: respiration foundation, articulation, and velopharyngeal function
Overall speech intelligibility using behavioral and instrumental treatments, prosthetics, compensatory strategies, AAC and/or environmental modifications
Why might the format, provider, and dosage of TBI interventions vary widely? What can be beneficial in the delivery of these services?
- vary based on the child’s individual needs, recovery stage, severity of injury, and the goals at different intervention stages.
- Telepractice is beneficial