Effective Treatment for Brain Injury in Children
Research in the physical problems from brain injury makes it clear that high intensity treatments are effective in children. St. Mary’s research on the use of Contraint Induced Movement Therapy has shown marked improvement in the use of arms and hands in hemiplegic children. For lower extremities, Lite Gait treadmill training with weight support has been found effective for improved walking.
High amounts of practice using may also be critically important for improving speech quality, language development, cognition and behavior. Advanced techniques in rehabilitation include electrical stimulation for training swallow and combined treatment of movement restriction and mallallignment with botox and serial casting. There is growing evidence that medications that enhance dopamine (e.g., Amantadine) or several excitatory neurotransmitters (e.g., Ritalin, Dexedrine) may reduce agitation or improve cognition and behavior.
What’s on the horizon that may help a child in the future?
- Medicines: Every year new medications are becoming available that increase memory and cognition (e.g., Aricept, Reminyl); these and other agents are being trialed in children with brain injuries. A big question is whether any medication will help with judgment, planning, and other executive cognitive processes.
- Brain Stimulation: r-TMS is a way of placing a magnetic pulse to a precise portion of the brain. This has been used in adults with brain injuries to allow speech in mute patients and to allow hand movement in those that had none. Trials are currently under way with children. For children with untreatable pain or movement disorders, deep brain (surgical placement) electrical stimulation is available within research settings.
- Equipment: External and implanted electrical stimulation devices are becoming available to children with neuromotor impairment to allow for more functional movement. Computerized devices can deliver electricity with precision to help in particular parts of the walking cycle. Robotic equipment has been developed to facilitate movement in arms and legs, for those who don’t have sufficient movement to participate in the intensive therapies mentioned above.