Providing Neuropsychological Interventions For Children And Young People With Acquired Brain Injury

CoRaL Psychology was set up to provide neurocognitive interventions that meet the needs of children with cognitive impairments, for example, attention, memory (short–term and long-term), planning, problem-solving, inhibition and cognitive flexibility. We follow a stepped care approach and work with the child, family, school and other agencies involved in the child’s care to identify appropriate strategies and approaches that are consistent with the child’s individual cognitive profile, developmental stage, physical health, home and school situation. This model has been presented at conferences in the UK and Europe and has been published in a peer-reviewed journal (Limond, Adlam and Cormack, 2014)1. Strategies and techniques that may be utilised include:

• Memory aids that increase independent functioning.

• Learning and memory encoding and retrieval strategies that increase the likelihood of key information being retained.

• Self-regulation interventions that help individuals choose and practice techniques that are aimed at improving control of their own reactions and impulses.

• Metacognitive and goal focused approaches that help support planning and problem-solving in both routine and novel situations.

• Computerised working memory training (Cogmed) to improve foundation skills that support literacy, numeracy, attention and adaptive functioning.

For the majority of young people with acquired brain injury numerous factors may need to be addressed before, or while, this type of work gets done, including:

• emotional factors such as anxiety, depression or trauma reactions.

• behavioural factors such as challenging or obsessive compulsive behaviour.

• psychosocial issues such as family factors and social circumstances.

Often we need to consider the ability of the individual to accept and understand their difficulties, developing their willingness to engage in interventions. Occasionally we may also need to focus on acceptance and adjustment in others e.g. family or school. We will work collaboratively across agencies in order to ensure consistent support across multiple environments. Depending on the individual’s situation and access to local services we may provide neuropsychology supervision and support to other therapists working on these emotional, behavioural and psychosocial issues or we may provide this support ourselves. Cognitive interventions can sometimes be introduced alongside this therapeutic work, but that can be challenging and in some cases needs to wait until this foundation work is better established. We take a responsive approach to the introduction of the cognitive interventions, and aim to be collaborative and flexible in all aspects of our work.

We work with children and young adults with a wide-range of difficulties. If children are using communication aids (e.g. eye gaze technology) we may request the involvement of an assistive technology expert to help us complete cognitive assessments and evaluate strategies to support cognitive interventions and any other therapies that the child may be receiving.

1 Limond, J., Adlam, A.-L.R., and Cormack, M. (2014) A model for paediatric neurocognitive interventions: considering the role of development and maturation in rehabilitation planning. The Clinical Neuropsychologist, 28(2), 181-198