Empirically Supported Psychological and Behavioral Therapies in Pediatric Rehabilitation of TBI

Warschausky, Seth; Kewman, Donald G.; Kay, Joshua B.

doi:10.1097/00001199-199908000-00006

Cited by 30 publications

(12 citation statements)

References 43 publications

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“…Children and adolescents who experience a traumatic brain injury (TBI) are at risk for social skills deficits and withdrawal and attempts at improving social functioning show promise [58]. The importance and usefulness of supportive and analytic psychotherapeutic approaches with brain injured populations has only recently been recognized [59].…”

Section: Cognitive Remediationmentioning

confidence: 99%

ReviewNeurocognitive sequelae of childhood cancers and their treatment

Mulhern

Butler

2004

Pediatric Rehabilitation

168

133

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The present review will focus on the neurocognitive aspects of the medical treatment of childhood cancer by discussing current knowledge of brain damage among patients and how it is reflected in their cognitive abilities. It will direct these efforts toward the two most common forms of childhood cancer, acute lymphoblastic leukaemia (ALL) and brain tumours. It will first provide the reader with a brief medical background followed by a review of the current literature. The literature review will provide an in-depth analysis of the types of cognitive impairments observed and known or suspected risk factors for impairments. Finally, the review will close with a section that discusses interventions with the potential to prevent or minimize cognitive deficits acquired in the course of cancer treatment as they impact on the quality of life of paediatric cancer survivors.

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Section: Cognitive Remediationmentioning

confidence: 99%

ReviewNeurocognitive sequelae of childhood cancers and their treatment

Mulhern

Butler

2004

Pediatric Rehabilitation

168

133

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“…Moreover, currently available training methods for children are often versions of material designed for adults [17].…”

Section: Introductionmentioning

confidence: 99%

Beneficial effect from a cognitive training programme on children with acquired brain injuries demonstrated in a controlled study

Hooft

Andersson

Bergman³

et al. 2005

Brain Injury

100

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“…One review and case study suggests modifying cognitivebehavioral and coping skills training for TBI-children and to include parental management training [78,Class IIIb]. It is therefore recommended that treatment of mood disorders in children with traumatic brain injuries be referred to a child and adolescent psychiatrist and associated neuropsychologist with experience in the field.…”

Section: Electroconvulsive Therapymentioning

confidence: 99%

Emotional disturbances following traumatic brain injury

Hurley

Taber²

2002

Curr Treat Options Neurol

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Mood disturbances are common sequelae of traumatic brain injury (TBI), but the scientific database for such disorders is very limited in descriptive, prognostic, and treatment data. Post-TBI symptoms often cross diagnostic boundaries and include cognitive loss, amotivation, psychosis, mood, changes, or other domains. The treating physician must be mindful that clear diagnostic boundaries may not exist. Premorbid level of functioning commonly affects post-TBI level of functioning. When setting treatment goals, this must be considered. Patients who had lower levels of psychosocial functioning before the injury may not fare as well afterwards. Treatment of post-TBI mood symptoms should proceed after a full diagnostic work-up including imaging and electroencephalographic (EEG) studies, neuropsychologic testing, and physical and laboratory examinations. Once the diagnostic picture is established, treatment should then proceed with a multidisciplinary team (physician, social worker, neuropsychologist, and others). For the medications, consider both target symptoms and side effects; start medications with low doses and raise slowly, give full therapeutic trials before switching or adding second agents, avoid benzodiazepines if possible, limit anticholinergic or antidopaminergic agents, and avoid providing large quantities of lethal medications. When starting medications for the treatment of mood disorders following TBI, several general principles of treatment in this population should be considered, including: balancing treatment of target symptoms with the potential for adverse effects; making use of side effects to treat comorbid problems when present (ie, relatively antidepressant for depression and marked insomnia); using a "start low, go slow" approach; continuing dose escalation to full therapeutic levels (ie, completing therapeutic trials) before switching or adding augmenting agents; avoiding agents with predictable and functionally important adverse effects (ie, benzodiazepines, strongly anticholinergic or antidopaminergic agents); and avoiding prescription of large and potentially lethal quantities of medications.

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Empirically Supported Psychological and Behavioral Therapies in Pediatric Rehabilitation of TBI

Cited by 30 publications

References 43 publications

ReviewNeurocognitive sequelae of childhood cancers and their treatment

ReviewNeurocognitive sequelae of childhood cancers and their treatment

Beneficial effect from a cognitive training programme on children with acquired brain injuries demonstrated in a controlled study

Emotional disturbances following traumatic brain injury

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