Most rehabilitation services include the following:
A licensed doctor provides evaluation, diagnosis, and treatment of your child's medical condition. This may be a physiatrist (who is a doctor that specializes in rehabilitation medicine involving the care of people with disabilities) or a pediatrician (whose specialty is children and youth). A pediatric physiatrist is trained in both areas.
Nursing care prevents medical complications and encourages skills to build your child's independence. Skin care, bowel and bladder training, medication administration, pain management, and seizure control are special areas of nursing care. The emphasis in rehabilitation nursing is not on doing it for your child, but helping your child and family learn how to manage care and become as independent as possible. The rehabilitation nurses have an overall picture of your child's condition and progress because they give 24-hour care.
Physical therapists help your child move by using the large muscles: the legs, hips, and trunk. They help your child increase muscle strength, become more mobile, and build endurance. They work on posture, walking, and body awareness. Canes, braces, splints, wheelchairs, or walkers may be used for mobility and safety. Special therapies may use heat, cold, electricity, massage, or exercise.
By contrast, the occupational therapist concentrates on the small muscles in your child's face, upper trunk, arms, and hands. They help teach your child how to do daily activities, such as eating and dressing. They also help prepare your child for school by developing necessary skills, such as using a pen or pencil and working at a desk or table. Adaptive aids or splints may help your child if hand coordination or upper body strength has been affected.
Speech/language pathologists, often referred to as Speech Therapists, can evaluate your child's ability to speak, understand, read, and write language. They can also evaluate your child's ability to use expressive language, which includes gestures and vocalizing. Speech/language pathologists also evaluate your child's ability to think and process information. A brain injury can affect cognition and language in many different ways and these therapists are trained to evaluate and treat communication disorders. They can also help your child if eating, swallowing, or controlling saliva has been affected, or if tubes in the throat or nose limit speech.
An audiologist can determine if your child's hearing has been affected by the brain injury. Once a hearing difficulty is understood, audiologists can help your child communicate better. Testing can also determine if your child will be helped by hearing aids or other devices to increase sound.
A child with a pulmonary or lung condition may require careful monitoring and special equipment, such as a ventilator or resuscitator. Therapies to keep the lungs clear and to manage or remove secretions can help prevent infections and make breathing more comfortable. Exercise conditioning, breathing retraining, and coughing exercises may be taught by a respiratory therapist.
Psychologists can counsel your child and family to help you adjust to the physical, behavioral, and cognitive changes from the brain injury. Special written and verbal tests can evaluate how the brain injury has affected your child's intelligence and mental status.
Specialists can help your family understand how the brain injury has affected your child's behavior. They can identify what noises, actions, or requests tend to upset your child. They work with family and staff to understand unusual and upsetting behaviors and to develop plans for calming and reassuring your child. They can help you understand how some behaviors are related to injured areas of the brain, and how others may be an emotional reaction to what has happened.
A neuropsychologist is a psychologist with additional training in the relationships between the brain and behavior. Interviews, written and verbal tests, and other exercises gather information on how your child's brain is functioning and its effects on behavior. They examine your child's ability to think clearly and logically, solve problems, recall information, and learn new information. These evaluations can be especially helpful for deciding whether special help will be needed when your child returns to school.
Social Work Services
Social workers can help your child and family cope with what has happened and prepare for the future. They are important links to resources in the school and community. Social workers are also experienced in discharge planning.
An education specialist is a certified school teacher who specializes in understanding how physical, cognitive, and behavioral deficits are related to learning and school functioning. During a hospitalization, the education specialist provides patients and families with information about school accommodations and resources. With family permission, this specialist can initiate communication with a child's school and school district. An education specialist can provide discharge information, in-service training, peer education, and collaboration with the school staff for a smooth transition.
Case management, which is also called care management, may be done by a social worker, case manager, rehabilitation nurse, or discharge planner. The purpose is to coordinate benefits and programs efficiently and effectively. Case managers help plan for moving your child from one stage of care to the next, and they can refer you to specialists and resources in the hospital and community. Case managers may be employed by the rehabilitation program, your insurance company, or a community agency.
Regardless of how brief or long your child stays in a rehabilitation program, it is important for your family to be educated about brain injury. If your child will be returning home, then your family must be trained to use special equipment and to provide ongoing care, medications, therapies, and supervision. Your family will also need to be prepared for responding to changes in your child's emotions and behaviors. Training should include discussions of how the brain injury may affect your child's development and maturation.
Play is important, but many games and activities challenge a child's eye-hand coordination and physical abilities, as well as their language and organizational abilities. Play that used to be fun can now be frustrating for the child with a brain injury. Recreational therapy can help your child develop the skills needed for games and other recreational activities.
Other Rehabilitation Services include: