Traumatic Brain Injury Rehabilitation: Children and Adolescents (2nd Ed.).

Traumatic Brain Injury Rehabilitation: Children and Adolescents (2nd Ed.)

Mark Ylvisaker, Ph.D. Butterworth-Heinemann Boston, MA 1998, 480 pages $65 hardcover

This text was written to provide a solid informational foundation for program development for rehabilitation professionals working with children and adolescents who have sustained a traumatic brain injury (TBI). Dr. Mark Ylvisaker, along with 29 contributing authors, combines current research and models of practice to provide comprehensive and practical information for rehabilitation professionals. Dr. Ylvisaker, an Associate Professor of Communication Disorders, has experience working directly with children and adolescents in rehabilitation settings as well as conducting research focused on understanding the needs of children and adolescents with TBI. It is important to note that the amount of information contained in this book is much greater than the few examples cited in this book review.

Dr. Ylvisaker states in the introduction that there are four concepts that guide his approach to TBI rehabilitation: (a) the only reasonable approach to TBI rehabilitation is prevention, (b) the best approach to TBI intervention after injury is prevention of growing disability, (c) efforts to collaborate with everyday people in the child's world must be emphasized due to the reduction in health care availability, and (d) good rehabilitation must focus on real-world issues. It is evident that these concepts also guide the type of information contained in the book. The themes addressed in each of the chapters combine to cover a broad range of topics that adequately speak to the concepts that guide Dr. Ylvisaker's intentions.

The first chapter offers an insightful glimpse into the experience of traumatic brain injury for children, adolescents, and their families. Three TBI survivors and four mothers whose children are TBI survivors provide the introduction in chapter one. Each shares a perspective based on his or her experience of TBI. With these scenarios, Dr. Ylvisaker is able to present common themes present in the lives of people who have been affected by TBI. Additionally, he is able to demonstrate the uniqueness of each individual TBI experience. The themes that emerge in these scenarios are expounded upon throughout the book.

One of the many strengths of this book is the amount of information written by therapists, nurses, and physicians actually working in the field. It acknowledges the realities of professional practice and offers suggestions that have a great deal of applicability to everyday service provision. Because of their daily involvement with clients and their families, the contributing authors are able to provide examples that clearly describe and emphasize the information presented in the book. In chapter 13, the case study of "Ben" provides a comprehensive illustration of the types of behavioral and communicative difficulties faced after TBI and the even more difficult task of establishing appropriate behavioral intervention. The contributing authors use concrete, detailed examples consistently throughout the book to help guide practitioners through the rehabilitation process. The illustrated models used and the detailed guidelines given make it possible for practitioners to follow and implement the procedures discussed in the book.

A common note in all the chapters is the idea that the rehabilitation process must be consistently approached from a "team" perspective. Although the individual chapters are written by professionals traditionally associated with the topic (e.g., physical therapists writing about motor disorders), an interdisciplinary approach is recognized as the most efficient and effective means of working with the child and the family. Additionally, all areas of rehabilitation from motoric to psychosocial are recognized as meaningful and necessary for the well being of the child and the family.

Another strength in the book is the author's ability to see beyond the rehabilitation process and recognize the difficulties inherent in everyday life for people with TBI. The notion that progress continues long beyond the provision of structured rehabilitation services is prevalent in many of the chapters. The public educational system is a valuable and necessary option for many children after formal rehabilitation services have been terminated and may provide access to further assistance that would otherwise be unavailable due to financial constraints. Upon re-entering the classroom and school setting, children with TBI display a wide range of learning and behavioral needs. Consequently, teachers must be aware of methods of intervention that most effectively allow children to reach their learning potential in a safe classroom environment. A chapter is dedicated to the education of educators regarding TBI, which provides constructive guidelines for education professionals working with children with TBI. Additionally, the focus on family and members of the child's world outside of the hospital is a common topic throughout the book.

One area of weakness in the book is the lack of information regarding leisure and recreation for children and adolescents. Recreation and play are mentioned only in the context of therapy and as therapy tools. While vocational intervention and outcome is commonly addressed in the TBI literature, leisure and recreational intervention is often neglected. Children play naturally and play serves as a necessary developmental function in children; however, in adolescents, recreation and leisure skills are learned, much like vocational skills. A comprehensive leisure education program that explores values regarding leisure and behavior, activity skills, social interaction skills, and the meaning of leisure would compliment the vocational skills that are taught. Depression, social isolation, and boredom are common following TBI. The body of research regarding leisure, social support, and coping suggests that leisure is a potentially effective means of ameliorating those problems and creating opportunity for better health and well-being following TBI. Including more information on this topic would have been helpful.

The book covers an overarching range of topics associated with TBI rehabilitation and life beyond rehabilitation for persons affected by TBI. Dr. Ylvisaker and the 29 contributing authors use case studies to effectively address the topics and provide sound intervention strategies. The information contained in this book is comprehensive, applicable, and up-to-date. It serves as a core source of information for any brain injury rehabilitation program or service professionals wanting to provide effective and efficacious programming. Traumatic Brain Injury Rehabilitation: Children and Adolescents (2nd ed.) is a valuable resource for any practitioner in the field of pediatric and adolescent TBI rehabilitation.

Julie Lammel, M.S., CTRS Doctoral Student, Department of Leisure Studies The Pennsylvania State University