A pediatric brain injury rehabilitation program helping children, adolescents, and young adults make meaningful progress

Therapies, medical services, and behavioral health support during brain injury recovery. Head injuries can occur in any number of ways, but there is one thing all traumatic brain injuries have in common — they change your life in an instant. After a child sustains a brain injury, families are often left wondering what lies on the other side of intensive care.

Children with brain injuries require a broad range of services as their level of responsiveness and medical conditions evolve. The RISE Program at Nexus Children’s Hospitals in Dallas and Houston emphasizes standards of care developed to help patients across all phases of brain injury recovery. Since every pediatric brain injury is unique, rehabilitation therapy must be creatively tailored to the patient, thereby helping children rise to their maximum potential. For over 30 years, our program has helped children make meaningful progress, because we’re experts at mending minds.

Resolved to recover

Our program is designed for any patient who has experienced a brain injury. We also admit a range of patients with additional complexities:

Inclusion Criteria

We accept patients in all phases of brain injury recovery, including those in disorders of consciousness who may not meet acute rehabilitation criteria*. Additionally, we accept patients with:

• Tracheostomies/Ventilators
• Complicated wounds
• Gunshot wounds/ penetration wounds
• Medically complex needs (i.e., neurostorming)

*Although our programs can provide an acute inpatient rehabilitation level of care (15 hours/week), patients do not have to be ready to participate in three hours of therapy a day at the time of their admission to qualify for programming.

PROGRAMMING PHASES MEETING PATIENTS AT THEIR LEVEL

Patients can admit to any phase of the program, just as they can progress to any level of care as their needs evolve. Treatment plans and goals are adjusted depending on patient’s level of responsiveness and medical conditions.

1. Disorders of Consciousness
For children and adolescents who continue to show altered arousal and/or limited ability to interact with their environment, and are not yet or inconsistently following commands (Unresponsive Wakefulness Syndrome/Minimally Conscious State).

2. Post Traumatic Amnesia/Delirium
Designed for recovery from acute confusion and/or post-traumatic amnesia (PTA) and beyond. This phase provides orienting information to promote increased environmental awareness and medical and environmental structure to promote behavioral regulation.

3. Recovery
Supporting children and their families as they navigate the transition from hospital back into their home, school, and community environments. Neuropsychological testing is provided to identify cognitive deficits and provide recommendations, for children to develop and progress towards independence.

PROGRAM STANDARDS OF CARE

• Optimize sleep/wake cycle with medications and limiting interruptions at night
• Manage high muscle tone to prevent contractures
• Initiate neuro stimulation, including medication and sensory stimulation
• Provide in-hospital monitoring (EEG) for seizures available (as needed)
• Test cognitive function weekly
• Provide traditional therapies led by Certified Brain Injury Specialist (CBIS) certified therapists
• Manage behavioral agitation, including medication management and environmental behavioral strategies
• Monitor patient progress with evidence-based outcome measures (refer to QR code for outcome data)
• Conduct neuropsychological evaluations to offer school entry recommendations to enhance developmental potential
• Provide recreational therapy and music therapy services on individual and small group basis
• Provide family/caregiver training and education throughout admission according to patient’s level of recovery and medical complications
• Plan for discharge, including scheduling relevant follow-up and outpatient appointments, preparing medications, organizing home equipment, and planning in-home services and supervision (as needed)
• Utilize evidence-based treatment modalities for best outcomes