Assessment of posttraumatic amnesia (PTA) in young children remains problematic. This article details a version of the Westmead PTA Scale, which was adapted for use with children aged 4 and 5 years, and an evaluation of this scale with typically developing children. The Westmead PTA Scale for Children (WPTAS-C) comprises 2 orientation and 4 memory questions, including 2 items involving remembering pictures of familiar objects. Participants included 55 preschool and kindergarten children aged 4 and 5 years. The scale was administered for 4 consecutive days. Ninety-three per cent of the children achieved a score of 6 out 6 for the final 3 days of the 4-day test period. It is concluded that the WPTAS-C is an appropriate measure of orientation and continuous memory in 4- and 5-year-old typically developing children. Validation of the scale in clinical populations is recommended.

Severe traumatic brain injury (TBI) is the most common cause of brain injury in the Western world and leads to physical, cognitive and emotional deficits that reduce independence. Changes to psychosocial function are the most disruptive, resulting in vocational difficulties, family stress and deteriorating relationships, and are a major target for remediation. But rehabilitation is expensive and its evidence base is limited. Thus, new collaborative initiatives are needed. This article details the development of ‘Moving Ahead’, a model for a Centre of Research Excellence (CRE) for Traumatic Brain Injury Rehabilitation. This CRE offers several major innovations. First, it provides an integrated, multi-faceted approach to addressing psychosocial difficulties embracing different clinical standpoints (e.g., psychological, speech pathology, occupational therapy) and levels of investigation (e.g., basic science to community function) across the lifespan. It is based upon a close relationship with clinicians to ensure transfer of research to practice and, conversely, to ensure that research is clinically meaningful. It provides an integrated platform with which to support and train new researchers in the field via scholarships, postdoctoral fellowships, websites, meetings, mentoring and across-site training, and thus build workforce capacity for individuals with TBI and their families. It has input from the international community to contextualise research more broadly and ensure scientific rigour. Finally, it provides collaboration across sites to facilitate research and data collection.

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.

The current study was designed to determine whether the Social Performance Survey Schedule (SPSS; Lowe & Cautela, 1978) is a useful measure of social skills in people with traumatic brain injuries (TBI). Forty-nine adults with TBI were compared on the SPSS to 190 adults without injuries. The validity of the SPSS was also investigated in relation to another measure of social performance, the first scale of the Katz Adjustment Scale (KAS-R1; Katz & Lyerly, 1963) and a broad measure of social function (the SPRS; Tate, Hodgkinson, Veerabangsa, & Maggiotto, 1999). Individuals with TBI had significantly lower scores on the positive scale of the SPSS than nonbrain-injured individuals. They did not have lower scores on the SPSS negative scale relative to the normative sample. Significant correlations with the KAS-R1 and SPRS provided evidence for the construct and criterion validity of SPSS within this population. In conclusion, this study suggests that where an appropriate normative sample is used, the positive subscale of the SPSS is a sound measure for detecting the extent and nature of deficits in prosocial behaviour seen in TBI, but raises the question as to how we define negative behaviours in the 21st century on scales such as the SPSS.

Individuals seeking compensation following traumatic brain injury (TBI) are often found to report a disproportionately high level of symptoms relative to objective indicators of impairment. Previous studies highlight that level of symptom reporting is also related to self-awareness, causal attribution, and emotional wellbeing. Therefore, the reasons for high symptom reporting in the context of compensation are generally unclear. This study aimed to identify whether self-awareness, causal attribution, and emotional wellbeing are significantly associated with level of symptom reporting after controlling for compensation status. A sample of 54 participants with TBI comprised two groups, namely, claimants (n = 27) and non-claimants (n = 27), who were similar in terms of demographic and neuro-cognitive variables. Participants completed the Symptom Expectancy Checklist, Hospital Anxiety Depression Scale, Awareness Questionnaire and a causal attribution scale. A series of independent t tests and Pearson's correlations identified that a higher level of symptom reporting was associated with the following: seeking compensation, less severe TBI, increased age, greater self-awareness, increased post-injury changes reported by relatives, a higher level of mood symptoms, and a tendency to blame other people. Multivariate analysis identified that after controlling for demographic, injury, and compensation status variables, level of mood symptoms and self-awareness were significantly associated with level of symptom reporting. The findings suggest that mood symptoms and heightened self-awareness are significantly related to high symptom reporting independent of compensation status, thus supporting the need for clinicians to interpret symptom reporting within a biopsychosocial context.

