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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

The Child-In-Context-Intervention (CICI): A randomized controlled trial addressing chronic symptoms of Pediatric Acquired Brain Injury

Alternative title: Barnet-i-kontekst studien (CICI): En randomisert kontrollert studie som adresserer kroniske symptomer på ervervet hjerneskade hos barn.

Awarded: NOK 15.6 mill.

Brain injury due to e.g. accidents, brain tumors or stroke is known as acquired brain injury (ABI). Children with ABI often struggle with complex impairments, including cognitive (such as memory and attention), social, emotional and behavioral challenges. We have knowledge about how to help children during the first, acute and post-acute stages of ABI. Yet, impairments are often long-lasting and, due to the vulnerability of children?s developing brain, new problems may emerge or become increasingly problematic over time. Children with ABI may struggle at school and with peers, which can lead to or increase emotional difficulties, and reduce quality of life, impacting the children and their families. There is agreement that there is a lack of evidence-based knowledge about rehabilitation for children with ABI in the chronic phase. In close collaboration with schools and local health care providers, we will conduct a study with 80 children, which focuses on the child?s and family?s individual rehabilitation goals. We aim to enhance everyday functioning in the home and school environment by reducing ABI-related symptoms, and attainment of rehabilitation goals in areas noted as challenging by the participants. Half of the participants will be randomly allocated to the treatment group. The other half, the comparison group, will continue to receive the same treatment as before. The efficacy of the rehabilitation will be measured in terms of goal attainment, community participation, cognitive, behavioral, social, and family functioning. Users have been involved in the development of the program, discussion of results, and of how the results will be implemented. In addition to obtaining evidence-based knowledge about rehabilitation of children with ABI in the chronic phase, the study aims to increase collaboration and knowledge transition between specialist health care and community health care services, and between health care services and the educational system.

Children with acquired bran injury (pediatric ABI - pABI) often struggle with complex, chronic cognitive, behavioral and emotional impairments, resulting in impaired everyday functioning, quality of life and participation. pABI represents a major challenge to the affected child and the family, as well as to the health care system. Yet children with pABI do not systematically receive comprehensive rehabilitation in the chronic phase, more than a year after injury, and a large proportion report unmet health care needs. Intervention studies that focus on the functioning of children with pABI as well as family and school functioning are scarce. The Child-in-Context-Intervention (CICI) is a complex and innovative randomized controlled trial that combines an individualized goal-oriented approach with a parenting group-intervention and school sessions, tailoring the intervention to the needs and problem perception of each child and family. We aim to include 40 children in each group. The main aim of the CICI is to enhance everyday functioning of children with ABI in the home and school environment by reducing pABI-related symptom burden of the participating children and families, and attainment of rehabilitation goals in the specific areas perceived as challenging for the children and their families. Outcome assessments will be performed immediately after the 4-month intervention and again 8 months later, i.e. 12 months after study inclusion. Thorough feasibility and process evaluations are included in the study protocol. The project is a collaborative effort between Sunnaas rehabilitation hospital, Oslo University Hospital and the national service for special needs education (Statped), which ensures feasibility of implementation of results. The study findings will be relevant for a wide array of health care professionals in the community and for educators.

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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering