Participation outcomes for children with acquired brain injury: A narrative review

Aim: To review the literature on participation outcomes used in children and adolescents with acquired brain injury (ABI) and to synthesize the available evidence on recovery trajectories in participation after ABI. Method: This study searched electronic databases (Medline, Cinahl, Embase and PsychInfo) from March 2011 back to the earliest available time (1966) using the following terms with brain injury (brain tumours excluded) and children: social or community or school and outcome assessment or participation. Retrieved articles were rated for methodological quality using Oxford Centre for Evidence Based Medicine criteria (CEBM). Results: Sixteen articles were included for analysis. The methodological characteristics and quality of these studies varied considerably. Three studies used an explicit participation measure, nine studies featured an implicit participation measure and four used tailored participation measures. There is level 1c evidence that children and adolescents with ABI have participation restrictions at home, at school and in the community 18 months (SD = 14) after discharge. Conclusions: The available literature indicates that children and adolescents with ABI are at risk for participation restrictions. Research on recovery trajectories in participation after ABI in children is lacking. Longitudinal studies using explicit participation measures and higher quality research methodologies (quantitative, qualitative and mixed methods) are recommended.