Exploring Barriers and Interventions for Long-Term Social-Emotional Impacts of Acquired Brain Injury on Pediatric Patients in Canada: A Narrative Review

Abstract

Background: Acquired Brain Injury (ABI) refers to brain damage caused by factors such as external trauma or internal infections that occur after birth. ABI is a leading cause of death, disability, and illness in Canada. Pediatric ABI can have various long-term social-emotional impacts, such as lower cognitive abilities, challenges in social interactions, decreased levels of self-esteem and adaptive behaviour, and higher levels of loneliness and antisocial behaviour.

Objective: The objective of this review is to investigate the long-term impacts and implications of moderate to severe ABI on social-emotional development throughout childhood, and the interventions available for pediatric patients.

Methods: This review includes literature from academic databases, including Web of Science, Ovid MEDLINE, and PubMed. Grey literature from reputable sources, including Holland Bloorview Kids Rehabilitation Hospital and CanChild, were also included to provide a holistic view of ABI research​​. Studies focusing on children ages 6–21 with moderate to severe ABI were prioritized, particularly those conducted in Canadian contexts.

Results: Beyond injury severity and mechanism, caregiver mental health and family functioning influence a child’s post-injury trajectory. Interventions addressing social-emotional development typically focus on reintegration into learning and recreation. Persistent challenges include disjointed hospital-to-school transition, insufficient long-term care coordination, and restricted teacher or caregiver training.

Conclusions: This review underscores the need for improved, evidence-based strategies to support the social-emotional development of Canadian children with ABI. Greater collaboration among healthcare providers, educators, and families, alongside more robust longitudinal research, could bridge existing gaps, thereby enhancing continuity of care and outcomes for pediatric ABI populations.