Nagele Drew A, McCart Melissa, Hooper Stephen R
Beechwood NeuroRehab, Langhorne, PA, USA.
Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
NeuroRehabilitation. 2018;42(3):289-298. doi: 10.3233/NRE-172386.
It is vital to engage in systematic screening to identify and serve children who may have sustained an acquired brain injury (ABI) - either traumatic or non-traumatic, so they can be successfully transitioned between environments and life stages. This is particularly important for children and adolescents given the impact an ABI can have on learning and social functioning over the course of the neurodevelopmental process. A pattern of repeated, undiagnosed mild brain injuries may lead to mood or behavior disorders, learning problems. Despite increasing awareness of brain injury as a public health issue, there has not been implementation of systematic screening practices in schools or other public health settings similar to other conditions (e.g., vision disorders, Autism Spectrum Disorders).
What is needed to address this lack of systematic screening for ABI is a rationale for systematic screening for ABI in children and adolescents, including examining successful models of screening for other disorders and conditions.
A review was conducted of available ABI screening methods, including a description of the available screening tools for pediatric ABI, along with supporting research findings.
A comparison was made of these pediatric ABI screening tools, looking at the purpose of the tool, the populations and settings in which the tool can be used, the time and cost for administering the tool, the evidence basis in the literature supporting the tool, and the types of outcomes that can be attained from using the tool.
Recommendations are made for procedures for systematically implementing ABI screening in pediatric settings including schools, primary care providers, mental health, and juvenile justice systems to improve the access to brain injury services and affording more successful transition of adolescents into the adult roles.
进行系统筛查以识别和服务可能遭受获得性脑损伤(ABI)的儿童至关重要,这种损伤可能是创伤性的或非创伤性的,以便他们能够在不同环境和生命阶段顺利过渡。鉴于ABI在神经发育过程中可能对学习和社交功能产生影响,这对儿童和青少年尤为重要。反复发生且未被诊断的轻度脑损伤可能导致情绪或行为障碍、学习问题。尽管人们越来越意识到脑损伤是一个公共卫生问题,但在学校或其他公共卫生环境中,尚未像对待其他疾病(如视力障碍、自闭症谱系障碍)那样实施系统的筛查措施。
解决ABI缺乏系统筛查这一问题所需的是为儿童和青少年进行ABI系统筛查提供理论依据,包括研究其他疾病筛查的成功模式。
对现有的ABI筛查方法进行了综述,包括对儿科ABI可用筛查工具的描述以及相关研究结果。
对这些儿科ABI筛查工具进行了比较,考察了工具的目的、可使用该工具的人群和环境、使用该工具的时间和成本、文献中支持该工具的证据基础以及使用该工具可获得的结果类型。
针对在儿科环境(包括学校、初级保健提供者、心理健康和青少年司法系统)中系统实施ABI筛查的程序提出了建议,以改善获得脑损伤服务的机会,并使青少年更成功地过渡到成人角色。