Accidents can happen, and comforting a child following a bumped head is a rite of passage for parents. The majority of these accidents won’t be serious, and for the most part, a trip to the hospital won’t be needed. For some families however, the incident is significant enough to warrant medical attention. In England, about 35000 children per year sustain a traumatic brain injury, and the vast majority of these are considered ‘mild’.
Children who sustain ‘moderate’ or ‘severe’ brain injuries tend to receive intervention automatically, and quickly, whether that be in A& E, on a neuro-rehab ward, or from community services once they are discharged to home. Children who have sustained a mild brain injury however do not. This is concerning, as studies tell us that children with even a mild brain injury can go on to experience persistent symptoms. These symptoms can include physical difficulties, changes in memory, thinking and problems solving, and emotional problems, like increased worrying or feeling sad.
Part of the problem is that these difficulties with thinking, memory and emotions can be harder to recognize, and so it might be a while before anyone even realises that there is a problem. And in children, because the brain is still developing, it may take a bit of time, sometimes even years, for difficulties to show. For example, it may only be when a child moves into secondary school, where independent planning and thinking skills become more important, that we see the full effects of an injury.
With mild brain injuries, as with moderate and severe, it is important to offer interventions as early as possible. Ideally, this should be before children and parents are really struggling. The following interventions may be helpful to families where a child has sustained a mild brain injury.
Information for families
Information on the possible consequences of a mild brain injury would be helpful, as it would guide parents to know what to look for, and difficulties could be identified and supported earlier. As well as helping the child return to previously enjoyed activities, this approach can also be useful in helping parents separate out symptoms of a mild brain injury from other normal developmental changes.
Information for professionals
Professionals who work with children following a mild brain injury e.g. GP, community paediatrician should be made aware of the available services for children with a brain injury, and how to make a referral. These supports may include both statutory services e.g. community occupational therapy, and charitable bodies.
Support with problem-solving
We know that when a child sustains even a mild brain injury, possible changes in the way that they think, feel emotion, and behave, can mean that the ways that their family previously used to resolve difficulties are now less effective. Learning new ways to problem-solve and deal with conflict can be really helpful, and your GP or community Paediatrician may have more information on how you can access this in your area.
Support with education
Parents may have concerns that their child’s academic ability has dipped following their brain injury. If this is the case, it is important that they discuss these worries with school, who may even have noticed changes that family have not. Where schools share parents’ concerns, they may be able to offer additional support, or arrange for an assessment of the child. Some organisations, including the Child Brain Injury Trust, offer training to schools to enable them to better recognise difficulties in children following a mild brain injury, and can even liaise directly with school about a child.
It is important to know that help and support following a mild brain injury is available to those children and families who need it. A child’s GP is a useful starting point for finding out what services might be best for their needs.
You may find the Child Brain Injury Trust’s virtual support page useful: https://childbraininjurytrust.org.uk/virtual-brain-injury-support/
Dr Katie Burns
Highly Specialist Clinical Psychologist – Belfast Trust