Analysis Of Case Studies On Brain Injury In Children

There are many situations that a child or even an adolescent can go through in which it can lead to very bad consequences. These consequences can have a major impact on the child, such as a brain injury. There are many different cases and causes of a brain injury to a child or an adolescent that will be presented.

Grand Larceny in the First Grade: Traumatic Brain Injury in the School-Aged Years “Motor vehicle collisions are the leading cause of unintentional injury and death among children aged 1 year or older in the United States”.

Cody's Case

Cody was about six years old when her mother and her had a very bad car accident. When help came Cody was still breathing but was in a coma because of the brain injury. Tests were done to Cody, she did have bleeding in the frontal lobe and some fractures in her bones. Cody’s eye was also nonfunctional, her mom was very glad to be alive but did not realize that these things were going to affect her daughter. When returning Cody’s mother did notice some things that Cody started to do such as her patience was very low and her awareness of her safety went out the door. Cody then returned to school which turn out not to be so good, she started to threat many of the other students and her behavior also changed. Cody’s behavior also lead to her getting caught stealing, that is when her mother wanted to take action and do neurological test. Cody’s eye never fully recovered so it is nonfunctional.

Even though Cody did have a brain injury she did have no sign of seizures or hydrocephalus. She also have to undergo into a surgery that helped her reconstruct some of her facial features. Cody when returning to school, did have to go to a new school in which the school did not have any history or aware of her injury. She was placed in a regular class but then her behavior changed and of course the school noticed. The school then had a “document portrayed Cody as a opptionsitional and defiant child, who should be in the most restricted classroom environment”. At home it was also the same problem, her mother had to have Cody’s grandparents on speed dial. Her mother says that Cody still is very charming but her behavior was really uncontrollable. After Cody’s test it was best for her to be in school placement, to improve her behavior and also to have some sort of support.

A year passed since the first time that Cody had her evaluation there was a major difference, because Cody in school and at home was a bad child but now was seen as a child with an injury and was cared for differently. The school then knew she did have a brain injury so teachers were able to have one on one with Cody. Cody’s behavior was very impulsive, with help from teachers with and also her mom Cody’s behavior did a turn around to be more positive. Deficits in Executive Functioning: Before the accident Cody’s mother describes her as being a very happy and charming child. Once Cody was brought home her mom did notice that there was something wrong with her behavior.

Also at school she started doing bad things such as cutting portions of her hair and taking things from other students that were not hers. By her first evaluation Cody had shown problems with attentions and impulsive control. It was suggested that Cody should be able to be in a special education program for children that do have a traumatic brain injury. At home her mother would be able to help her with trying to portray a positive behavior rather than bad.

• Deficits in Motor and Sensory Functioning: The evaluation did show that there was a weakness in verbal attention. In the academic testing Cody is good mostly all of them were average, she had barely started to do math problems so her math was also average which was great because the math was related to her own grade in school. The second evaluation a year later showed that Cody in ger academic skills was average or above average. When the second evaluation was done it was suggested for her to have one on one with the teacher, the results are great because she does show that she is improving with her grade level.
• Deficits in Visual Skills: With the force of impact, Cody also had a injury to her eye. Doctors told her mother that in a future Cody can lose her version in her right eye. At that exact moment Cody’s mother was not very concerned about her daughter losing vision in one eye but that she was live. Cody returned home and her eye was still nonfunctional, she also had ptosis as well. A year after the first evaluation, Cody’s right eye was completely nonfunctional.
• Deficits in Memory and Attention: In the first evaluation another weakness was Cody’s memory. “Performance on ancillary neurological measures revealed impaired sustained attention”. During her evaluation, Cody was given different tasks and that is when it was shown that her attention and memory were impaired. “Memory deficits further appeared to be a consequence of poor retrieval rather than inability to encode information”. Also during her evaluation it would be considered to give Cody medication that can help improve many things such as attention skills.

Adolescent Traumatic Brain Injury

Judy was working at a school carnival, making sure the children would not fall into the slippery descent. Judy did have some trouble helping another child, and also began to have a breeze. The winds reached to 40 miles per hour, which no one expected for a sudden change in the weather. Judy was up 25 ft when a breeze really hit, she was thrown in the air about 150 ft in the air. Medical services were able to come and assist, within fifteen minutes Judy was able to regain conscious. Judy then had to get a cranial computerized tomography (CT), that revealed that from the fall that she had she did have bleeding in the right frontal lobe. There was also bleeding in the right lateral vertical. “In addition, preventable injuries were noted to be higher among children aged 0–14 years compared with other age groups, with the commonest cause of recent injury within this age group being TBI due to falls, followed by collisions or being struck by an object”.

