The Brain Injury Responsiveness Program at Kennedy Krieger Institute evaluates and treats children and adolescents with a history of injury to the brain who exhibit altered awareness of the self and their environment. Our patients include those in a coma, vegetative state, and minimally conscious state. 

Disorders of consciousness (DOC) is characterized by severely altered arousal or awareness of the self and the environment.

Stacy Suskauer, M.D., co-director of the Center for Brain Injury Recovery at Kennedy Krieger Institute leads an innovative team that is investigating and refining the way patients with DOC are managed in the inpatient setting.  This “low responsiveness team” includes pediatric rehabilitation medicine, neuropsychology, behavioral psychology, and brain injury therapists. Behaviors relevant to return of consciousness are collected in a standardized, detailed manner and analyzed.

The low responsiveness team meets weekly to develop recommendations for adjustments to the therapeutic regimen for each patient, based on analysis of the data. Under Dr. Suskauer’s guidance, members of the team have presented widely to professional audiences and have published journal articles about DOC patients. They fill a critical gap in our understanding of this fragile neurologic state and bring “best practice thinking” into the discussion about care for these patients.

The Brain Injury Responsiveness Program at Kennedy Krieger Institute evaluates and treats children and adolescents with a history of injury to the brain who exhibit altered arousal and/or altered ability to interact with their environment. Our program includes detailed interdisciplinary evaluations and state-of-the-art treatment techniques. Patients are initially evaluated in our outpatient clinic by an interdisciplinary team of physicians and therapists. During this initial assessment period, the team will evaluate medical issues, including medication regimen and sleep, sensory and motor functioning, responsiveness, and motivational stimuli.

Following the evaluation, the interdisciplinary treatment team and the patient's family will work together to identify goals for participation in the program. Patients will either be admitted to our inpatient neurorehabiliation unit or receive intensive outpatient coordinated care. Subsequent evaluations and treatment are carried out by a specialized interdisciplinary team with expertise in disorders of consciousness that works together to address issues through direct interaction with patients and regular interdisciplinary discussions.

Primary Program Goals:

Our expert physicians and therapists make it possible for our program to address goals in patients with limited to no response to their surrounding environment. We currently admit two types of patients:

  • Acute Rehabilitation Patients: Acute rehabilitation patients are children who are experiencing their first rehabilitation following a new injury or illness. For an acute rehabilitation patient, goals of the inpatient admission include optimizing the child's responsiveness and function, in addition to preparing the family to care for the child at home.
  • Chronic Rehabilitation Patients: Chronic rehabilitation patients are children with chronic effects of injury or illness who have previously been discharged from an inpatient rehabilitation setting or never received acute inpatient rehabilitation. For a chronic rehabilitation patient, specific goals are identified prior to admission and are addressed in a time-limited manner that typically lasts two to four weeks. Common goals include optimization of medication management, strengthening of potential means of functional communication, maximizing positioning, and other goals to promote motor functioning.  

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Measure Improvement, Anticipate Success: Tools developed at Kennedy Krieger allow for more accurate prognoses after brain injury.
 

Related Materials and Information:

Neurorehabilitation Updates Newsletter
Center for Brain Injury Recovery Brochure (PDF)
Brain Injury Responsiveness Program Factsheet (PDF)