I’ve created this page separately to post my thoughts about working with children with head injury.
I’ve recently seen several young children with concussion/mild head injury who have not recovered quickly. One of the issues I’ve been talking about with another therapist is the most effective way to manage the fatigue the children present with. They clearly tire more quickly complaining of problems such has headache, double vision or nausea. Or sometimes their behaviour changes, with obvious irritability. Previously, rest was prescribed for adults with the above symptoms. But more recently there has been discussion in the literature about the need for rest versus having a graded return to previous activities – ie that we don’t recommend sleep in the afternoon for example, but that people return to work quite quickly, even if for short periods on quite different duties. My issue is that return to school is much harder… cant control as many of the variables as you can in the workplace, and also that these kids seem to need to sleep. I’ll use this site to record what I find, and my reflections on my learning. Please feel free to follow my searching and to comment on what I find, or point me in the right direction.
Merrolee I totally agree that we need to provide help for people with MTBI. After my concussion I realised that I needed to place a high priority on RESTING and titrating the cognitive demands I placed on myself. And those demands include the need to filter out stimuli, the degree of cognitive demand in the actual activity (eg visual vs verbal vs words). In the case of MTBI it’s NOT like chronic pain where ‘pacing’ equals gradually increasing activity level and pain is not the guide – it’s much more about using subtle symptom cues to guide the demands over a day, and recognising that any energy deficit from the day before will carry over to the new day – demanding more rest!
By: adiemusfree on 12 November, 2007
at 1:57 am
Hi Merrolee,
I’m very pleased I have stumbled onto your blog. I’m not sure how this works, and perhaps this discussion should be on the NZAOT site, your advice would be appreciated. Anyway – just this very morning I did an assessment with a boy diagnosed with post-concussion syndrom. I noticed that you mentioned double vision; here in Hamilton we some times refer to a vision therapist for this problem, but the referral often results in a very long and time consuming vision therapy programme. Often these kids/families have a lot of other things going on, and I’m not sure whether it is beneficial to go down the therapy vision track. I’m sure a lot of centres dont even have vision therapists. I would love to know whether you and others have found that double or blurred vision usually resolves spontaneously, or if vision therapy is a valuable addition to therapy?
By: Stephanie Hessell on 29 June, 2008
at 11:25 pm
Kia,
I am sorry to leave this on your blog –> I couldn’t locate a direct e-mail address:
Kia,
My name is Jena and I am a Speech-Language Pathologist in the Boston area. I was doing some searching on the web for private clinicians and came across your site. I am in the process of developing materials for physical, occupational and speech therapists to learn more about seeing private patients. While I have some products about ready to launch, I am interested in learning more about people who are actively seeing private patients and what kinds of topics they feel they want to learn more about.
http://FreeOnlineSurveys.com/rendersurvey.asp?sid=ilab1xv555q08vq527161
If you have an extra two minutes, would you mind filling out my survey? In exchange for filling it out, I will make sure that you are among the first to know when my resources are available.
Thank you again in advance,
Jena
http://www.JenaCasbon.com
By: Jena Casbon on 24 December, 2008
at 4:58 pm