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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

COgnitive REhabilitation in pediatric Acquired Brain Injury (CORE pABI). A randomized controlled study

Alternative title: Kognitiv rehabilitering av barn og unge med ervervet hjerneskade. En randomisert kontrollert studie.

Awarded: NOK 14.6 mill.

Acquired brain injury (ABI), often caused by trauma or brain tumors, affect several hundred children and adolescents in Norway every year. ABI may substantially reduce cognitive functions like attention, memory, learning, language and executive functions. Executive functions are needed for all aspects of our lives, including everyday tasks like getting dressed or making a meal, academic achievement, social relationships and future employment. ABI in children and adolescents not only impact cognitive functions at the time of injury or onset of disease, but also cognitive functions that are yet to develop. Previously we considered rehabilitation of cognitive functions following ABI a difficult task. Recent knowledge about brain function may prove us wrong. There is currently increasing interest in novel methods to restore brain function after injury. Some of these have been proven effective in adults, but few studies have tested methods adapted for children and adolescents. The present study aims to further increase the knowledge base by employing two different group-based brain training methods. The methods have different approaches to promote awareness about everyday tasks. Patients, their families, health care providers and government have all identified an urgent need for improvements in the quality of rehabilitation services for ABI. With this study we hope to show that group-based brain training improves health and everyday life of children and adolescents with ABI. We have included 80 children and adolescents between 10 and 18 years of age in a study to compare two different group-based brain training programs to improve cognitive function (and in particular executive functions) following ABI. In addition to being assessed immediately following intervention, the participants were also assessed 6 months after the training. Recruitment, interventions and 6-month post-intervention testing have now been completed for all paticipants. We are now analyzing the results from the study, and we are preparing publications describing study results.

Acquired brain injury (ABI) is one of the leading causes of death and disability in children and adolescents. Unlike adult injury, pediatric ABI does not only impact cognitive functions at the time of injury or onset of disease, but also cognitive functions yet to develop. Change in cognitive function is associated with negative impact on everyday function, academic achievement, social relationships, independence and future employment. Hence, improvements by cognitive rehabilitation interventions may potentially have important life-long effects. Patient organizations and governmental reports describe severe deficiencies in rehabilitation services for children. Important knowledge gaps and methodological shortcomings have been identified in pediatric cognitive rehabilitation research, including the need to evaluate long-term effects, larger sample size, and investigate if variables such as age, etiology or medical treatment influence intervention outcomes. The present study has been designed in close proximity between a multidisciplinary team and relevant user groups to address methodological weaknesses of prior studies. The study presents a long-awaited act directed towards a vulnerable patient group, hopefully closing knowledge gaps and seeks to give rise to new and evidence-based interventions that can be implemented in clinical practice. The research group has conducted a pilot on the study intervention and outcome assessment and has included patients and families from this pilot in the development of the current proposal. The study will be conducted as a multidisciplinary and a multicenter study with two sites that have extensive clinical experience with the patient group. Cooperation with key international actors, including developers of the most central methods employed in the study, has also been established. This project will further strengthen national and international collaboration, and ensure frontline knowledge within pediatric cognitive rehabilitation

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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering