The assessment for children that have survived a pediatric TBI is a complex process. It can be difficult to figure out how to provide evidence-based assessment specific to the pediatric TBI population that will lead to a functional, patient-centered treatment plan.
If you’re an SLP, measures that you might traditionally use in child language assessment such as the Comprehensive Assessment of Spoken Language (CASL) or the Clinical Evaluation of Language Fundamentals (CELF), are a necessary component of assessment and can be used with children with TBI. Whether you’re an SLP or another rehabilitation therapist, to more fully and accurately capture both the cognitive and communication deficits that this group often experiences it’s advisable to use a variety of other available measures. The assessments outlined below can help all clinicians working with pediatric TBI.
Domains of Assessment
To get a complete picture of the child’s strengths and weaknesses after brain injury, you need to gather information in the following areas:
- Executive Function
- Visuospatial skills (for reading and writing)
- Problem solving
- Processing speed
- Deficit awareness
- Drive and motivation
- Receptive and Expressive language (across all language modalities)
In order to address the areas listed above, you might consider the following standardized assessment measures:
- Pediatric Test of Brain Injury
- Behavioral Rating Index of Executive Function
- Student Functional Assessment of Verbal Reasoning and Executive Function
- Test of Everyday Attention
To enhance ecological and predictive validity, you should also complete informal assessment including:
- Parent/caregiver interview to determine family-based goals
- Discourse analysis (e.g., conversational discourse, procedural discourse, monologic discourse)
- Social communication and social cognition
- Academic needs assessment
- Exploration of environmental and contextual barriers and facilitators
The complex nature of pediatric TBI means an individual clinician, whether they be an SLP, OT, or PT, cannot gather all the necessary information that will lead to a functional, patient-centered treatment plan. The members of the inter-professional team supporting children after TBI (e.g., Neuropsychology, Occupational Therapy, Physical Therapy, Social Work, Counselors, etc.), can provide additional information regarding the areas noted above as well as:
- Behavioral regulation
- Sensory deficits
- Gross and fine motor deficits
- Co-morbid psychiatric conditions
- Family environment and needs
- Adaptive and daily living skills
The next time you need to assess a child with a TBI, use this information to ensure you’re completing your assessment based in best-practice recommendations – doing so will improve the lives of the children you serve.
- ASHA Evidence Maps: Pediatric TBI http://www.asha.org/PRPSpecificTopic.aspx folderid=8589942939§ion=Assessment
- NINDS Common Data Elements in TBI https://www.commondataelements.ninds.nih.gov/TBI.aspx#tab=Data_Standards
- Sohlberg, M & Turkstra, L (2011). Optimizing Cognitive Rehabilitation: Effective Instructional Methods. Guilford Press.