There has been a dramatic increase in recent years in the literature available on community integration among people with acquired brain injuries. At the same time, however, clinicians are calling for information that has utility in the complex environment of community practice. The study was a scoping review to address the question: What is known from the existing literature regarding the best ways to promote community integration in the postacute phase of brain injury recovery? From a preliminary pool of 925 studies identified by electronic searching of 5 databases in a 15-year time window, a final set of 30 was selected for further review, referring to 25 distinct programs. This scoping review has shown that there are 5 types of programs typically offered to survivors of brain injuries to assist with community integration: supported employment, traditional rehabilitation, environmental adaptation, support development and transitional living. These 5 approaches were primarily used to address 2 aspects of community integration: traditional rehabilitation was most commonly used to promote independent living, and supported employment was the most common approach used to promote productive occupation. Themes that emerged from the review were the need for highly individualised programming, in vivo approaches, tailored supports, early intervention and a focus on participation. Methodologically, the study represents an important acknowledgment of the valuable information that is available in the literature in descriptive and small sample research.

Background: Persistent post-concussion symptoms (PCS) are associated with adverse psychosocial outcomes, including psychological distress and poorer health-related quality of life (HRQOL). Research has found that the occurrence of persistent PCS can be lowered via paper-based psychoeducation. Unfortunately, these resources have mostly been evaluated in adult populations. Studies in children have failed to address the role of parents in the development and maintenance of PCS, and unfortunately fail to reach a large proportion of the mild traumatic brain injury (mTBI) population who do not attend hospital. This study aimed to describe and evaluate a parent information booklet and child information website, for the prevention of paediatric PCS.

Methods: Children with uncomplicated mTBI were randomly assigned to either the Intervention (n = 29) or Usual Care condition (n = 20). Families completed pre-treatment, post-treatment (3 month) and follow-up (6 month) assessments of children's PCS, cognitive and psychosocial functioning, and parent's psychosocial functioning. Families also provided feedback on the psychoeducation resources.

Results: The Intervention programme, compared to Usual Care, was not associated with significant reductions in children's PCS or HRQOL, parent or child psychological distress, or parent or child knowledge of mTBI.

Conclusions: Psychoeducation resources do not appear to be superior to usual care in promotion of both child and parent psychosocial outcomes following mTBI.

Many individuals require long-term community-based support following acquired brain injury (ABI). However, very few studies have examined individuals' perceptions of these support needs. The present exploratory study examined individuals' perceptions of community-based support following severe ABI. Participants included eight individuals (aged 20–48 years) with severe ABI, seven relatives and three case managers. The individuals were receiving long-term specialised lifestyle support ranging from 3–70 hours per week. A structured interview with open and closed questions was developed to explore perceptions of individuals' support needs across the areas of personal and home-based activities, community-based activities, self-organisation and vocational activities and social and psychological well-being. The questions investigated whether support was needed, the importance of support, the sources of support, the effectiveness of support and the need for change. A comparison of the three respondent groups' perceptions of support indicated a general consensus that community-based activities were the most important and most effective area of support. When the issues raised by the three respondent groups were compared and contrasted two main themes emerged from the data, which were labelled “relationships” and “individual choice versus support needs”. These themes are discussed in relation to the provision of long-term community-based support services following ABI.

