How Are the Psychological Needs of Children with ABI Responded to and by Whom?

Paediatric acquired brain injury is the leading cause of death and disability in children and young people internationally. Whilst there is a wealth of research examining cognitive and physical sequalae, comparatively fewer explorations of the psychological impact of ABI in childhood have been conducted. Furthermore, there is a dearth of literature examining how the psychological needs of children and young people are being responded to. This study aimed to converge multiple perspectives from across the child’s ecosystem (parents and professionals involved in the care of children with ABI) to identify contextualised psychological needs and consider how these are being met, and to contribute to a greater understanding of the risk and resiliency factors for positive adjustment and psychological wellbeing in this population.

The study employed a mixed methods design. Semi-structured interviews were conducted with eight parents, and an online questionnaire was completed by 36 professionals. Data were analysed using Thematic Analysis and two overarching themes were constructed, consisting of five themes and 11 subthemes. Descriptive statistics were also included in the analysis.

The findings indicate that participants construed the considerable psychological impact of childhood ABI as a product of factors related to participation, identity development and social exclusion. This was juxtaposed against narratives of very little formal psychological support and missed opportunities for support in naturalistic environments such as schools, as well as a lack of understanding and awareness of paediatric ABI and associated needs amongst the workforce, resulting in unsupported needs that have the propensity to worsen over time with significant consequences for children and young people. Participants outlined sources of support and resilience for CYP including parents, positive peer relationships, meaningful participatory experiences and professionals who could provide continuity of care. The findings and implications of the study are discussed.