Service Delivery in the Healthcare and Educational Systems for Children Following Traumatic Brain Injury: Gaps in Care.
Juliet Haarbauer-Krupa, Angela Ciccia, Jonathan Dodd and 4 others
PMID 28060211WHAT IT FOUND
Children with TBI often miss needed care: few receive inpatient or outpatient rehabilitation, and schools rarely identify them for TBI-related support.
Children who receive systematic transition services are more likely to be identified for school support.
Key findings
01Only a small number of children with TBI are admitted to inpatient rehabilitation, and a minority receive ongoing therapy after initial care.
02Few children are identified for TBI-related special educational services, and many are misidentified as having other disabilities.
03Children who receive systematic transition services as part of their medical care are more likely to be identified for specialized school support services, such as speech therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a review of service delivery and literature, not a controlled trial, so it cannot show that any service model improves patient outcomes. The authors state that quality indicators for inpatient rehabilitation are based on expert consensus, not evidence verifying validity or clinical feasibility. They note limited research on the effectiveness of the care continuum and on components of healthcare or educational systems. The scope did not address all issues related to TBI management, including community services, state-based services, transitions within school, and transition to adulthood. Service delivery varies by state and local system, so concrete methods for implementing recommendations may not transfer everywhere.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the association with systematic transition services as proof that any service model works. The review is not a controlled trial, and it notes limited evidence on effectiveness of care components.