Brain injury services at Kids Rehab at The Children's Hospital at Westmead

Contact details

Enquiries: (02) 9845 2132

Appointments: (02) 9845 2132 or 9845 2131

Fax: (02) 9845 0685

Location: Children's Assessment Centre, Outpatients building, level 3

The Brain Injury Service at The Children's Hospital at Westmead sees children and adolescents who have suffered an acquired brain injury, either through a motor vehicle accident, fall, stroke or other disease process. It is part of Kids Rehab. We aim to help children and adolescents reach their potential in all areas of development by providing a multi-disciplinary team approach to assist with physical, cognitive, behavioural, social and emotional difficulties.

All clients of the Brain Injury Service are seen for a medical rehabilitation assessment to review their progress at home and school. Most children will be seen in clinic for a medical follow-up approximately six weeks after discharge from hospital. Time frames for future follow-up appointments vary, depending upon the needs of each individual child/young person.

Inpatient services are provided by some members of the Rehabilitation Department in conjunction with clinicians from Nursing, Allied Health and other Departments within the Hospital.

We provide:

inpatient rehabilitation
outpatient clinics
outreach services, including home and school visits and community liaison.

Clinic

The Brain Injury Clinic runs each Wednesday morning in the Children's Assessment Centre on Level 3. Appointments last approximately one hour. From here, referrals can be made to other specialist clinics within the Rehabilitation Department or Hospital. For example, the Spasticity Management Program, Botulinin Toxin Program, Intrathecal Baclofen Program, Eye Clinic and Orthotic Clinic.

Parents and carers are asked to attend the clinic with their child and bring any relevant school, medical or therapy reports with them. Other members of the Brain Injury Service may also attend, such as the Case Manager or Therapists. Treating therapists from the community are also welcome to attend. Clinics are held in the Children's Assessment Centre on Level 3.

Who Can Make A Referral?

Referrals to the Brain Injury Service may be made by anyone in the community such as a parent, school or therapist. Parent consent is needed to make a referral. Referrals can be made in writing or by phoning the Brain Injury Intake Officer. A written medical referral from a GP or specialist is required in order for the child to attend a Brain Injury Medical Clinic.

How Does the Intake Process Work?

The Intake Officer completes a checklist to ensure they collect important information to assist the referral process. The Intake Officer will help decide whether a child is eligible for the Brain Injury Service. This may involve discussing the case with the Rehabilitation Specialist allocated to support the intake process and phoning the family, school and other community services for supporting information. The child/young person will be seen by the Rehabilitation doctor who will determine if the child is appropriate for the Brain Injury Service and what services the child requires. This may include:

Medical Review
Case Management
Therapy assessment
Referral to another medical clinic
Other investigations eg medical tests
If the child is not eligible, then the family will be assisted to help find other suitable services.

Under 5's Brain Injury Rehabilitation Clinic

This is a multidisciplinary clinic to monitor the development of children under five years of age who have sustained a brain injury. This clinic is held monthly in the Children's Assessment Centre (Level 3). A Rehabilitation Medical Specialist, Physiotherapist, Occupational Therapist, Speech Pathologist all attend the clinic. The Clinical Psychologist, Clinical Neuropsychologist, Social Worker and/or Case Manager can attend on request.

The Under 5's clinic is often a valuable time for parents and carers to receive feedback about their child's development and to gain information and ideas for future therapy and/or medical needs of their child.

Westmead Hospital Clinic

Paediatric Rehabilitation Specialists from the Brain Injury Service can provide a consultative service to Westmead Hospital for young people who have sustained a brain injury and were admitted to Westmead Hospital. The young person may be seen while they are an inpatient in conjunction with the Adult Brain Injury Team, so that issues such as return to school can be addressed. The Paediatric Rehabilitation Specialist may continue to review the young person through the Adult Brain Injury Clinic held at Westmead Hospital. However this mainly occurs for those who are about to leave school. Young people who require significant ongoing follow-up will be seen in the Brain Injury Clinic at The Children's Hospital at Westmead. Once a young person leaves school, they are transferred to the adult Brain Injury Service in their area.

Ward

The Inpatient service sees patients from the time of admission to hospital until discharge home. Children and young people are usually admitted to Surgical or Commercial Travellers wards, but may go to any of the Hospital wards. The inpatient Brain Injury Team can see patients in any of the wards (sometimes contact can begin in intensive care if the patient is medically stable and able to commence rehabilitation).

The inpatient team consists of a multi-disciplinary team which includes:

Rehabilitation Medical Specialists and Registrars
Clinical Nurse Consultants
Specialist Nursing Staff
Occupational Therapists
Physiotherapists
Speech Pathologist
Dietitian
Child Life Therapist
Clinical Psychologist
Clinical Neuropsychologists
Social Worker
School Teachers
Specialist School Counsellor - Brain Injury

Case Managers

The inpatient team is involved in providing consultation, assessment, treatment, education, support and counselling for children/young people who have sustained an acquired brain injury within a holistic framework of care.

The inpatient team works closely with families, other medical and surgical teams, nursing staff on the wards and hospital school staff to ensure an optimal environment in which effective rehabilitation can occur.

The inpatient rehabilitation framework of care includes:

Weekly case conferences

These provide an open forum for team discussion. Each patient's progress is discussed, current needs evaluated, goals set, rehabilitation plans formulated and discharge planned.

Update meetings

These are held on a Monday morning to plan the week. Patient goals are reviewed and new information from the weekend about our patients is shared amongst the team. Times for therapy and assessments are arranged and timetabled to ensure adequate rest and to coordinate care.

