Affiliations: [a] Department of Neurology and Pediatrics, University of California San Francisco, San Francisco, CA, USA
| [b] Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| [c] Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| [d] Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Correspondence:
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Corresponding author: Bethany L. Johnson-Kerner, MD PhD, Assistant Professor, UCSF Neurology and Pediatrics, Mission Hall Global Health and Clinical Sciences Building, 550 16th Street, 4th Floor, San Francisco, CA 94143, USA. Tel.: +1 4153533939; Fax: +1 4153532400; E-mail: ccbethany.kerner@ucsf.edu.
Abstract: PURPOSE:More than 50,000 children are hospitalized yearly in the U.S. for acquired brain injury (ABI) with no established standards or protocols for school re-entry and limited resources for hospital-school communication. While ultimately the school has autonomy over curricula and services, specialty physicians were asked about their participation and perception of barriers in the school re-entry process. METHODS:Approximately 545 specialty physicians were sent an electronic survey. RESULTS:84 responses (43% neurologists and 37% physiatrists) were obtained with a response rate of ∼15%. Thirty-five percent reported that specialty clinicians currently make the plan for school re-entry. The biggest challenge for school re-entry noted by physicians was cognitive difficulties (63%). The biggest gaps perceived by physicians were a lack of hospital-school liaisons to help design and implement a school re-entry plan (27%), schools’ inability to implement a school re-entry plan (26%), and an evidence-based cognitive rehab curriculum (26%). Forty-seven percent of physicians reported that they did not have adequate medical personnel to support school re-entry. The most commonly used outcome measure was family satisfaction. Ideal outcome measures included satisfaction (33%) and formal assessment of quality of life (26%). CONCLUSION:These data suggest that specialty physicians identify a lack of school liaisons in the medical setting as an important gap in hospital-school communication. Satisfaction and formal assessment of quality of life are meaningful outcomes for this provider group.
Keywords: Traumatic brain injury, acquired brain injury, school re-entry, cognitive rehabilitation, access to care
