Direct clinician-delivered versus indirect family-supported rehabilitation of children with traumatic brain injury: a randomized controlled trial.
OBJECTIVE
To explore the relative effectiveness of clinician-delivered vs family-supported interventions for children with chronic impairment after TBI.


METHODS
Randomized controlled clinical trial.


METHODS
Children aged 5-12 years in the chronic phase of their recovery were randomly assigned to the clinician-delivered or to the family-supported intervention group; both samples received intensive services for 1 year; physical outcome was measured by the SARAH scales, cognitive outcome by the WISC-III.


RESULTS
Parents in the family-supported intervention sample efficiently acquired the skills needed to deliver physical and cognitive interventions within the context of everyday routines of the child's life at home; family education level was not a factor. Although both groups demonstrated improvements, only the children in the family-supported intervention group demonstrated statistically significant--and clinically important--improvements on both outcome measures.


CONCLUSIONS
This RCT provides compelling evidence for organizing cognitive and physical interventions and supports for children with TBI around the everyday routines of their lives, with intensive supports for their families.
Braga
L W
LW
SARAH University for Rehabilitation Sciences, SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil. luciabraga@sarah.br
Da Paz
A C Júnior
AC
Ylvisaker
M
M
D001930:Brain Injuries / Q000534:rehabilitation*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D002908:Chronic Disease; D003695:Delivery of Health Care / Q000379:methods*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care