Acquired brain injury in children – The early rehabilitation stage

Each child will progress in a different way following a brain injury and will experience different problems. It is not possible for anyone to predict exactly how well or how fast your child will recover. We understand that it is really hard for parents when we cannot give a clear idea about what the future might look like.. One of the reasons for this is that your child could take one of the many paths in recovery as shown in the following diagram:

1. Fast recovery in early stages which then slows down.
2. Periods of fast recovery followed by periods of slow progress.
3. Steady progress in recovery.
4. Slow recovery in early stages which then speeds up but eventually your child will reach their potential in rehabilitation

As you can see, every child progresses differently and at varied speeds. There are many factors which impact a child’s rehabilitation including a child’s age, a child’s engagement in sessions and the area of the brain that’s been impacted.

It is important to mention that some difficulties may arise later as the brain continues to develop throughout childhood and adolescence. At the time of injury only problems present can be detected. As children get older and are expected to acquire new skills, problems may then become apparent. One example is that we are often aware of difficulties with movement earlier than difficulties with how are brain is thinking , these difficulties can sometimes take longer to emerge.

Rest is important. The brain needs rest to recover from an injury. Stimulation and activity must be balanced with lots of rest to be effective. This is because rest is important: rehab takes a great deal of work and time to redevelop skills that have been affected by a brain injury.

The most important thing for you to know is that you are not alone, we try our best to support family members as well as the child. We know that when a child’s experienced a brain injury, it doesn’t just impact the child but can have far reaching impact on parents, siblings, family members and communities.

It is normal and common for parents and family members to not feel quite themselves during this time, particularly at the beginning. However, every family responds slightly differently. Some family members feel very overwhelmed, might become tearful or upset and feel they can’t cope. Some family members focus on the day to day and settle into a routine on the ward.

It is really important that family members look after themselves too so that they are to be able to provide the best care for their child. Members of the neuro-rehab team and ward team will check in with you and ask how everyone is doing. Please do speak to us about how you’re feeling so that we can listen or help problem solve anything we can.

Plan care programmes and provide physical care for children such as washing and feeding. They also check on them throughout the day and night. Each child has a named nurse who will look after your child whenever they are on duty. Parents are encouraged to do as much as they want or feel able to do in the day-to-day care of their child (e.g. washing etc). However, you should remember that the nursing staff are always there to care for your child and you should only do as much as you feel happy with. The nurses will provide support and teach families about aspects of care.

Are responsible for the medical management of your child. This includes investigations and assessments, the prescribing of drugs and the co-ordination of all aspects of care.

Supports you and your child during your inpatient admission. They provide a link to the medical and rehabilitation team, provide information and advice and will make referrals for additional support and information. They will arrange and chair meetings with the rehabilitation team to discuss discharge home and your child/young persons’ rehabilitation journey.

Are specialists involved in the rehabilitation of movement and mobility. They will use specific positioning, stretches, facilitation techniques and exercise to help your child achieve their best possible function. The activities and treatment will depend on your child’s individual ability and the physiotherapist will advise you on what you can do to help while visiting and caring for your child. They may also work with your child to help them maintain a clear chest if this is appropriate.

Are specialists who are involved in supporting daily functioning such as your child’s abilities in self-care, leisure and educational activities. They use specific techniques, equipment and / or activities to maximise your child’s abilities. They can also assess your home circumstances and offer advice regarding any equipment / alterations needed to enable your child to return home.

Establishes nutritional needs and recommends appropriate nutritional treatment tailored to each child. They will monitor dietetic interventions to help ensure a positive effect on your child’s nutritional status and aid the recovery process

Are specialists focusing on swallowing and communication. Firstly, they may need to assess your child’s swallowing skills and whether they are ready for eating and drinking. They may advise modification of food / fluid consistency or specialised equipment. It may be necessary for them to also assess communication skills. This area includes your child’s ability to understand language and their ability to express themselves appropriately. If it is appropriate to help support your child’s understanding, or ability to express themselves a speech and language therapist may introduce an augmentative or alternative form of communication such as picture communication symbols.

Provides education for children in hospital, and in some cases temporarily after discharge. They also assess educational needs and liaise with your child’s own school to help them go back to school as smoothly as possible

Provides a space to talk about the child’s admission and brain injury. The psychologist often starts with family support, meeting with family members to provide a space to talk through any concerns and identify the best way of supporting your child and family. . Overtime, if your child is able to communicate, the psychologist may meet with your child to talk about his or her feelings about what has happened to them and to work through any problems.

Alongside this, the psychologist will identify any early concerns about cognition. Formal cognitive assessment may be offered as an outpatient following discharge.

Uses play as a resource to encourage the holistic development of your child whilst in hospital. They are also available to prepare your child for any forthcoming medical interventions and to provide diversional therapy during painful or invasive procedures.

Your child may sometimes have to be seen by specialists. Any care given by these people will be co-ordinated by the team. This may include eye and ear specialists, dentists, radiographers, neuro-surgeons, and orthopaedic surgeons.

These are available, please ask nursing staff or ward clerk regarding the application process. These are only valid within the hospital grounds/car parks.

Toast is provided for all resident parents for breakfast, please speak to the housekeepers. there is a canteen on C floor in clarendon wing and shop on A floor. There is a large selection of sandwich shops opposite the Great George Street entrance. At the Jubilee Wing entrances you will also find newsagents and coffee shops.

The Leeds Hospitals Charity brings a snack trolley on the ward at around 2pm also providing tea and coffee.

Tea, coffee, sugar and milk is provided within the parents kitchen. Parents can help themselves but ask that parents keep this tidy and wash up. A fridge and freezer is available in the kitchen, please label with your name and date. Home made food can be kept for 1 day. Some snacks are provided in the parents kitchen from the Millie Wright Charity.

Unlimited for parents. Anyone else may visit between 11am – 7pm. Only 4 visitors are allowed per bed. Press the buzzer to enter the ward which is locked for security reasons.

To aid rest and recovery the ward has a quiet hour 3-4pm. At these time the lights will be lowered and we ask to keep noise to a minimum.