title: Service Delivery in the Healthcare and Educational Systems for Children Following Traumatic Brain Injury: Gaps in Care.
abstract: To provide a review of evidence and consensus-based description of healthcare and educational service delivery and related recommendations for children with traumatic brain injury.
  
  
  
  Literature review and group discussion of best practices in management of children with traumatic brain injury (TBI) was performed to facilitate consensus-based recommendations from the American Congress on Rehabilitation Medicine's Pediatric and Adolescent Task Force on Brain Injury. This group represented pediatric researchers in public health, medicine, psychology, rehabilitation, and education.
  
  
  
  Care for children with TBI in healthcare and educational systems is not well coordinated or integrated, resulting in increased risk for poor outcomes. Potential solutions include identifying at-risk children following TBI, evaluating their need for rehabilitation and transitional services, and improving utilization of educational services that support children across the lifespan.
  
  
  
  Children with TBI are at risk for long-term consequences requiring management as well as monitoring following the injury. Current systems of care have challenges and inconsistencies leading to gaps in service delivery. Further efforts to improve knowledge of the long-term TBI effects in children, child and family needs, and identify best practices in pathways of care are essential for optimal care of children following TBI.
authors.affiliation: Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Haarbauer-Krupa); Department of Psychological Sciences, Program in Communication Sciences, Cleveland, Ohio (Dr Ciccia); Department of Psychology, St Louis Children's Hospital, and Washington University School of Medicine, St Louis, Missouri (Dr Dodd); Education Support Services, Eugene School District #4J, Oregon (Dr Ettel); Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Department of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Ohio (Dr Kurowski); Pediatric Emergency Medicine, Washington University School of Medicine, St Louis Children's Hospital, Missouri (Dr Lumba-Brown); and Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Suskauer).
authors.forename: Juliet
authors.initials: J
authors.lastname: Haarbauer-Krupa
authors.forename: Angela
authors.initials: A
authors.lastname: Ciccia
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dodd
authors.forename: Deborah
authors.initials: D
authors.lastname: Ettel
authors.forename: Brad
authors.initials: B
authors.lastname: Kurowski
authors.forename: Angela
authors.initials: A
authors.lastname: Lumba-Brown
authors.forename: Stacy
authors.initials: S
authors.lastname: Suskauer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000534:rehabilitation*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000458:organization & administration*; D004493:Education / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D017063:Outcome Assessment, Health Care; D018570:Risk Assessment; D012737:Sex Factors; D014481:United States