Dr. Sarah O'Doherty:

Deputy Kelleher asked about education, which is a key area. We need development in liaising with schools. I work very closely with the Department of Education and Skills. However, acquired brain injury is not even listed as a disability within its categories. When a child sustains an acquired brain injury, one is reinventing the wheel every time in terms of accessing a special needs assistant and other resources because there is no template for them. So it is necessary to explain every individual case to the decision makers about that child. Sometimes they do not meet the criteria laid down by the Department of Education and Skills and therefore miss out on resources and miss out on getting an SNA.

It would be very important if we could explain acquired brain injury at a more general level to educators by getting into teacher training colleges so that it is there on the map as a disability. There are varying degrees of acquired brain injury. It is a very individualised injury.

Schools have been fantastic to date. I have worked in my post for 14 years and it usually is the first time the school in question has ever received back a child with an acquired brain injury. The good news is that most children return to school. While that is where the majority of their rehabilitation will take place, schools do not have a background in providing strategies and supports to a child with an acquired brain injury. It would be wonderful if there could be a post of an outreach person who would be a link with schools. Such a person would visit a school when someone returned with an acquired brain injury to educate the school and support it with regard to a child's changing needs as he or she is in education. The big difference with children with an acquired brain injury when compared with adults is their needs change with development. Disabilities and problems can occur later on or can become more evident when a skill is required or the system changes and more pressure is put on the child. Something may not have been an issue at the age of four, but suddenly a teenager is presenting as being disinhibited or unable to process information or not finding their way around a new school. It must be a service that can adapt and change to those emerging disabilities. To revert to the education piece, that person also could provide information at a more general level, as well as supporting individual schools and children with plans. I would envisage that as a key area of development and I thank Deputy Kelleher for raising it.

As for other issues raised, Deputy Ó Caoláin asked about numbers. Another issue is that we actually have no figures in Ireland with for the incidence of acquired brain injury or head injury. No data are being collected and, at present, we rely on figures from the United Kingdom or the United States. Approximately 4,000 to 5,000 children present in hospitals in Ireland with a head injury. That could include children who do not have acquired brain injury. Of those children, using British figures, approximately 400 to 500 will have a brain injury of a moderate to severe nature. Again, however, the language there is confusing because mild traumatic brain injuries were mentioned and these are concussive injuries or ones in which the child may actually be fit to go home on the same day. In this context, "mild" does not mean mild outcome and those children also need following and services. I suppose that in the region of 400 to 500 children are in need of services with a brain injury every year.