Self-Care Recovery of Children with Brain Injury

Abstract

The purpose of this study was to describe self-care recovery of children and adolescents with acquired brain injury using six newly derived self-care functional classification levels, to examine the responsiveness of the levels, and to compare level changes with scaled score changes. Upon admission and discharge to inpatient rehabilitation, the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skills Self-Care domain was administered by occupational therapy staff to 152 children and adolescents with brain injury (mean age = 9.3 years; SD = 6 5.2). Scaled scores were converted to self-care classification levels. Using the Wilcoxon matched pairs signed rank test, a difference between admission and discharge level was found for the entire group. Children with traumatic brain injury and stroke demonstrated the most change. When compared with scaled score changes, minimal sensitivity was lost when using classification levels. The PEDI self-care levels provide a responsive analysis of recovery and offer an alternative to the reporting of change scores.

Key Words:

• Brain injury
• outcomes
• Pediatric Evaluation of Disability Inventory
• pediatric rehabilitation
• self-care

Additional information

Notes on contributors

Helene M. Dumas

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.

Janette McDougall, MA, was Project Coordinator

Kip Husted, BEd, was a parent representative on the study team.

Aviva Yochman, MA, OTR, was a student in the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel at the time of this study.

Imelda Burgman, MA OTR/L BCP, completed her MA in Movement Sciences at Teachers College, Columbia University, and was an Occupational Therapist at The Shield Institute, Bronx, NY. She is currently Lecturer, Habilitation, School of Community Health, Faculty of Health Studies, Charles Sturt University, Albury, N.S.W., Australia.

Barbara J. Steva, OTWL, BCP, is Occupational Therapist, University of New England Community Occupational Therapy Clinic, Saco, ME. She was Director of Occupational Therapy and Therapeutic Recreation, Franciscan Children's Hospital and Rehabilitation Center, Boston, MA, when this work was completed.