Neuropsychological, Behavioural Assessment and Treatment of Children with Acquired Brain Lesions: From Disorders of Consciousness to School Reentry


Sandra Strazzer


Susanna Galbiati
Monica Recla
Valentina Manfredi
Katia Colombo
Loredana Stella



Introduction: Acquired brain injuries are a main cause of disability and mortality in childhood and adolescence and they can result from a variety of etiologies. Children who sustained severe brain insults show, after a period of prolonged reduced responsiveness, residual cognitive and functional impairment and long-term deficits, that have the potential to significantly interfere with development. Our working group is trained and specialized in the evaluation and treatment of pediatric patients suffering from disorders of consciousness and neuropsychological acquired deficits. As already documented in several previous studies, our clinical experience confirms the importance of an early multidisciplinary intervention, taking into account individual needs and continuously monitoring the clinical picture of every single patient. Cognitive rehabilitation begins with a thorough neuropsychological assessment to identify cognitive strengths and weaknesses and the degree of change in cognitive ability following a brain injury. The results of the assessment are used to formulate appropriate treatment plans. We have developed specific protocols that, alongside the most well-known rehabilitative interventions, includes cognitive-behavioral stimulations, speech, neuropsychological and behavioural therapy. It is known that a spontaneous neuropsychological recovery takes place after brain injury. Moreover environmental stimulation (school, family, sensory stimulation), together with different rehabilitation intervention may promote an increase in global attention to the environment and an improvement in cognitive function when the subjects return home and resume their daily habits. However, levels of normality are not achieved, and this has an impact on functional recovery. Our studies and clinical experiences allow us to conclude that patients with severe brain damage benefit from rehabilitation immediately after lesions and over the next two years. Cognitive rehabilitation is a set of interventions that aim to improve a person’s ability to perform cognitive tasks by retraining previously learned skills and teaching compensatory strategies. Rehabilitation should importantly be aimed at improving the ability to interact with environment, sustained and selective attention, processing speed, speech, working memory and problem-solving. If adequately stimulated, these functions improve and may also promote the recovery of skills that are crucial for school and social re-entry. For this reason the last part of our intervention consists in studying the way which neuropsychological deficits affect school learning and planning school reentry interacting with teachers and family.
Main Objectives: To extend the knowledge about neuropsychological and psychological assessment in order to plan early effective interventions and organize social and school reentry.
Methods: Frontal lesson, discussion and analysis of single cases, video tutorial.


Learning Objectives:

  1. Assess and plan specific treatments for children and adolescents with disorders of consciousness.
  2. Assess cognitive and behavioural  profile and organize neuropsychological treatment for children and adolescents with severe acquired brain lesions.
  3. Project school reentry cooperating with pedagogists and teachers.