Participation of children and youth after mild traumatic brain injury.

Traumatic brain injury is the leading cause of acquired brain injury among
children and youth. Approximately 14,000 children and youth under the age of 24
years are diagnosed annually with traumatic brain injury in the Netherlands.
About 80% of this group is diganosed with mild traumatic brain injury (LTH).
This subgroup is not structurally followed by a practitioner, while an
estimated 10-20% of this group still have adverse consequences after six
months. In the Netherlands, this accounts for approximately 1,700 children and
youth each year. Lack of diagnostics, underestimation and a too late
recognition of the often invisible long-term consequences (such as reduced
capacity and cognitive problems), often lead unnecessarily to chronic and
disruptive consequences for youth and family participation, such as problems at
school and in social relations. The consequences are a major expense for the
Dutch society. Early detection of problems in this group and early intervention
could potentially prevent the long-term consequences.

The aim of this study is to examine the daily level of activities and
participation after LTH in children and adolescents (6-18 years) and to
identify possible predictors. In addition, experimental research is done in a
subgroup to measure the effect of an early intervention, which contains
monitoring, psycho-education and case management, meant to prevent the
consequences of brain injury on daily activities and participation, compared to
regular care.

Multicenter prospective longitudinal cohort study with a nested randomized
clinical trial in a subset of participants in the cohort study, in which the
effectiveness of an early intervention compared with usual care is measured.
There will be three measurement points for the participants: within 2 weeks
after injury, three months after injury and six months after injury.

The intervention is offered by a rehabilitation professional, with at least HBO
skill level and experience of working with children with aquired brain injury
(eg. A paramedic or nurse). Participants in the RCT assigned to the
intervention group receive the intervention in addition to the usual care.
Participants in the RCT assigned to the control group only receive the usual
care. The intervention consists of 1) monitoring, 2) psyco-education, and 3)
case management.

Patients are not at risk. It involves questionnaire administration.
Child/adolescent and his/her parents are (in the private, secure home) assisted
by the researcher during the administration of the questionnaires. It is known
that a part of this population (children and youth with mild traumatic brain
injury) suffers from complaints. It is unknown which of these children are at
risk for complaints and how these complaints can be prevented. This justifies
the conduct of this study.