Overview

Pediatric brain injury rehabilitation is at a crossroads. At times a treatment stepchild within rehabilitation, most pediatric outpatient brain injury rehabilitation programs have gone into decline. While not ignored, perusals of rehabilitation journals clearly indicate that most work is directed toward adult populations. Inpatient treatment remains a mainstay, but is typically characterized by quite brief stays, largely due to the rapid physical healing that occurs in childhood. While the 1980s and early 1990s were characterized by adequate medical insurance support for outpatient pediatric brain injury rehabilitation, this is no longer the case. In the United States, we have, largely, left the task of cognitive rehabilitation to educational professionals. Unfortunately, while these individuals are quite skilled in working with children who have a learning disability, with some exceptions they have minimal background in brain injury rehabilitation. Thus, the child who suffers a central nervous system (CNS) insult such as traumatic brain injury, or a brain tumor, will frequently receive services similar to that of a child with a learning disability, whom does not necessarily have the specific medical, neuropsychological, and remediation needs associated with a brain injury. This chapter will present the current status of education-based standards of care for cognitive rehabilitation secondary to a brain injury. I will then review recent literature on specific cognitive rehabilitation programs designed to improve functioning in children following a brain injury.