Pediatric Brain Injury Neurocontinuum
Nexus Children’s Hospital offers a distinct subspecialty program for any patient — newborn to age 21 — who has experienced an injury to the central nervous system (CNS) including traumatic or acquired brain injury. As children progress through the stages of brain injury recovery, they may require a broad range of specialized services to meet their individual physical, cognitive, emotional, and behavioral needs. As a result, many children will receive a combination of neurobehavioral and neurorehabilitation services provided in each of the following inpatient programs:
- Brain Injury Responsiveness
- Brain Injury Rehabilitation
- Home, School, and Community Re-Entry
Our program is designed for any patient who has experienced an injury to the central nervous system (CNS) including*:
Traumatic Brain Injury
- Motor vehicle/ATV accidents
- Gunshot wounds/ penetration wounds
- Non-accidental head trauma
Acquired Brain Injury
- Cardiac arrest
- Neoplasms/brain tumor
- Drug overdose/ poisoning
Although our programs can provide an acute inpatient rehabilitation level of care (15 hours/week), patients do not have to be ready to participate in three hours of therapy a day at the time of their admission to qualify for programming.
Brain Injury Continuum of Care Programming Features*
- Rehabilitation and Child Life services
- Neuropsychological services
- Respiratory therapy, tracheostomy care, and ventilator management
- Medication and respiratory need optimization
- Secondary complications prevention
- Assistive technology for communication
- Spasticity management
- Discharge and long-term needs planning (for school and home)
- Education, training, and support for families and caregivers
*Services may vary between Nexus Children’s Hospital Houston and HealthBridge Children’s Hospital Orange.
PEDIATRIC BRAIN INJURY NEUROCONTINUUM
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Brain Injury Responsiveness Program
Designed for children and adolescents who continue to exhibit altered arousal and/or limited ability to interact with their environment and are not yet or inconsistently following commands (Unresponsive Wakefulness Syndrome/ Minimally Conscious State).
- Determine the level of consciousness and monitor using evidence-based measures
- Evaluate for barriers to recovery of consciousness
- Normalize sleep wake cycle
- Improve alertness during the day
- Initiate sensory stimulation treatments
- Initiate a medically appropriate rehabilitation program
Brain Injury Rehabilitation Program
Designed for recovery from acute confusion and/or post-traumatic amnesia (PTA) and beyond.
- Provide orienting information to promote increased environmental awareness
- Creation of a “Memory Log”
- Management of behavioral agitation
- Intensive multidisciplinary rehabilitation
Home, School, & Community Re-Entry Program
Designed to support children and their families as they navigate the transition from hospital back into their home, school, and community environments.
- Neuropsychological evaluation during admission
- Enrollment in home-bound educational services while hospitalized (when appropriate)
- Work with families and schools to develop an individualized plan for academic re-entry
- Provide families with information about special education supports through school
- Support family in identifying and scheduling relevant follow-up and outpatient appointments
- Coordination with insurance to obtain necessary discharge prescriptions and home equipment
2016 Outcome Data for Our Brain Injury Rehabilitation Continuum of Care
Functional Recovery as Assessed by the WeeFIM-II
Sample characteristics for the WeeFIM-II analyses presented below:
- Only children with severe non-penetrating traumatic brain injury (Glasgow Como Scale [GCS] score between 3 and 8) were included in the analysis below (n=18).
- Ages ranged from 7 to 19 years
- 66.6% male
fig 1. Wee-FIM-II Mobility
fig 2. WeeFIM-II Cognition
fig 3. WeeFIM-II Self-Care
Figures 1 – 3: Change in WeeFIM Ratings from Admission to Discharge as assessed by Wilcoxon. Signed Ranks Test for dependent, non-normally distributed, ordinal data. *p > .01.