presented by Angela Ciccia
This course will explore factors that contribute to the difficulties children with traumatic brain injury (TBI) and their families experience in accessing rehabilitation services for cognitive-communication disorders. Specifically, the course will discuss how and why children with TBI experience difficulties in accessing services, including a discussion of the impact of health care and educational policy. The course will then discuss specific ways to support change and improvement in access to care for pediatric TBI in daily practice for the individual clinician across a variety of levels.
Angela Hein Ciccia, Ph.D., CCC-SLP is an assistant professor in the Department of Psychological Sciences. Dr. Ciccia’s research focuses on factors that impact childrens’ ability to recovery/develop in the presence of a diagnosis of an acquired (i.e., new onset) and/or developmental neurogenic communication disorder. Dr. Ciccia is also interested in the use of novel service delivery models (including telemedicine) to enhance access to rehabilitation/support services for these children. Clinical populations of interest include Traumatic Brain Injury, ADHD, Autism Spectrum Disorders, Learning Disability, and other neurodevelopmental disabilities.
In Chapter One, the epidemiology of pediatric TBI will be reviewed and referral rates of SLP services will be explored. Factors that contribute to the discrepancy between incidence/prevalence and service utilization will also be discussed. Understanding the rates of injury and disability and service utilization is critical to understanding many of the underlying issues that impact both access to care and policy.
In Chapter Two, pathways of care through the medical and education system are briefly reviewed. Then, “danger zones” for losing children with TBI are examined. Understanding how children with TBI move through care and how they can be lost in the system for management is critical to finding opportunities to improve access and service utilization. Chapter 2 also highlights where health care and educational policy can be improved to support these children and their families.
In Chapter Three, principles of public health change are reviewed including what an individual clinician can do to be a change-agent for improved access and management for children with TBI and their families. Tackling the issues of access and policy in pediatric TBI can appear overwhelming; however, this chapter provides “to-do” suggestions that the individual clinician can start today.
In Chapter Four, local, state, and national efforts to improve access and policy for children with TBI are reviewed. Individual clinicians are encouraged to familiarize themselves with these resources and become actively involved in whatever way they can.
In Chapter Five, Dr. Ciccia and a school speech-language pathologist discuss some of the very real challenges for working with children with TBI in the school system and discuss simple ways to make small changes to improve service provision to this population.