Paediatric Brain Injury Case Management
Brain injury in a child is not the same as brain injury in an adult, and it does not follow the same pattern. A child’s brain is still developing at the time of injury, which means some of the most serious consequences may not appear until years later, as the demands placed on the child increase.
This is one reason why paediatric cases require a different kind of case management from adult cases, and why specialist expertise matters.
Growing into deficit
One of the most important concepts in childhood acquired brain injury is what clinicians call “growing into deficit.” A child who appears to recover well at age seven may face serious difficulties at twelve or fifteen, when the demands of school, social relationships, and adolescent development begin to exceed what their injured brain can manage.
This is not a failure of early treatment. It is the nature of the injury. The parts of the brain that were damaged may not have been fully called upon yet. As the child develops, the gaps become visible.
It means that prognosis in paediatric ABI cases is genuinely difficult, and it means that long-term planning, not just early intervention, is essential.
Hidden disability
Physical recovery in children can be good, sometimes deceptively so. The difficulties that remain after acquired brain injury tend to be cognitive, emotional, and behavioural: problems with attention and memory, fatigue that is easy to misread as disinterest, emotional regulation difficulties that can look like conduct problems, and social difficulties that can leave a child progressively more isolated.
Because these are not visible, they are routinely missed by schools, and sometimes by families too. Children with unrecognised brain injury-related difficulties are often labelled as lazy, difficult, or unmotivated. Without the right support in place, they tend to fall further behind over time, rather than catching up.
Early, well-coordinated case management can change that trajectory. It does not always fix the problem, but it puts the right people around the child at the right time.
What paediatric case management involves
Working with a child client means working across every part of their life. In practice that includes coordinating therapists, psychologists, and other specialists so that the team around the child is working towards the same goals; liaising with schools, supporting education, health and care (EHC) plan applications, and helping teaching staff understand what the brain injury means for the child in the classroom; supporting families, who are managing their own responses to what has happened while also trying to support their child; and planning for the transition from child to adult services, which is a known risk point and needs to be addressed long before it arrives.
Louise and Ken both have direct clinical experience of paediatric acquired brain injury across the full range of severity.
Research into childhood ABI
Louise’s MSc research focused on children with acquired brain injuries and the relationship between family functioning and resilience. The study drew on established psychometric measures and found a direct link between how well a family functions after a child’s brain injury and the child’s own resilience outcomes. That research underpins several of the articles in our resources section.
Her PhD research, ongoing at Plymouth Marjon University, investigates psychosocial outcomes in children and adolescents with acquired brain injury. The work is focused on a group that is under-researched relative to adult brain injury, and whose sequelae remain poorly understood by many of the professionals working around them.
That research background affects how we assess paediatric clients, how we set goals, and how we think about what a realistic outcome looks like over a ten or fifteen year horizon. You can read more on our Research page.
Working with us on paediatric cases
We are appointed by solicitors handling paediatric personal injury and clinical negligence claims. We carry out Immediate Needs Assessments and provide ongoing case management where instructed.
Our reports are clear, based in evidence, and produced to the timescales the litigation process requires. We understand what solicitors need from a case manager, and we work within the framework that courts and experts expect.
Our approach to paediatric case management reflects the specific recommendations in NICE guideline NG252 (Rehabilitation for chronic neurological disorders including acquired brain injury, 2025), which sets out standards for rehabilitation planning in children including goal setting at key developmental stages and coordination of education, health and care plans.
If you have a paediatric ABI case and want to discuss whether an instruction is appropriate, contact us directly.
