After an acquired brain injury, children may need help with
dressing and bathing because of problems with balance, changes in
sensation and awareness, less control of their hands, or poor
planning skills.
During the early stages of recovery, the child may be confused
and highly distractable. Activities for daily living should
occur in an environment with few distractions and preferably
somewhere that is familiar.
Knowledge of the child or young person's self care
abilities before the brain injury is necessary so appropriate
tasks can be chosen to include in the treatment program.
Who can help?
Occupational therapists assess children with difficulties in
this area. Often this assessment is done at home. Occupational
therapists identify the cause of the problem and offer appropriate
solutions together with the child and family.
What is the
treatment?
- Developing routines so
the child or young person can complete these activities in a familiar
way.
- Often the child or young
person needs supervision and help in the early stages of
recovery to ensure their safety. For example, they may not be able
to safely monitor water temperature in the bath or get in and out
of the bath safely.
- As children and young people
recover, they are encouraged to take more
responsibility for their own self care. The degree of independence
expected will depend on the child or young person's level of functioning before the injury, their age and any residual
physical and cognitive difficulties.
- Repetition (frequent
practise) and use of training strategies (for example, backward chaining, where the child or young person learns an activity by starting with
the final step and progressing backward until all the steps
are learnt).
- Use of prompt sheets.
These may have pictures and words to help the child or young person
remember the sequence of actions involved in the task.
- Special equipment may need to be used to accommodate physical changes. This may include equipment such as
bath seats, adding hand rails, providing clothing that
allows the child to dress and undress more easily (e.g.
elastic-waisted pants).
- Often the way the
child or young person completes the particular activity needs to be
modified, either temporarily or permanently. For example, the
child or young person may need to sit on a chair in the shower if
they are unable to climb into or out of the bath. The child or young person may
need to sit to dress or learn one handed dressing techniques if
they have a hemiplegia (where one half of a person's body is weak
or paralysed).
- It is important to
consider the safety of carers when helping the child or young
person do their self care tasks. For example, lifting
even small children can cause a back injury to the carer. This can
be avoided if carers are shown the best way to help the
child/young person.
For more
information
Developed by The Royal Children's
Hospital Paediatric Rehabilitation Service based on information from the Brain
Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH
consumers and carers.
Reviewed September 2020.
Kids Health Info is supported by
The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.