NSW Brain Injury Rehabilitation Forum May 2011

 

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Innovative treatment of behavioural problems in paediatric brain injury: challenges and opportunities
WENDV MCCONNELL, Hunter New England Paediatric BIRT

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Title: Innovative treatment of behavioural problems in paediatric brain injury: challenges and opportunities

Authors: Wendy McConnell, Fiona Dyet & Matthew Frith, Paediatric Brain Injury Rehabilitation Team, Hunter New England Local Health Network

Behavioural problems in children following traumatic brain injury pose difficulties for families and service providers. Children who live in rural and remote areas are disadvantaged due to difficulty accessing specialist services.

The aim of this research was to investigate the benefit of providing parenting support and TBI information using a structured program accessed by parents via the internet. The program was augmented by 9 weekly sessions with a psychologist to consolidate the learning tasks and tailor the intervention to the specific needs of the family. These sessions were conducted face to face, or by videoconference for those living a distance from the service. Participants were parents of children aged 3 to 10 years old who had sustained a traumatic brain injury who were being managed by a paediatric brain injury service, and had identified behavioural problems.

Parents completed pre-intervention, weekly, and post-intervention questionnaires of child behaviour and parenting self-efficacy. The data from three families will be discussed. The intervention was successful in assisting families to normalize child behavioural difficulties, and utilize existing family practices to address problematic behaviours. Child behavioural problems reflective of parental conflict did not improve with the intervention.

Interviews were conducted with paediactric case managers to investigate behavioural difficulties in this client group, the kinds of interventions required in these families, and individual and service barriers preventing a successful intervention. Themes identified included disorganized family structures limiting ability to access structured programs, the need for systemic interventions rather than specific behavioural management approaches, and a high frequency of pre-existing problematic family dynamics and child behavioural issues for children presenting with post-injury behavioural difficulties.