Beyond Survival: Outpatient Treatment for Functional Recovery After Brain Injury
Emily Kivlehan1, Uchenna Ewulonu Pelzer2, Sophie Leib3
1Pediatric Physical Medicine & Rehabilitation, Shirley Ryan AbilityLab, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Abstract:
Acquired brain injuries (ABIs), including hypoxic-ischemic and traumatic injuries, are leading causes of long-term disability in children. While acute treatment has advanced, many survivors face persistent cognitive, emotional, and physical challenges that require coordinated outpatient care. This review aims to equip pediatric providers with the knowledge and tools necessary to provide longitudinal, comprehensive, and family-centered outpatient care for children recovering from ABIs. This review begins with the definitions, etiologies, and prognostic factors associated with pediatric brain injury, followed by key components of outpatient assessment, including symptom monitoring, appropriate use of diagnostic tools, and identification of early warning signs for complications. This review then highlights common neuropsychological impacts-such as deficits in memory, attention, and executive functioning-as well as emotional and behavioral concerns including anxiety, depression, and social withdrawal. Musculoskeletal complications and tone abnormalities are discussed alongside strategies for outpatient treatment. The roles of physical, occupational, and speech therapy are explored, with emphasis on collaborative, goal-directed care that extends into school and community settings. Finally, ongoing gaps in outpatient care are identified and examined, particularly in terms of access and continuity of services.
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