Child's name:  Alfie
Support Coordinator's name:  Emily Colley
Location:  South West

Alfie was 13 when he sustained a blow to the head in an incident with another child. He was rushed to the local hospital by ambulance before being transferred to the Major Trauma Centre (MTC) in Bristol where he was treated as an inpatient for 2 weeks before being discharged home. Things got off to a rocky start with the transition back to the community and Alfie’s mum had felt very abandoned. They had no ongoing therapies arranged but needed access to speech and language therapy for some ongoing word finding issues. It took a little while but Alife was able to access this in the community. Alfie’s main difficulties were all hidden and, as a result, school where expecting him to go right back into full time school after being home for only a few days. They had no understanding about ABI and long-term impact of it. At school, Alfie was having trouble with being able to pay attention for long periods of time, being able to recall information and knowing what he needed to write. A card enabling early exit from class was put in place, but Alfie hated standing out and, after being questioned on why he needed to leave, this was abandoned by Alfie. This meant he was left to struggle in class unless someone checked in to see how things were, Alfie would just sit in silence and struggle alone. The feedback from teachers was that Alfie was a quite child who “just gets on with work with no issues” despite his grades slowly slipping.

As well as ongoing cognitive issues, Alfie was also experiencing difficulties with mental health including flashbacks and aversions to certain things that served as reminders of the incident. This made things difficult and Alfie retreated into a more secluded lifestyle. This was a big change for a child who used to be very social and was always playing out with friends.

The Child Brain Injury Trust got involved with this family following a referral from the Trauma team from the local MTC about 2 weeks after discharge. After an initial meeting with the family in their home it was established that the biggest challenges facing Alfie was school and the impact the incident had on his mental health. Alfie was refusing to go to school most days and where he was attending, there would be incredibly challenging behaviours at home. It was arranged that the Child Brain Injury Trust would go in to school and run an ABI awareness session with the staff. This session was attended by every member of the secondary school staff who all noted how useful it had been and how they had not realised the impact the incident had had on Alfie. Strategies were agreed with the school and successfully implemented. Alfie began to enjoy school again and stopped refusing to attend. Following this, our Child and Family Support Coordinator has continued to support this family by attending regular team around the family meetings and this has allowed close monitoring of how Alfie is doing in school. It has recently been identified that, despite the measures that are in place, Alfie continues to struggle in school, so our child and family support coordinator has been able to use the link with the MTC to get Alfie rereferred for a full cognitive assessment. This will help pinpoint exactly which areas of cognition he is struggling with so school can better support in these areas, it is also going to support the Education Health Care Plan application to get extra support in school. Alfie is still happy in school and is reassured that things are being put in place for the future.

As well as the school support, our Child and Family Support Coordinator worked with the team at the MTC to ensure that Alfie was referred to CAMHS. CAMHS diagnosed him with Post-Traumatic Stress Disorder from the incident and referred onto local clinical psychology teams. With input from them Alfie has started to reintegrate with friends and has even slept over with family for the first time in over a year. Alfie has ongoing input from psychological services to support with the PTSD.

Our Child and Family Support Coordinator also suggested that the family apply for a break as they had all been through a traumatic time and had missed out on most of their summer holiday. With the support of the Child and Family Support Coordinator they successfully applied for a break to holiday camp by the sea and enjoyed a week away reconnecting after the incident. We also supported the family with an application to the local authority for a house move to allow Alfie to have a room that would be just for him. This has helped with his fatigue as Alfie no longer has to share with his brother which allows more recovery time from the day at school.

With support from the Child Brain injury Trust, Alfie’s family have been able to face the challenges ABI bring head on. As well as offering vital emotional support to the family, we have been able to implement support strategies within school to support Alfie in the ongoing years and continue to support as Alfie heads towards GCSEs. We are continuing to support Alfie to ensure psychological needs are being supported and continue to work closely with the MTC to support the family and their needs.