scholarly journals Cognitive-Communication Interventions for Youth with Traumatic Brain Injury

2020 ◽  
Vol 41 (02) ◽  
pp. 183-194
Author(s):  
Sarah A. Laane ◽  
Lori G. Cook
Keyword(s):  
Brain Injuries ◽  
Pediatric Population ◽  
Communication Disorders ◽  
Treatment Needs ◽  
Successful Communication ◽  
Effective Interventions ◽  
Wide Range ◽  
Pediatric Tbi ◽  
Communication Interventions

AbstractTraumatic brain injuries (TBIs) are relatively common in the pediatric population, yielding several potential challenges across a wide range of skills and abilities. Cognitive-communication disorders are particularly prevalent, with implications for long-term academic and social outcomes. While considerable evidence exists for identifying and characterizing the effects of cognitive-communication deficits, evidence informing effective interventions is still emerging. This review includes discussion of individual factors that affect treatment needs and outcomes as well as evidence that supports cognitive-communication intervention approaches at both a fundamental/discrete and integrated level. Also addressed is the need for modifying contextual factors that may be barriers as well as augmenting facilitators of successful communication and participation, including collaboration with everyday communication partners and identification and use of appropriate accommodations. Overall, research suggests a growing trend toward interventions that are individualized, dynamic, and combine multiple approaches for cognitive-communication treatment after pediatric TBI.

Association of Pediatric Hearing Loss and Head Injury in a Population-Based Study

2021 ◽  
pp. 019459982098290
Author(s):  
Elliott D. Kozin ◽  
Renata M. Knoll ◽  
Neil Bhattacharyya
Keyword(s):  
Hearing Loss ◽  
Brain Injury ◽  
Head Injury ◽  
Pediatric Population ◽  
Population Based ◽  
Level Of Evidence ◽  
Wide Range ◽  
History Of ◽  
Pediatric Hearing Loss ◽  
Pediatric Tbi

Traumatic brain injury (TBI) is the leading cause of acquired long-term disability during childhood, and it may result in wide range of negative developmental consequences. Auditory dysfunction is generally recognized to be a possible sequela of pediatric TBI. Unfortunately, few contemporary studies have quantified the association between head injury and hearing loss in the pediatric population. The National Survey of Children’s Health (NSCH) for the combined years 2017-2018 was used to determine the association of hearing loss with TBI. Deafness or problems with hearing were more commonly reported in children with a history or current brain injury/concussion compared to those without any such history (3.2% [70,000] and 1.2% [830,000] children, respectively; odds ratio, 2.67; P < .001). Findings suggest a notable association between TBI and hearing loss. Children with a history of TBI are 2.67 times more likely to have concurrent hearing complaints. Level of Evidence: IV

scholarly journals Mild traumatic brain injury in children is associated with a low risk for posttraumatic seizures

2016 ◽  
Vol 17 (4) ◽  
pp. 476-482 ◽  
Author(s):  
Anna L. Huguenard ◽  
Brandon A. Miller ◽  
Samir Sarda ◽  
Meredith Capasse ◽  
Andrew Reisner ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Brain Injuries ◽  
Neurosurgical Procedures ◽  
Mild Tbi ◽  
Posttraumatic Epilepsy ◽  
Long Term Follow Up ◽  
Pediatric Tbi ◽  
Posttraumatic Seizures

