Jenny Limond | PubMed Health

PubMed2005

Practitioner review: cognitive rehabilitation for children with acquired brain injury.

BACKGROUND: The need to address acquired cognitive impairments is increasing in child populations seen across a range of settings. However, current clinical practice following brain injury in children does not necessarily incorporate the use of cognitive rehabilitation models or techniques. The aim of this paper is to review the literature in this area. METHODS: All published interventions targeting the cognitive domains of attention, memory and/or executive function that could be identified were reviewed. Different cognitive rehabilitation techniques are briefly described and the clinical and research implications of the findings are discussed. RESULTS: Eleven papers, involving 54 children and adolescents receiving intervention, were identified. This literature describes generalised cognitive rehabilitation programmes as well as more specific strategies targeting focal deficits. CONCLUSIONS: There is an absence of randomised controlled trials and a very limited number of studies using other methodological approaches, providing at this time no conclusive evidence for the efficacy of cognitive rehabilitation for children with acquired brain injury, but a clear need to address a range of methodological difficulties in this field of enquiry.

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A developmental framework for memory rehabilitation in children.

Memory difficulties in adults with acquired brain injuries have been reported in the literature for some time. In recent years, the consequences of memory difficulties from acquired and neurodevelopmental disorders in children have also been investigated. Initial studies have suggested that, like adults, children can experience severe and specific memory deficits. However, there are important developmental differences, both in terms of the nature of cognitive difficulties experienced, and the subsequent consequences for learning, educational attainment and everyday living. Despite the advances made in developmental memory studies, as yet, there appears to be scant literature to guide effective rehabilitation specifically targeted at children. As a starting point, it may be appropriate to consider adaptation of adult rehabilitation strategies to address memory problems in children. This paper describes some of the common principles and practices of adult rehabilitation strategies and then considers the validity of such strategies against developmental models of the memory system and child's learning environment. In particular, four important areas are highlighted: the development of normal memory functions in children, the range of cognitive deficits that can occur in a developing brain, the interaction of memory deficits with other immature cognitive skills and the context of the psycho-social environment in which rehabilitation may take place.

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