There is a scarcity of research investigating interdisciplinary early rehabilitation intervention models for people with low levels of responsiveness following acquired brain injury. This is particularly problematic for service models in acute hospital settings where early rehabilitation of such patients may be assigned a low priority in comparison to other competing demands. This pilot study investigated the feasibility of implementing an interdisciplinary early rehabilitation intervention in an acute neurosciences ward within existing staffing, and describes clinical changes among intervention participants. A prospective longitudinal study, with a matched historical control (individually matched by Glasgow Coma Scale) was undertaken. Prospective intervention participants (n = 13) received up to twice-weekly interdisciplinary intervention in addition to usual care. Matched historical controls (n = 13) received only usual care. Implementing an interdisciplinary early intervention proved feasible in this acute care setting. Significant improvement (alpha = .05) among the patients receiving the interdisciplinary intervention was observed across all clinical outcomes, including: Coma Recovery Scale-Revised, Glasgow Coma Scale, Mental Status Questionnaire, Royal Brisbane Hospital Outcome Measure for Swallowing, selected subtests of the Functional Independence Measure, Acquired Brain Injury Physiotherapy Assessment and the Clinical Outcomes Variable Scale. A future randomised clinical trial is warranted.

Primary objective: To investigate which variables predict referral for rehabilitation in the participants of the Tasmanian Neurotrauma Register (TNTR), a large (N = 1226) prospective population-based study of adult traumatic brain injury (TBI) in southern Tasmania.

Method: Over a 3-year period, only 54 TBI patients were referred by hospital or local health services for public community rehabilitation, with 121 referred by TNTR research assistants. A further 247 accessed private rehabilitation and 804 received no rehabilitation. These four groups were compared on a range of variables to identify which factors determine referral.

Results: Those referred by hospital or community services and those receiving private rehabilitation had more severe TBI (p < .001), greater disability (p < .001) and were more likely to have been hospitalised post-injury (p < .001). The TNTR-referred group reported more post-concussion symptoms (PCS; p < .001), anxiety (p < .001) and depression (p < .001). TNTR-referral was more likely (p < .001) following assault, compared with other causes of injury. Sixteen per cent of those not referred for rehabilitation had suffered moderate or severe TBI.

Conclusions: These results indicate that no recognised pathway existed for non-hospitalised TBI patients to access public rehabilitation, even if they were reporting high levels of PCS and psychological distress. Furthermore, routine follow-up to assess rehabilitation needs was not occurring in Tasmania, even for some with moderate and severe TBI.

Objective: Very few studies have examined permanent post-concussion symptoms (PCSs) after mild traumatic brain injury (MTBI). None have reported the nature of such symptoms. Our recent study was the first to report on a wide range of factors affecting PCSs in a representative sample of such patients. This paper presents the frequencies of the different PCSs experienced by this group and compares them with PCSs at earlier stages post injury.

Method: One hundred consecutively referred patients to a Community Head Injury Service in Buckinghamshire, UK, for the treatment of long-term PCSs after MTBI were invited to participate in the original study. Those consenting to do so (n = 24, mean time post injury = 6.9 years) completed a Rivermead Post Concussion Symptoms Questionnaire. The frequency of the types of symptoms reported is presented. These are then contrasted with comparable PCS presentations at 7–10 days and 6 months post injury from two other studies.

Results: Fatigue was reported by all long-term patients. Poor concentration, sleep disturbance, taking longer to think and irritability were the other most frequently endorsed permanent symptoms. The least reported were blurred/double vision, photophobia, nausea, headache and dizziness. A similar pattern was present in those at earlier stages post injury.

Conclusions: The most common permanent PCSs may be those best conceptualised as the more cognitively and emotionally based symptoms, and the least common the more somatically based ones. There may be some consistency in the nature of PCSs reported over time.

The Austin Maze is a neuropsychological assessment tool used to measure cognitive function. A computerised version of the tool has recently been developed and shown to be equivalent to the conventional version in terms of performance. However, controversy remains regarding which specific cognitive constructs the conventional and computer versions of the Austin Maze purport to measure. The aim of this study was to investigate which cognitive constructs are associated with Austin Maze performance and whether these constructs remain equivalent across conventional and computer versions. Sixty-three healthy people completed both conventional and computerised versions of the Austin Maze in addition to a number of established measures of planning, error utilisation, working memory, visuospatial ability and visuospatial memory. Results from a series of regression analyses demonstrated that both versions of the Austin Maze were predominantly associated with visuospatial ability and visuospatial memory. No executive measures, including those of planning, error utilisation or working memory, significantly contributed to any Austin Maze performances. This study complements previous research and supports equivalency of the conventional and computer versions of the Austin Maze.

Paediatric acquired brain injury (ABI) is the most common cause of acquired disability in childhood. It frequently results in significant personality, cognitive, emotional and behavioural changes, and consequent impairment in independent functioning, education, employment and interpersonal relationships. Additionally, paediatric ABI impacts on the entire family system, with parents commonly reporting significant distress and adjustment difficulties. Despite this, there is currently limited research into effective programmes to support families following their child's ABI. This protocol describes a wait-list randomised controlled trial of a behavioural family intervention plus a parent stress management programme for paediatric ABI. Interventions will be conducted with parents in a group format, aiming to improve child outcomes by improving parenting behaviour and coping. Outcomes assessed will be: (i) child behaviour and emotional outcome as measured by parent and teacher reports; (ii) parental style and confidence; (iii) parental adjustment (stress, anxiety and depression symptoms); (iv) family functioning; (v) parent relationship; and (vi) parent psychological flexibility. Assessments will be via questionnaires conducted pre-, mid- and post- intervention, and at a 6-month follow-up. The theoretical basis, study hypotheses, methods and planned analyses are described.

This project aims to optimise outcomes for children with cerebral palsy (CP) and their families by testing the efficacy of two complementary interventions novel to the CP population: (1) parenting intervention (Stepping Stones Triple P, SSTP); and (2) parental stress management (Acceptance and Commitment Therapy, ACT) tailored for parents of children with CP. The efficacy of SSTP and the additional effects of ACT will be tested in a wait-list randomised controlled trial, with parents of children with CP (N = 110) randomised into three groups; SSTP, SSTP + ACT and wait-list control. Intervention delivery will combine group sessions with phone consultations. Outcomes will be assessed post-intervention with retention of effect examined at 6-month follow-up. Child outcomes will include: externalising behaviour (primary child outcome), functional performance, parent-reported child quality of life; and parent outcomes will include: dysfunctional parenting (primary parent outcome), parental confidence in performing disability-related parenting practices, degree of problems in performing disability-related parenting practices, parental adjustment, psychological flexibility and parental attitude to child emotions. The theoretical background, study design and study procedures are discussed. The validation of a parenting intervention and a parenting stress intervention for parents of children with CP is crucial to better support parents of children with CP in their parenting role and in providing evidence-based intervention for behavioural and emotional problems in children with CP.