Building capacity for clinicians to develop services for children with acquired brain injuries (ABI)

East of EnglandGeneric Health Relevance
Published Date: 18 Apr 2019

 

Acquired brain injury (ABI) is a leading cause of disability in the UK, especially amongst children. However, there are major gaps in research and in national health service provision for the children, young people and their families (CYP+F) affected by ABI.  Over the past 8 years, 4 CLAHRC fellowships have been integral to the development of our understanding of the needs of children as well as the development of the design of services in the East of England for children with ABI.

The Cambridge Centre for Paediatric Neuropsychological Rehabilitation (CCPNR) was established in 2009 for children with Acquired Brain Injury.  This is an interdisciplinary neurorehabilitation service designed to support children and families in the community.  Here’s how the CLAHRC helped the CCPNR service develop, the only one of its kind in the UK:

In 2011, as lead for the new service for children with acquired brain injury Dr Fergus Gracey, Clinical Neuropsychologist used his CLAHRC Fellowship to investigate the mental health needs in children who have had an acquired brain injury.  He found that children with ABI matched their CAMHS peers with the cognitive, emotional, behavioural and social problems once discharged into the community. 

In 2012 Dr Anna Maw, Consultant Paediatric Neurologist at Addenbrookes Hospital, explored who were the children in Cambridgeshire who got admitted to hospital following a Head Injury with a CLAHRC Fellowship: 70% were under the age of 6 years old yet only 30% had follow up.  With help from colleagues at UEA, Dr Fergus Gracey and Dr Suzanna Watson further analysed the initial data collected from the young people with ABI in the community to understand how younger age at injury affects later social relationships via certain executive cognitive functions, which was published in Social Care and Neurodisability. In 2015, the CCPNR team wrote two book chapters in the Neuropsychological Rehabilitation of Childhood Brain Injury.

Eager to understand the impact of childhood brain injury further, in 2016 Gillian Shravat, Specialist Speech and Language Therapist, worked with Dr Fergus Gracey and Dr Adam Wagner (CLAHRC Health Economist & Statistician) in her CLAHRC Fellowship to identify clinically meaningful clusters of children, characterised by pre and post injury cognitive, emotional and social issues, that require different approaches to service provision (building on a previous CLAHRC fellow’s work in adult neurorehabilitation). This is now being used to inform ‘stepped care’ triaging within a new brain injury follow-up clinic with Dr Anna Maw in Addenbrookes Hospital.

Inspired by all this research and service development, Dr Suzanna Watson (Clinical Psychologist at Addenbrookes Hospital and at the CCPNR) has been grateful to have a CLAHRC Fellowship to scope the provision of services with commissioners in the East of England with the help of Alexander Komashie (CLAHRC Engineering Design Centre).  “What children with brain injuries want” has been accepted for publication in the Journal of the International Neuropsychological Society and Suzanna and Fergus are due to have another book chapter published in September.