OBJECT Of the 1.7 million traumatic brain injuries (TBIs) in the US, a third occur in patients under 14 years of age. The rate of posttraumatic epilepsy (PTE) may be as high as 19% after severe pediatric TBI, but the risk for seizures after mild TBI is unknown. Although the rate of seizures after mild TBI may be low, current practice is often driven by high clinical concern for posttraumatic seizures. In this study, the authors evaluated electroencephalography (EEG) results and antiepileptic drug (AED) use in a large cohort of children with mild TBI to estimate the incidence of posttraumatic seizures in this population. METHODS Patients presenting to Children’s Hospital of Atlanta for mild TBI from 2010 to 2013 were evaluated. Five thousand one hundred forty-eight patients with mild TBI were studied and divided into 3 groups: 4168 who were discharged from the emergency department, 868 who were admitted without neurosurgical intervention, and 112 who underwent neurosurgical procedures (craniotomy for hematoma evacuation or elevation of depressed skull fractures) but were discharged without an extended stay. Demographic information, CT characteristics, EEG reports, and prescriptions for AEDs were analyzed. Long-term follow-up was sought for all patients who underwent EEG. Correlation between EEG result and AED use was also evaluated. RESULTS All patients underwent head CT, and admitted patients were more likely to have an abnormal study (p < 0.0001). EEG evaluations were performed for less than 1.0% of patients in all 3 categories, without significant differences between groups (p = 0.97). Clinicians prescribed AEDs in less than 2.0% of patients for all groups, without significant differences between groups (p = 0.094). Even fewer children continue to see a neurologist for long-term seizure management. The EEG result had good negative predictive value, but only an abnormal EEG reading that was diagnostic of seizures correlated significantly with AED prescription (p = 0.04). CONCLUSIONS EEG utilization and AED prescription was low in all 3 groups, indicating that seizures following mild TBI are likely rare events. EEG has good negative predictive value for patients who did not receive AEDs, but has poorer positive predictive value for AED use.

scholarly journals Beyond the adrenals: Organ manifestations in inherited primary adrenal insufficiency in children

2020 ◽  
Vol 182 (3) ◽  
pp. C9-C12
Author(s):  
Clemens Kamrath
Keyword(s):  
Adrenal Insufficiency ◽  
Bone Growth ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Term Treatment ◽  
Primary Adrenal Insufficiency ◽  
Long Term Treatment ◽  
Wide Range ◽  
Organ Manifestations

Primary adrenal insufficiency (PAI) in children is mostly due to genetic defects. The understanding of the molecular genetics of the causes of adrenal insufficiency in the pediatric population has made significant progress during the last years. It has been shown that inherited PAI can lead to certain clinical manifestations and health problems in children beyond the adrenals. Organ dysfunctions associated with different forms of PAI in children include a wide range of organs such as gonads, brain, heart, bone, growth, bone marrow, kidney, skin, parathyroid, and thyroid. Diagnosing the correct genetic cause of PAI in children is therefore crucial to adequately control long-term treatment and follow-up in such patients.

scholarly journals Neuropsychiatric Outcome of Children Born to Women With Systemic Lupus Erythematosus and Exposed in Utero to Azathioprine: A Case-Control Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Maria-Grazia Lazzaroni ◽  
Laura Andreoli ◽  
Francesca Crisafulli ◽  
Francesco Tamborini ◽  
Irene Debeni ◽  
...  
Keyword(s):  
Case Control Study ◽  
Pediatric Population ◽  
Renal Involvement ◽  
In Utero ◽  
Case Control ◽  
Long Term Outcome ◽  
Wide Range ◽  
Control Study ◽  
Neuropsychiatric Outcome