Besides all of these happening to Judy had broken ribs, cracked pelvis, one of her lungs was failing, and finally some bones were broken in her arm. Judy did experience headaches or nausea. She then was very sensitive to noise, and would sleep more many hours. “In fact, her parents said that Judy had been sleeping about 15 hours per day since coming home from the hospital”. Her parents were really concerned because Judy really really depend on them. Other concerns that her parents had were having to do with her behavior and cognitive changes. Judy really wanted to go back to school, but her parents are really concerned that she would not be awake for that time of day. Judy’s parents then decided to have an evaluation on Judy because they just wanted to know a way to help her.

After the evaluation was completed it was suggested that Judy would go to school only part time meaning for only two hours, and if there was improvement she could go to school full time. Judy on her sophomore year was able to return to school full time. Judy also experiences episodes where she was very disoriented, headaches, and dizziness. All of these symptoms Judy was having were going to be considered when the evaluation was done to be able to have a plan for her education and rehabilitation.

• Deficits in Executive Functioning: Judy’s parents noticed that her behavior changed, she was a very quiet girl and turned to a very talkative young women. She would get mad when people would talk to her and she wouldn't understand. She would get really frustrated at times just because she would not have it that way. After Judy’s second evaluation her parents did say that she was back to being herself, she would be active and very bubbly.
• Deficits in Motor and Sensory Functioning: When Judy would talk, she would mix up her words. It was very difficult to be able to understand what she was saying at times. At times she would slow down and try to talk but would have to repeat herself in order to understand what she was saying.
• Deficits in Visual Skills: Judy’s visual skills were unimpaired.
• Deficits in Memory and Attention: In the first evaluation Judy’s working memory was low average. She also had a very difficult time grasping everything and then trying to remember things later. Judy would have a hard time with names and having to remember information. After Judy’s second evaluation, she still had problems with her memory and retaining information.

Medulloblastoma

Anthony was four years old when everything changed for him. When Anthony’s mom went to pick him up from daycare, she was told that Anthony have been having problems balancing, had fallen a couple times, his eyes were really moist and also his head would tilt to one side than the other. After being sedated for a couple of hours doctors did find that Anthony did have a big mass that was in shown the MRI that had been done. The tumor that was found in the posterior fossa where the cerebellum is located and also critical brainstems.

The neurosurgeon did suggest that the tumor should be removed, the sample of the tumor was identified as medulloblastoma that is malignant and very aggressive. “Medulloblastoma, one of the most common types, has a 10-year survival rate of 50%, and many survivors have neurological and cognitive sequelae”. Anthony’s parents then knew that Anthony had to undergo radiation and also chemotherapy. “Fast forward eight years, and Anthony was in the middle of fifth grade and struggling significantly”.

For the four years Anthony had to undergo many Magnetic Resonance Imaging (MRI). Anthony was in a private school which made things a bit better for him because the classroom was going to be smaller and would have more attention. Anthony’s father employer decided to move his father to a new city. When Anthony went back to school, within days Anthony brought notes from his teacher that he had a lot of unfinished work. Teacher conferences came along, the teacher told Anthony’s parents that he was very behind. This is what made Anthony's mom think that Anthony needed to be evaluated.

Anthony’s parents had to consult with staff at his school to be able to understand that he was having a hard time at school, having neurocognitive weaknesses, and also having hard time adjusting with other students. Since in this school the staff was not aware of what was truly going on with Anthony until the evaluation was done then his parents decided to put him in a special education services. In Anthony’s regular class, he would do good in his work but when it came to getting along with this peers it was not so good. “Consequently, the recommendation was made to the multidisciplinary team determining special education eligibility that it swiftly act to develop an appropriate Individualized Education Plan and supportive educational placement for Anthony”. These plans were going to help Anthony in the way that it will assist him in cognitive and academic deficits.

• Deficits in Executive Functioning: Before finding out that Anthony had a tumor his parents would describe him as a very bright, and creative boy. When going back to school there was a private school which was a lot of help but moving to a regular school it was harder to adjust. Anthony’s parent did not want to put him in a special student class but after the evaluation they decided to do that because it was better for Anthony to have one on one with a teacher.
• Deficits in Motor and Sensory Functioning: During Anthony’s evaluation, he did to move slower and be more aware of his surroundings. Also Anthony had to take more breaks between evaluation because he would get tired really fast. His work was slow that the evaluation did have to be split into two sessions. At school during a test Anthony would also take more time than the limit and teachers, even his parents noticed as well when having to do either classwork or homework. Being able to be in a new school placement helped Anthony be more active when it came down to social groups and also seemed happier with this.
• Deficits in Visual Skills: Anthony did have some impairment in visualize information processing. It was suggested that organizing and dividing information was going to help. An example would be that be highlighting when needed, use spacers or place markers to not be so hard on Anthony.
• Deficits in Memory and Attention: Anthony’s memory was strong, reading information out loud was going to help because it would be better to digest and also to be able to remember more of the information. Reading things out loud was also helpful when Anthony would study, he could remember the information. Oral testing was also a strategy that was going to be used.