2014 Grant Recipients

Moving Ahead’s Small Seed Grant recipients are selected on the basis of project merit, the project’s consistency with the overall goals of Moving Ahead, and the project’s ability to progress our knowledge or understanding of psychosocial issues in TBI.

Every year the standard of applications is very high, with a significant number of applicants obtained.

The Moving Ahead NHMRC Centre for Research Excellence Small Seed Grant recipients for 2014 are:

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The following is a summary of their respective projects:

The Participate Project: Preparing children with acquired brain injury for integration into community recreation and leisure activity

By Claire Willis, Anna Gubbay, Siobhan Reid, Sonya Girdler, Astrid Nyquist, Reidun Jahnsen, Michael Rosenberg, Noula Gibson, Jane Valentine and Catherine Elliott

What the study will be about:

Participation is associated with a child’s behavioural and emotional wellbeing, the development of psychosocial and physical competencies, and the development of sense of meaning and purpose in life. Although participation is considered a key component of rehabilitation, there is limited empirical evidence regarding approaches to improve this domain in the paediatric ABI population. Thus, this research aims to develop a rehabilitation model and intervention to help facilitate the community participation of children with an ABI.

What we have done:

A needs assessment has been used to develop the model, involving both a local environment analysis and an international model analysis. In Western Australia (WA), we have identified the most significant factors impacting upon a child’s participation in the community following ABI. The second part of this analysis will identify services in WA that do and do not facilitate participation of children with ABI in community activities. The last component of the needs assessment is being undertaken at Beitostølen Healthsports Centre (BHC) in Norway. This rehabilitation centre successfully meets the needs of children and youth, adults and their families in Norway, providing them with the skills and confidence to participate in home, school and community settings following intervention. The analysis of this Norwegian model has identified key structures and elements that are required for successful intervention in preparing children for integration into community activities.

What we expect to find:

Collating the findings of the needs assessment will provide the context and conceptual basis that will form the key pillars of our Australian rehabilitation model. The model will provide the framework that will guide the development of the participation-based intervention. The intervention will be designed to support children and families in gaining skills and confidence to move into community programs to promote empowerment, social inclusion and participation in children with an ABI. Importantly, the model developed in this research will outline key strategies to guide future program development and implementation, support replication into other rehabilitation frameworks, and assist in enhancing the participation opportunities and quality of life of children with ABI in Australia.

Structural imaging biomarkers and predictors of social cognitive and behavioural functioning after pediatric traumatic brain injury (TBI): A longitudinal prospective analysis

By Nicholas Ryan, Cathy Catroppa, Timothy Silk and Vicki Anderson

What this study is about:

Pediatric traumatic brain injury (TBI) is a common cause of childhood disability, and is associated with elevated risk for social, behavioural and cognitive-communicative difficulties. In addressing substantial gaps in current knowledge of the neurobiological and neurocognitive mechanisms that link TBI to socially maladaptive behaviour, this study aims to; (1) characterize the nature and prevalence of social cognitive, communication, and behavioural difficulties up to 24 months post-pediatric TBI, and (2) relate social cognitive and behavioural outcomes to both (i) the location and extent of microhaemorrhagic lesions detected using susceptibility weighted imaging (SWI) and (ii) alterations in structural network topology quantified via diffusion weighted imaging (DWI) and graph theoretical methods.

What we have done so far:

Our research team has recruited 147 children and families: 104 children and adolescents with TBI, and 43 typically developing (TD) children and adolescents aged between 5 and 15 years. Participants have undergone research MR imaging at 2-8 weeks post-injury, and completed cognitive and behavioral assessments at 6, 12- and 24-months post injury. A subset of the sample has undergone structural imaging at 2-years post-TBI.

What we expect to find:

We predict that paediatric TBI will be associated with elevated risk for impairments across domains of social cognition, pragmatic communication and social adjustment. Compared to typically developing children, we expect that paediatric TBI will be associated with both alterations in existing structural brain connections, as well as a decrease in the number of edges between brain areas across time. More specifically, we expect that TBI patients will show abnormal small-world organization, reduced network efficiency and altered nodal efficiency in white matter networks.

Furthermore, we expect a relation between the degree of network connectivity and social cognitive and behavioural function in children and adolescents with TBI, whereby decreased connectivity degree will be associated with impairments in social and behavioural functioning.

Results from the study will enable identification of potential ‘critical developmental periods’ for better and worse recovery of social cognitive and pragmatic-communicative abilities, as well as assist to identify neural correlates and acute structural imaging biomarkers to improve prediction of long-term social outcomes. The results will also extend current knowledge of risk factors for externalizing trajectories post-TBI, ensuring clinicians and policy makers are better equipped to identify and target children who may benefit from long-term follow up and/or psychological interventions.

Improving quality of life and communication skills for people with acquired brain injury (ABI) following project-based therapy

By Nicholas Behn, Madeline Cruice, Jane Marshall and Leanne Togher

What the study will be about:

Communication impairments are common following acquired brain injury (ABI) and have a significant impact on a person’s quality of life post-injury. Therapy can involve conversational skills training and training the communication partner (i.e. family member, paid carer). While both approaches improve communication skills, quality of life is less amenable to change. An alternative therapy, called project-based therapy, has been proposed where a person with ABI works collaboratively towards a common goal (or project), providing a meaningful, engaging and motivating environment. This study will evaluate the effect of project-based therapy on improving the communication skills and quality of life for people with ABI.

What we have done:

Twenty-one people with ABI with communication impairments participated in this study (ten were allocated into a delayed treatment group). Following an initial assessment, therapy involved 10 sessions over 6 weeks (each session lasting 2 hours). The first therapy session involved setting individualised communication goals and useful strategies for the person with ABI and their communication partner. The next nine sessions involved group sessions (of two to three people) where participants worked towards achieving a meaningful project identified by the group. Each session provided a supportive environment for people with ABI to work on their communication goals and problem-solve, plan and organise a range of tasks to achieve the project. Regular text-messages were sent to people with ABI to remind them of their individualised goals and any tasks they need to do to complete the project.

What we expect to find:

It is anticipated that people with ABI will have better conversations and report a higher quality of life following the therapy. The design of this study will also enable us to identify the most critical components of project-based therapy for people with ABI. Completed projects can be found on YouTube via the Brain Injury Projects channel – view here.