| Abstract |
Acquired Brain Injury (ABI) is a leading cause of disability in children, as recognised by the World Health Organisation (1). Children with ABI often have ongoing difficulties that can significantly impact on their educational engagement, including fatigue, difficulties processing information, impaired memory, difficulties with organisation and planning, reduced concentration, impulsivity, and hyperactivity (2, 3). This fellowship aims to understand long term educational outcomes for children following an ABI, and how forms of educational support can improve these outcomes. We will subsequently develop guidance for schools to improve awareness. Cross-sectional evidence indicates that children with traumatic brain injuries are vulnerable to long-term academic difficulties, when compared to both healthy controls and children with orthopaedic injury (2). The consequences of ABI can affect academic performance (4), school absences (5, 6), peer group exclusion and bullying (7), and school exclusion, which can contribute to a 'school-to-prison pipeline' (8). All of these factors can significantly influence health-related quality of life (9). Despite this emerging evidence, there are significant gaps in understanding outcomes for children with ABI within schools, which this project will address. To our knowledge, no large-scale prospective study has been conducted in the UK that tracks educational outcomes after ABI. In 2019, an American study examined discrepancies between hospital data for ABI, and the numbers of students receiving special educational support at school (10), with only 33% of children whose hospital presentations indicated a moderate-severe ABI (likely to lead to ongoing difficulties) found to be receiving special educational support. While no such large-scale study of educational support has been conducted in England, recent policy analysis indicate similar challenges within our systems. Most notably, the All Party Parliamentary Group for ABI report, 'Time for Change' (3), highlighted the chronic lack of understanding amongst education professionals about ABI, the common lack of awareness within schools of a child's prior injury, and the associated difficulties in identifying the specific educational support needed (11). This fellowship will meet these gaps in evidence: Provide the most robust estimation in the UK to date as to how many children are presenting at hospital with an ABI. Track how ABI impacts on outcomes in education, including attainment, school exclusion, and persistent absence. Identify the frequency of SEN provision after ABI and elucidate what categories of support children with ABI in England receive. Consider how different forms of support (e.g. classification of SEN, time after injury) influence educational outcomes. Explore pre-injury demographic profiles, as it is known that gender (12), socio-economic status (13), and care status (14) influence both prevalence of and outcomes after brain injury. Assess whether these demographic profiles elucidate sub-populations of children with ABI who are not identified for SEN support. I will also map variation in support and outcomes by geography and school type. I will do this using the ECHILD dataset, which links health and education records for children in England. We will use a prospective longitudinal cohort design. Throughout the project, I will work collaboratively with the UK Acquired Brain Injury Forum (UKABIF) and the National ABI in Learning and Education Syndicate (NABLES) to ensure our research speaks to the experiences of those affected by ABI, as well as the realities of educational settings and SEN support. We will co-create impactful resources for education professionals based on our findings. |
