Identifying Needs for Children and Adolescents with Traumatic Brain Injury....How Do We Manage the Gaps?


Christine MacDonell


Adriaan Theeuwes
Carole Chantler
Francisco Angulo Parker


In February 2017 the World Health Organization developed Rehabilitation 2030...A Call for Action. This course of action called for the "upscaling" of rehabilitation in many areas and recognized that throughout the lifespan rehabilitation is beneficial. Since 2005 there has been an increase of 183 million individuals with severe levels of disability who are in need of rehabilitation services. This growth is not limited to one area of the world but in all countries. The demand for rehabilitation services already exceeds capability in many low to middle income countries, A main problem is the lack of qualified rehabilitation experts to deal with the rehabilitation needs in their countries. Even in more adequately staffed countries there is a low utilization of rehabilitation services. The lack of rehabilitation health care networks from trauma to living and participating in the community of choice are almost non-existent in most countries. there are pockets of facilities but not developed, integrated networks to facilitate greater levels of participation and inclusion.

What this means to children and adolescents with traumatic brain injuries may range from poor survival due to lack of acute trauma services to limited access to designated brain injury rehabilitation continuums of care, to limited integration into education, limited rehabilitation services facilitating movement into adult health care systems and limited opportunities for full inclusion back into society.

It is always important to hear from different perspectives and what others are doing to improve the development and utilization of rehabilitation for children and adolescents with TBI. We will explore through the eyes of a father their adolescent son's journey from acute trauma care through the Dutch system and what were the gaps, how they were filled and the plan of action to make change in the system. Also critical to good care is a case management approach. We will hear from a case manager and leader in that field how to work within the UK system which divides health care from social care. This system does not support collaborative networks of providers so the development of appropriate care plans are challenging and many times the gaps are areas that there is limited access or communication with like education, vocational trainings and transfers to adult health care. An important dimension is the paeditatric physiatrist's role and how to facilitate appropriate health, rehabilitation, and educational services across the lifespan of the child and adolescent and the fostering of transition to adulthood.

The discussion is one that will not solve issues but open the dialogue to know what others are doing to address and improve the quality of services for these children and adolescents and hopefully trigger new thinking and collaboration among the participants. There will also be a short discussion of the WHO's Rehabilitation 2030's next steps.


Learning Objectives:

  1. Address gaps that were identified and discussed during presentation and use them as a guide to identify gaps in their systems.
  2. Develop strategies to address gaps in their systems.
  3. Identify what Rehabilitation 2030 identified as next steps and how they relate to the participants country.