Cyberscams, such as romance scams, are prevalent and costly online hazards in the general community. People with Acquired Brain Injury (ABI) may be particularly vulnerable and have greater difficulty recovering from the resultant emotional and financial hardships. In order to build capacity in the neurorehabilitation sector, it is necessary to determine whether clinicians currently encounter this issue and what prevention and intervention approaches have been found effective. This scoping study aimed to explore clinicians’ exposure to and experiences with cyberscams in their adult clients with ABI.

Background and aims: Community-based rehabilitation programs for people with a brain injury are diverse. Comparative program evaluation is required to identify optimal type, intensity and duration of programs. The aim of this study was to compare the effectiveness of two community-based rehabilitation programs using a set of standardised outcome measures.

Methods: The study used a quantitative, multicentre, longitudinal design. Persons with severe traumatic brain injury (TBI, n = 39) and acquired brain impairment (n = 2) were recruited from two residential, transitional living programs (TLU; n = 21) and two home-based community rehabilitation programs (CR; n = 20). Participants were assessed via interview at program entry, 2 months and 6 months later using a broad range of standardised measures. The quantity and types of intervention provided to study participants were recorded. Results: No significant differences were identified between the TLU and CR groups at baseline or 6-month follow-up. Two significant group-by-time interactions were identified on the Community Integration Questionnaire (CIQ). First, the CR group had significantly greater changes in productivity (p = .003; d = 1.0) compared to the TLU group over time; by contrast, the TLU group showed significantly greater improvements in social integration (p = .007; d = .86). The TLU participants received up to five times more intervention than the CR participants. This finding is significant considering the similar levels of improvement in function made by both TLU and CR participants.

Conclusions: Both TLU and CR groups improved on a range of measures. The TLU group however, received significantly more face-to-face interventions. Further examination of the relationship between participant contextual factors, such as coping style and self-esteem, and impairments such as challenging behaviour and decreased self-awareness, of people attending TLU and CR programs is required.

Aim: To investigate the characteristics of Australian organisations providing case management to individuals who have acquired brain injury, and to determine the methods of case management service delivery including professional development and evaluation of outcomes.

Method: An anonymous 23-item web-based survey was used. Respondents were case managers who deliver services to adults and/or children with brain injuries. A snowball sampling method was used to recruit respondents from around Australia.

Findings: Fifty-one case managers completed the survey. Respondents were from a wide range of professions, the largest group being occupational therapy. The majority of respondents were based in metropolitan areas, were employed within the public health system and were based in the community. Respondents reported that the main determinant for clients receiving case management was the severity of the brain injury followed by complex family needs. Variations in practice and a lack of consistency in outcome measurement, goal setting and professional development were noted.

Discussion: This study provides an overview of characteristics of case management practices for people with acquired brain injury (ABI). Identifying roles and responsibilities of case managers is the first step to developing future research designs, which determine the effectiveness of case management.

Recently, there has been a surge of interest and research in social functioning throughout childhood and adolescence, and how social development is affected by acquired brain injury (ABI). Despite ongoing research and theoretical advances, there remains a lack of specific, relevant and robust measurement tools that draw upon current clinical and social neuroscience knowledge, and which are developmental in nature, to assess social competence within the nonclinical and the ABI population. The aim of the current project was to develop a questionnaire to measure social competence and the quality of relationships of children and adolescents between the ages of 5 and 18 years. This questionnaire, the Developmental Assessment of Social Competence (DASC), also aimed to be sensitive to the specific social problems often associated with children who have suffered ABI. The current article outlines the process and challenges faced in developing such a measure up to the initial pilot stage. Participants included a pilot group of 40 parents who completed the pilot questionnaire, as well as an established questionnaire that assesses social functioning. Parents rated their own children who were aged between 6 and 14 years, and who were within the nonclinical population. Preliminary analyses found that the children generally scored highly on the DASC, and that a higher score on most scales of the DASC tended to be associated with a higher score on an established questionnaire measuring social skills. These data are promising, and provide important information for the following stages of development and evaluation of this new questionnaire.