Treatment for neurobehavioral disorders should include rehabilitation and special education services through a multidisciplinary team of professionals, including licensed psychologists, physical and occupational therapists, speech and language pathologists, behavioral specialists, and teachers specifically trained in the treatment of brain injury. Residential services can also be useful for individuals who need extra care.
Each year, approximately 2.5 million children and adults in the U.S. sustain a traumatic brain injury (TBI); 2.2 million are treated for TBI in Emergency Departments or Trauma Centers; 280,000 are hospitalized; 50,000 die.*
Currently, more than 5.3 million children and adults in the U.S. live with a lifelong disability as a result of TBI. The effects of TBI can include impaired thinking or memory, movement, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression). These issues not only affect individuals, but can also have lasting effects on families and communities.*
(*Brain Injury Association of America and the Centers for Disease Control and Prevention, 2018)
Neurobehavioral disorder is a term used to describe a group of diagnoses related to behavioral challenges that accompany brain disease as well as traumatic and acquired brain injury. These behavioral challenges may result from brain diseases such stroke, neuro-oncological conditions, and trauma.
Acquired brain injury refers to a traumatic or non-traumatic brain injury that occurs after birth. Traumatic brain injury is caused by an external force. Non-traumatic brain injury occurs as a result of disease or illness.
One of the most common neurobehavioral disorders in children is Attention-Deficit/Hyperactivity Disorder (ADHD). According to The Centers for Disease Control, a 2016 parent survey indicated 9.4% of children ages 2 -17 had received a diagnosis of ADHD.
Autism Spectrum Disorder (ASD) is a complex neurobehavioral disorder that currently affects one of 54 children in the United States (CDC 2020). Individuals with ASD often have impairments in social interactions, communication deficits, and behavioral challenges.
Traumatic Brain Injury (TBI) affects nearly 1.4 million people a year in this country. Some of the behavioral changes that can be associated with TBI may include, but are not limited to, increased impulsivity, increased agitation, dysregulated emotional responses, and social inhibition.
Professionals who work with individuals with neurobehavioral disorders often take a multidisciplinary approach to treatment that may involve a combination of pharmacological and behavioral interventions. A neurologist or neuropsychologist will often start an assessment by gathering relevant history, interviewing caregivers, and observing the individual. A clinical team may also conduct formal/standardized tests of cognition, memory, and attention.
Applied behavior analysis (ABA), the application of principles of learning to achieve desired outcomes, has been found to be effective in decreasing challenging behavioral associated with neurobehavioral disorders. Oftentimes behavior analysts begin by conducting a functional behavior assessment or functional analysis to determine the function of, or reason for, the challenging behavior. Once they have identified the variables that maintain, or perpetuate, these unwanted behaviors, they can put in place interventions to decrease them. Interventions should include positive reinforcement of socially acceptable replacement behaviors, and often involve withholding reinforcement of the challenging behaviors targeted for decrease. Treatment is individualized, and therefore the duration of treatment is variable.
Neurobehavior Disorders in Children: An Evolutionary Perspective by Robert Melillo and Gary Leisman
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