Objective: The long-term outcome of children born to SLE mothers still represents a controversial topic in literature, with some studies reporting a possible increased prevalence of different neurologic and psychiatric diseases (NPD), including neurodevelopmental disorders (ND), and in particular learning disorders (LD). Different risk factors have been advocated, such as the in utero exposure to auto-antibodies and drugs, particularly Azathioprine (AZA).Methods: A case-control study was designed to compare pregnancies treated with AZA (cases) with those not treated with AZA (controls). All the pregnancies had been prospectively followed in two Italian centers. The match was based upon renal involvement, antiphospholipid (aPL) status, maternal age at pregnancy (±5 years) and child’s age at the time of the study (±2 years). SLE mothers were interviewed by a telephone survey, particularly focused on the presence of a certified NPD in their children ≥6 years of age.Results: Twenty-seven cases and 65 controls were similar in terms of demographic, immunological and clinical features, except for a higher rate of SLE flares during pregnancy in cases (22.2% vs. 10.8%, p:0.191). The 92 children had a mean age of 14.0 years at the time of the survey; 11 had at least one NPD (12.0%). The frequency of each single NPD was similar to that of the general pediatric population and no association was found with either the in utero exposure to AZA, or other specific factors (auto-antibodies, disease activity, obstetric complications, prematurity).Conclusion: The long-term neuropsychiatric outcome of the children born to SLE mothers did not show neither an increased frequency of NPD as compared to the general pediatric population nor a specific pattern of NPD. The in utero exposure to AZA was not associated with the development of NPD in this case-control study of prospectively-followed pregnancies. NPD are complex conditions and large prospective studies are needed to capture the wide range of variables that may contribute to their development in the offspring of SLE women.

scholarly journals Prospective Outcomes of Injury Study 10 Years on (POIS-10): An Observational Cohort Study

2021 ◽  
Vol 4 (2) ◽  
pp. 35
Author(s):  
Sarah Derrett ◽  
Emma H. Wyeth ◽  
Amy Richardson ◽  
Gabrielle Davie ◽  
Ari Samaranayaka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Post Injury ◽  
Related Data ◽  
Health And Wellbeing ◽  
Effective Interventions ◽  
Accident Compensation ◽  
Wide Range ◽  
Observational Cohort ◽  
Injury Outcomes

Injury is a leading cause of disability and is costly. This prospective cohort study extension aims to improve disability, health, and wellbeing outcomes for injured New Zealanders, including for Māori. We will identify predictors and modifiable risk factors of long-term outcomes (positive and negative), and develop an Injury Early Care Tool (INJECT) to inform the implementation of effective interventions to improve outcomes. In the Prospective Outcomes of Injury Study (POIS), 2856 people participated following an injury (occurring between 2007 and 2009) registered with New Zealand’s no-fault accident compensation scheme (ACC). POIS-10 will invite 2121 people (including 358 Māori) who completed a 24-month POIS interview and agreed to follow-up, anticipating 75% participation (n = 1591). Interviews will collect sociodemographic characteristics, life events, comorbidities, and new injuries since participants’ 24-month interview, as well as key disability, health, and wellbeing outcomes 12 years post-injury. Injury-related data will be collected from ACC and hospitalisation records 12 years post-injury. Regression models for the main outcomes will examine the direct effects of predictor variables after adjustment for a wide range of confounders. POIS-10 is enhanced by our partnership with ACC, and expert advisors and will benefit injured people, including Māori, through increased understanding of mechanisms and interventions to improve long-term post-injury outcomes.

Speech-Language Pathology in the Peace Corps: Necessity and Sustainability

2012 ◽  
Vol 2 (1) ◽  
pp. 11-18
Author(s):  
Melissa A. Pierce
Keyword(s):  
United States ◽  
Special Education ◽  
Peace Corps ◽  
People With Disabilities ◽  
Communication Disorders ◽  
The United States ◽  
Speech Language Pathology ◽  
Speech Language Pathologists ◽  
Language Pathology

In countries other than the United States, the study and practice of speech-language pathology is little known or nonexistent. Recognition of professionals in the field is minimal. Speech-language pathologists in countries where speech-language pathology is a widely recognized and respected profession often seek to share their expertise in places where little support is available for individuals with communication disorders. The Peace Corps offers a unique, long-term volunteer opportunity to people with a variety of backgrounds, including speech-language pathologists. Though Peace Corps programs do not specifically focus on speech-language pathology, many are easily adapted to the profession because they support populations of people with disabilities. This article describes how the needs of local children with communication disorders are readily addressed by a Special Education Peace Corps volunteer.

