Parents Caregiving for Children after a Traumatic Brain Injury: Structuring for Security

By Jones, Margaret; Hocking, Clare et al. | New Zealand Journal of Occupational Therapy, March 2010 | Go to article overview

Parents Caregiving for Children after a Traumatic Brain Injury: Structuring for Security


Jones, Margaret, Hocking, Clare, Wright-St Clair, Valerie, New Zealand Journal of Occupational Therapy


Occupational therapists are concerned with enabling people to engage in the activities and tasks that are meaningful to them in their worlds (Townsend & Polatajko, 2007). This may include providing services to children who have sustained a traumatic brain injury and have difficulties with occupational performance (Rogers, 2005). In a family-centred service delivery framework (Law, Rosenbaum, King, King, & Evans, 2003), it is important to consider the child in the context of their family. The occupations of the child and their parents are seen as interdependent, and both should therefore be considered by the occupational therapist when developing and delivering interventions. While therapists have general understandings about the things parents will need to do to raise a child who has had a brain injury, little is known about what is actually involved in their caregiving occupations. Having that information would assist therapists to offer advice in keeping with the parents' concerns and circumstances. Therefore, this small-scale, qualitative study was designed to develop theory in response to the research question "What is involved for parents in the day-to-day occupations of caregiving for a child who has had a severe traumatic brain injury?" Simultaneously, things that assist and things that hinder those occupations are examined.

Literature review

Traumatic brain injury is defined as "injury to the brain resulting from externally inflicted trauma" (New Zealand Guidelines Group, 2006). Brain injuries may be classified for their severity by the depth and duration of coma, and by the duration of posttraumatic amnesia (New Zealand Guidelines Group). Severe traumatic brain injuries are generally classified as a score of consciousness on the Glasgow Coma Scale between 8-3, where 3 is the lowest possible score (James & Trauner, 1985; New Zealand Guidelines Group; Teasdale & Jennett, 1974). While most children who sustain mild injuries go on to make a good recovery (Ponsford et al., 2001), those with a severe traumatic brain injury may experience global changes in function, resulting from diffuse injuries, or specific deficits (e.g. movement, memory, sensory processing, or communication skills) (Appleton, 1998; Ylvisaker, 1998).

Traumatic brain injury at any stage in childhood can have serious consequences for both the child and their family (Appleton, 1998; Taylor et al., 2001), with severe injuries generally associated with worse sequelae (Babikian & Asarnow, 2009; Fay et al., 2009). The functional outcomes for children vary according to gender and age at injury; the severity, type and site of injury; and individual differences in brain function, experience, personality, and skills (Demellweek, O'Leary, & Baldwin, 1998; Ylvisaker, 1998). Parents are reported to experience ongoing and increased levels of stress and burden as they care for their injured child. The community also accrues significant ongoing costs in terms of providing interventions and supports through into adulthood and beyond (Kao & Stuifbergen, 2004; New Zealand Guidelines Group, 2006).

After a severe traumatic brain injury, it is likely to be many months before children can attend school full-time (Jaffe et al., 1993). It is indicated that delays in specific skill attainment take place if injury occurs at times that are critical for skill development and brain maturation (Anderson, Catroppa, Morse, Haritou, & Rosenfeld, 2005; Chapman & McKinnon, 2000; Ewing-Cobbs, Levin, & Fletcher, 1998; Levin, 2003). Further, the likelihood of frontal lobe involvement, the emotional trauma of the accident, and variability in functioning may result in behavioural changes, stress disorders and poor outcomes (Fletcher, Ewing-Cobbs, Miner, Levin, & Eisenberg, 1990; Luis & Mittenberg, 2002; Sherwin & O' Shanick, 2000, 1998; Ylvisaker, Szekeres, & Feeney, 1998). The majority of outcomes studies have focused on the children's intelligence, cognition, motor and perceptual skills, psychosocial functioning and social skills, and ability to carry out daily living and classroom tasks (Ewing-Cobbs et al. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Parents Caregiving for Children after a Traumatic Brain Injury: Structuring for Security
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.