This poster was presented at 16^th NR-SIG-WFNR conference Granada, Spain in June 2019

We recently worked with the University of Bristol to test the measures currently used by our community-based neuropsychological rehabilitation service, as recommended by McCauley et al (2012).

The study’s aim was to see whether there would be an improvement between assessment and review on a range of measures representing key areas of function for the child in a systematic context.

Our data was collected from 159 children with brain injuries and their families, with both traumatic and non-traumatic brain injuries, ranging from mild to severe. This was done using an outcome questionnaire.

There were encouraging improvements in reports of the children’s executive function, their participation and wellbeing of their family members. 

Download the full study here.

Working with the University of Bristol, our aim was to explore clinical hypotheses in assessment data.

We analysed data which Recolo’s associates have collected through routine clinical practice, of 150 children with brain injuries. The children were aged from 0-18 yrs, with both traumatic and non-traumatic brain injury types, ranging from mild to severe.

Preliminary analysis of our outcome data regarding the a priori hypotheses, provided evidence of the relationship between cognitive, emotional, social and educational measures of brain injured children.

Once further analysis is complete, recommendations from the project will feed in to an improved Recolo database that will allow for targeted case and item-specific analysis.

Download the full study here.

We recently worked with the University of Bath and University of Exeter, to test the feasibility of using a Single-Case Experimental Design (SCED) in routine rehabilitation practice.

The participant was a 10-year-old boy with cerebral palsy who also had epilepsy and fatigue. He had average IQ but impairments in vision, attention and memory. His attainment was 2 years below his chronological age. He attended mainstream school. Improvement of his engagement in learning tasks was a key priority. His physical rehab involved 1- hour a day in a standing frame.

The rehab and education team investigated whether a change in the physical demands of his timetable and standing practice would help him better engage. They found that his engagement improved when his standing practice was alternated across the week between morning and afternoon. This was when compared with him standing routinely in the afternoon only. Family and teachers subsequently decided to continue alternating the standing session.

It’s important to say that for clinical reasons a true experimental design was not used. This means that, although there his engagement improved, it was not possible to attribute that directly to his changed schedule.

We believe that more such studies are needed to decide whether it is feasible to use SCED in routine practice. We continue to develop SCEDs in our service to build the evidence to decide this.

Download the full study here.

This poster was presented at the European Federation for Research in Rehabilitation, Glasgow in September 2017.

At Recolo we are keen to promote the idea of Practice-Based Evidence, where real world practice is designed, documented and measured well.

We have worked with the University of Bath and University of Exeter to develop a protocol for child neuropsychological rehabilitation. The protocol is designed to provide our clinical practice in a way that can be reported as high-quality research evidence. The central process is to design each tailored intervention as a Single Case Experimental Design (SCED). This is a design that helps us determine whether it is our intervention or something else that improves the child’s function. Each SCED is then rated against an agreed standard to test its quality.

The protocol is reported in two parts: 1) the ‘inner’ clinical framework which can be used to design the rehab intervention as a SCED; 2) the ‘outer’ research evaluation framework to test how good the intervention and write-up was as research practice.

The project attempts to answer the question: “Is it feasible to produce level 1 evidence (the highest standard of clinical evidence) from normal clinical practice in neuropsychological rehabilitation?”

Download the full study here.