The PEDS Model of Child Neuropsychological Rehabilitation

Again, there is evidence of the efficacy of these types of intervention (Feeney & Ylvisaker 1995, Feeney & Ylvisaker 2003).

Systems perspective: there is an increasing body of research stressing the importance of context-sensitive neuropsychological intervention (eg Ylvisaker 2003, Ylvisaker et al, 2005). This approach argues that the best form of rehabilitation is that which integrates therapy into the child's everyday activities of daily life (ADLs) and routines at home, school, work and community life. In addition, in this approach, the role of the therapist after the initial period, is to act as a support system and for day to day therapy to be maintained by familiar people in the life of the child such as parents and teachers (Feeney et al, 2001, Feeney & Ylvisaker 2003).

What the literature says about the importance of the family in child neuropsychological riabilitazione rehabilitation
Psychosocial context and family function play important roles for recovery in childhood brain injury and it is recognised that there is a reciprocal relationship between family functioning and the neuro-behavioural disturbance of the child with brain injury (Anderson et al. 2001, 2005, 2006). Previous anecdotal evidence of the role of family functioning on brain injury recovery is now established in the literature such that there are significant benefits in the scholastic, behavioural and emotional functioning of the child when the family is supported, for example, through cognitive and behavioural strategies to cope with and manage the child and their behaviour more effectively (Taylor et al. 2002, Wade et al. 2005, 2006 a, b, c). Furthermore, the context-sensitive approach recognises the role of the family in the care and rehabilitation of the child with a brain injury (Feeney et al, 2001, Feeney & Ylvisaker 2003). It is acknowledged that because of these new responsibilities, the family must be assessed, prepared and empowered by the rehabilitation team to take its place as an integral part of the caring and rehabilitating process (Armstrong & Kerns, 2003, Anderson et al. 2006).

The PEDS Model of Child Neuropsychological Rehabilitation
In the context of recent literature and anecdotal evidence from our own clinical work, we believe that neuropsychological recovery/development takes place within specific contexts. We have developed the PEDS model which stands for P hysical brain, E xecutive functions, D evelopmente and S ystems:
P hysical Brain: The brain is a physical organ connected to the rest of the body. A healthy body results in a healthy brain. It is important to look at diet, exercise and rest in a holistic approach in order to promote development and recovery.
E xecutive Function: Brain injury nearly always results in executive system damage. This is because the executive system is associated with the front areas of the brain (dorsal lateral pre frontal cortex and ventral medial cortex). The front part of the brain is most vulnerable to injury due to the impact of the brain hitting the skull at speed. Executive systems include planning, organisation and self control of behaviour and these are often impaired as a result of brain injury.