ENDOSCOPIC TREATMENT OF CHRONIC PANCREATITIS IN PEDIATRIC POPULATION: LONG-TERM EFFICACY AND SAFETY

2019 ◽  
Author(s):  
D Kohoutova ◽  
A Tringali ◽  
G Paparella ◽  
V Perri ◽  
I Boškoski ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Treatment ◽  
Pediatric Population ◽  
Efficacy And Safety ◽  
Term Efficacy

Skull base aneurysmal bone cyst presenting with hydrocephalus: progressive residuum obliterated by Gamma Knife stereotactic radiosurgery in a pediatric patient

2020 ◽  
Vol 26 (1) ◽  
pp. 76-81
Author(s):  
George H. Tse ◽  
Feng Y. Jiang ◽  
Matthias W. R. Radatz ◽  
Saurabh Sinha ◽  
Hesham Zaki
Keyword(s):  
Skull Base ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Pediatric Population ◽  
Bone Cyst ◽  
Disease Free Survival ◽  
Long Term Follow Up ◽  
Aneurysmal Bone Cysts ◽  
Gamma Knife Stereotactic Radiosurgery

Aneurysmal bone cysts (ABCs) are an uncommon entity predominantly encountered in the pediatric population. The skull is rarely involved, but these cysts have been reported to arise in the skull base. Traditional treatment has been with surgery alone; however, there is a gathering body of literature that reports alternative treatments that can achieve long-term disease-free survival. However, these therapies are predominantly directed at peripheral skeletal lesions. To the authors’ knowledge, this report is the first to describe long-term follow-up of the efficacy of Gamma Knife stereotactic radiosurgery for treatment of ABC residuum in the skull base that resulted in long-term patient stability and likely ABC obliteration.

One-year costs of intensive care in pediatric patients with traumatic brain injury

2021 ◽  
Vol 27 (1) ◽  
pp. 79-86
Author(s):  
Era D. Mikkonen ◽  
Markus B. Skrifvars ◽  
Matti Reinikainen ◽  
Stepani Bendel ◽  
Ruut Laitio ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Social Security ◽  
Functional Outcome ◽  
Injury Severity ◽  
Pediatric Population ◽  
Favorable Outcome ◽  
Index Hospitalization ◽  
Pediatric Tbi

OBJECTIVETraumatic brain injury (TBI) is a major cause of death and disability in the pediatric population. The authors assessed 1-year costs of intensive care in pediatric TBI patients.METHODSIn this retrospective multicenter cohort study of four academic ICUs in Finland, the authors used the Finnish Intensive Care Consortium database to identify children aged 0–17 years treated for TBI in ICUs between 2003 and 2013. The authors reviewed all patient health records and head CT scans for admission, treatment, and follow-up data. Patient outcomes included functional outcome (favorable outcome defined as a Glasgow Outcome Scale score of 4–5) and death within 6 months. Costs included those for the index hospitalization, rehabilitation, and social security up to 1 year after injury. To assess costs, the authors calculated the effective cost per favorable outcome (ECPFO).RESULTSIn total, 293 patients were included, of whom 61% had moderate to severe TBI (Glasgow Coma Scale [GCS] score 3–12) and 40% were ≥ 13 years of age. Of all patients, 82% had a favorable outcome and 9% died within 6 months of injury. The mean cost per patient was €48,719 ($54,557) (95% CI €41,326–€56,112). The index hospitalization accounted for 66%, rehabilitation costs for 27%, and social security costs for 7% of total healthcare costs. The ECPFO was €59,727 ($66,884) (95% CI €52,335–€67,120). A higher ECPFO was observed among patients with clinical and treatment-related variables indicative of parenchymal swelling and high intracranial pressure. Lower ECPFO was observed among patients with higher admission GCS scores and those who had epidural hematomas.CONCLUSIONSGreater injury severity increases ECPFO and is associated with higher postdischarge costs in pediatric TBI patients. In this pediatric cohort, over two-thirds of all resources were spent on patients with favorable functional outcome, indicating appropriate resource allocation.

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