The latest version of the Personal Child Health Record (also known as the PCHR or ‘red book’), the national standard health and development record given to parents/carers at a child’s birth, now includes a section for recording accidents or injuries that need medical attention. This will allow mild, moderate and severe brain injuries to be recorded which will facilitate essential long-term monitoring post-injury.
Professor Michael Barnes, UKABIF Chair said: “We’re delighted that the Royal College of Paediatrics and Child Health has included a section for accident reporting. This is good news for children with an acquired brain injury (ABI). There is a general lack of understanding about the effects of brain injury in children and a lack of awareness that over time it is a developing disability and requires monitoring long-term to identify problems arising post-injury”.
ABI is a non-degenerative injury to the brain that has occurred after birth. It includes traumatic brain injuries (TBIs) such as those caused by road traffic accidents and non-TBIs, such as those caused by strokes and other vascular accidents, tumours and also infectious diseases. Although road traffic accidents are the most common cause of ABI in older children and adolescents, falls, being dropped or non-accidental injuries are more common in children and infants1.
The prevalence rates of ABI in childhood are very high. NICE (2007) reported that each year in England around 200,000 under-15s attend Accident and Emergency departments with head injuries2. Most are minor but 1 in 10 are moderate to severe. The Child Accident Prevention Trust stated that in 2010/11 around 36,500 children under 14 years of age in England were admitted to hospital with head injuries3.
As a child recovers from the initial stages of ABI, and depending on which regions of the brain are injured, longer-term effects may become apparent e.g. cognitive, behavioural or emotional, or mental functioning. For example pre-school children with injuries to the frontal-temporal regions of their brains may look ‘medically fine’ within a few weeks or months after injury (e.g., they can walk, talk, eat, sleep); however, as they get older and their brains mature, new cognitive, behavioural and motor deficits can emerge. Often the cognitive, behavioural and personality deficits, rather than the physical deficits, produce the greatest disruption to quality of life, and the extent of these impairments may only become apparent longer term.
Last year UKABIF launched a Manifesto for Children and Young People with ABI as part of its campaign ‘Life After Brain Injury? Improve Services Now’, to highlight the need for improvements in service provision. One of its demands was to facilitate long-term monitoring of children that had an ABI.