Pediatric acquired brain injury (pABI) may lead to long-lasting cognitive, emotional, behavioral, and somatic challenges, which in turn may have a negative impact on the child´s ability to participate in school, leisure, and social life. In addition, a pABI constitutes a substantial caregiver burden and may negatively influence parents´ and family functioning. Families often experience unmet health care needs. In Norway, the long-term rehabilitation options for this vulnerable group are limited.
This thesis describes 1) the 6-month outcomes of a sample of Norwegian children with traumatic brain injury, and 2) the development, feasibility-testing and initial results from an individualized and goal-oriented rehabilitation intervention: the Child in Context Intervention study (CICI). The CICI is tailored to the specific needs of each family and includes a collaboration between families and the children´s schools. The most frequently occurring topics that were addressed in the intervention were related to the child´s fatigue and emotional symptoms, and to increased independence in everyday life, school, and social life. Goal attainment was high, as 94.4% of the goals had a positive progress through the intervention. The families were satisfied with the treatment.
The results of the studies included in this thesis demonstrate the need to apply a biopsychosocial framework to assessments and interpretations of symptoms in this patient group. The thesis also presents promising results in applying a holistic intervention program that provides individualized and goal-oriented rehabilitation in collaboration between the child, the families, schools, and health-personnel in the long-term phase of injury.