Family meetings

These are arranged on a regular basis and provide an opportunity for families to ask questions, voice concerns and be involved in the decision making and ongoing rehabilitation of their child. The Hospital embraces the view of 'parents as partners' and acknowledges the integral part that parents and other family members play in their child's rehabilitation.

Therapy

Intensive individual therapy sessions are a key component of the child's/young person's inpatient rehabilitation program. Therapy includes physiotherapy, play therapy, occupational therapy and speech pathology. The frequency and intensity of therapy is dependent on the child/young person's recovery and progress. Therapy activities are incorporated into the child's/young person's daily routine wherever possible to maximise effectiveness of intervention.

The Hospital School

The Hospital School plays an integral part in a child's rehabilitation. It allows children to attend a school environment within the Hospital that is supportive of their individual and rehabilitation needs. The school is run by teachers experienced in teaching children with special needs, including brain injury. The teachers provide valuable feedback to the rehabilitation team regarding the child's progress. This assists in identifying some of the issues for the child's return to school after discharge.

Lunch Club

This is a weekly session run by the Occupational Therapists and Play Therapist. This session allows children/young people from the ward to participate in food preparation and cooking within a social, non-clinical environment. This provides an opportunity for the Occupational Therapist to assess skills of daily living and observe how the child/young person interacts with their peers.

The Multisensory Room

This is located on Surgical Ward and is dedicated to the purposes of relaxation, stimulation and rehabilitation. The room consists of an interactive bubble tube, strands of fibre optics, projector screen, a tactile interactive wall, disco ball and lights, bean bags, and soft, vibrating and sound toys. The therapists use the room to assess children during their rehabilitation for potential functional movements, sight and sound. The room was funded by the Variety Club of Australia.

Case management

This may be offered to families who require ongoing intervention and coordination of care to facilitate the transition back to home and school. This may include school and home visits. The inpatient team is also involved in liasing with the Rural Brain Injury Teams who provide ongoing case management for children in the rural setting.

Case Management within the Brain Injury Service at The Children's Hospital at Westmead is an outreach service for children and young people with an acquired brain injury, their family, school and community. The Case Manager is the link between the Brain Injury Service, family, school or preschool and key people in the community such as therapists. The Case Manager provides information and support about acquired brain injury and the impact this has on all aspects of the life of a child and their family. Case Management is a goal-focussed service provided at key times which aims to support and empower parents during the rehabilitation process.

What is the Role of the Case Manager?

Once a child/young person returns home, the family and Case Manager work in partnership to look at areas of need, such as returning to school, ongoing therapy, home support and community activities. Home and school visits are offered in addition to phone contact. The length of time and frequency of contact with a Case Manager is dependent upon the needs of the child. However, Case Management services may be offered long-term with the degree of involvement changing according to recovery, development and key times of a child's life, e.g. commencing preschool, primary or high school.

Liaison with Schools

A Case Manager can be involved with assisting a child's or young person's return to school by providing information and education to the school about the effect of the brain injury upon all aspects of schooling (learning in the classroom, socialisation in the playground and behaviour). The Case Manager can act as a consultant for concerns that may be raised in the school environment, participate in relevant meetings, such as Integration and Individual Educational Planning Reviews, as well as assisting with long-term educational planning.

Liaison with Community Services

The Case Manager can provide information to the family about appropriate community services such as therapy, respite and attendant care. In partnership with the family, the Case Manager can make referrals and assist with clear communication between services and persons involved with the child/young person.

Liaison with Insurance Companies and Solicitors

Many children sustain their injury in motor vehicle related accidents, either as a passenger or pedestrian. If a child/young person has an insurance claim, through the NSW Third Party Scheme or other insurance scheme, the Case Manager can act as an advocate for the child/young person and family to make requests for specific rehabilitation services which might be met under the Motor Accidents Act. The Case Manager is then required to submit a rehabilitation plan to the insurance company describing a child's/young person's rehabilitation needs, their progress and rehabilitation goals. The Case Manager will also have regular phone contact with the insurance rehabilitation advisor. The Case Manager may also keep the child's/young person's solicitor informed of ongoing rehabilitation needs.

Who Receives Case Management?

A child/young person can be referred for case management when they are an inpatient or as an outpatient through the intake process.

Camp Go Ahead

Camp Go Ahead is a joint project run by the Brain Injury Services of The Children's Hospital at Westmead and Sydney Children's Hospital. Camp Go Ahead is an annual camp for those children and young people, aged 10-16 years who are facing the challenges of recovery from and living with a brain injury. These acquired brain injuries may be as a result of an accident, illness or stroke.

A brain injury may cause physical difficulties ranging from minimal to severe, and may result in specific language, cognitive, memory, behavioural and emotional difficulties. These difficulties may not be obvious but can still have a significant impact on the lives of the child/young person and their family - learning new things, keeping up at school, making and keeping friends, learning to be independent and participating in sporting and recreational activities. Children attending the camp are encouraged to become actively involved in all aspects of camp life and staff are available to address issues common to children with a brain injury such as teasing, shyness and low self-esteem.

Why is Camp Go Ahead special?

Camp Go Ahead is a camp with a difference because it provides the opportunities to:

Try activities which they wouldn't normally have the opportunity to participate in
For the child / young person and family to have a break
Be away from parents and siblings
Be in a supportive environment with staff who understand brain injury
No longer be the one that is a bit different but being 'one of the crowd'
Camp Go Ahead is the place where funny scars, a limp, slowed speech or being forgetful is not out of the ordinary
Make new friends and meet up with old friends from Camp, when friendships in everyday life are often difficult
Have fun!

These children / young people are a special group and it is an inspiration to see children with severe difficulties have a great time. Camp Go Ahead also provides a well deserved break for families. Campers bring back with them a new confidence in themselves and their ability to participate in a range of activities.