A review of family intervention guidelines for pediatric acquired brain injuries

Abstract

Pediatric acquired brain injury (BI) not only affects the child with the injury, but also greatly impacts their family. Studies suggest there are higher rates of caregiver and sibling psychological distress after a child in the family has sustained a BI. Also, family functioning after BI impacts the child's recovery. In reviewing the literature, we identified seven theoretical clinical guidelines for working with families of children and adolescents with BI. These clinical guidelines are as follows: (1) select developmentally appropriate interventions, (2) match the intervention to the family, (3) provide advocacy, (4) provide injury education, (5) focus on family realignment, (6) appropriately adjust the child's environment, and (7) provide skills training to the family and child. The existing research on family interventions for BI is reviewed within the context of these theoretical guidelines, and the empirical support for each guideline is subsequently evaluated using specific criteria for empirically supported treatments. Unfortunately, very few randomized controlled studies exist, and continued research is needed to classify all clinical guidelines as "efficacious." In addition, continued research will aid in informing professionals of specific approaches to utilize when working with a family of a child with BI. Currently, clinicians and researchers can turn to the existing clinical guidelines to help address the numerous barriers posed by implementing and studying family interventions for pediatric BI.

A Systematic Review of Parenting Interventions for Traumatic Brain Injury

“…Reviews of the TBI literature consistently identify limited numbers of controlled trials, 11,12,38,39 presumably due to recruitment challenges inherent in this population, 40 and these studies are therefore an important contribution to this field of research. Reviews of the TBI literature consistently identify limited numbers of controlled trials, 11,12,38,39 presumably due to recruitment challenges inherent in this population, 40 and these studies are therefore an important contribution to this field of research.…”

Parenting a child with a traumatic brain injury: Experiences of parents and health professionals

“…Despite knowledge of the impact of TBI on the child, parents and family and the importance of family factors in recovery, there remains limited quality research considering effective family interventions for this population, both in terms of interventions teaching parents behaviour management strategies [24] and interventions addressing the adjustment of parents and families [24][25][26]. Clearly there is a need for more research to be conducted in this area to determine the best ways of supporting families in order to improve both child and family outcomes, reduce burden on healthcare systems and potentially minimize future use of mental health services.…”

Quality care in pediatric trauma

“…Family functioning before and after the injury has a significant effect on HRQOL outcomes in children after trauma. [79] Parental behaviors after the traumatic event are perhaps more important for the child's adjustment and recovery than the actual event exposure itself. Identification of these at-risk families is crucial to provide support and ultimately mitigate these stressors.…”