PROJECT EVIDENCE for Prevention of Mental Disorders. The project coordinator is Dr Allan Mawdsley. The version can be amended by consent. If you wish to contribute to the project, please email admin@mhyfvic.org
[3] Indicated Programs are those for young people who will inevitably develop mental disorders unless there is preventive intervention.
[3 a ] Biological factors
i Brain injury
ii Chronic illnesses
iii Substance abuse
iv Psychosexual and gender dysphoria
[3 a i ] Brain injury
Brain injury, whether developmentally acquired such as Foetal Alcohol Syndrome, or subsequently acquired such as post-traumatic chronic brain syndrome, renders the person less capable than unimpaired agemates for coping with functional challenges and thereby warrants special assistance.
Foetal Alcohol Spectrum Disorder.
FASD is a complex neurodevelopmental disorder caused by prenatal alcohol exposure, resulting in lifelong learning and attentional difficulties. Because diagnostic criteria have only recently been agreed, there is no general population data available, but impressions are that it is more widespread than previously recognized.
Professor Elizabeth Elliott gave the Howard Williams Oration at the recent Royal Australasian College of Physicians congress and reported on a survey she had undertaken in the aboriginal population of the Fitzroy River district in far north-western Australia.
45% of the women did not drink during pregnancy, but many of the 55% who did drink, drank at high risk levels. One in five of the children had FASD. The survey led to investigations of the psychosocial reasons for high alcohol use, as well as public health interventions for prevention and for special programs for affected children.
This example is that it highlights how research can lead to effective public health initiatives, once a problem has been identified and measured. Professor Elliott set up the Australian Paediatric Surveillance Unit (APSU) in 1993. It facilitates active surveillance of rare childhood diseases, complications of common diseases or adverse effects of treatment. It is through scientific study like this that preventive measures can be found.
Children and adolescents with acquired brain injury
Brain injury is a common cause of childhood disability. Research has reported cognitive difficulties following such injuries, in particular for those with more severe injury, with attention and memory often affected.
In the attentional area, sustained attention (maintaining attention over time), selective attention (selecting relevant stimuli and ignoring irrelevant stimuli), shifting attention (changing attentional focus when required) and divided attention (dividing attention across two stimuli) may be compromised. Similarly, researchers have reported deficits in various memory components including immediate, short-term and long-term memory, multi-trial learning and manipulating information held in memory.
Research at Murdoch Children’s Research Institute has found difficulties in these areas both acutely and up to ten years post-injury, suggesting that these difficulties persist over time and may not improve without intervention.
This is problematic as attention and memory skills underpin a person’s ability to interact and function in everyday life – socially, educationally, and vocationally- and therefore are a key area to target in order to improve these skills and reduce their impact on everyday functioning.
Despite this, there are limited intervention programs to assist children and adolescents post-brain injury with attention and memory difficulties. intervention research in this area is still emerging. Several programs targeting executive functioning, memory and attention, and social-cognition difficulties are currently being adapted and trialled at the Royal Children’s Hospital, but more research is needed.
References
Taylor, K., Catroppa, C., Godfrey, C., McKinlay, A., Matthews, J., & Anderson, V. (2017) Managing challenging behaviour in preschool children post-Traumatic Brain Injury with online clinician support: Protocol for a pilot study. BMC Pilot and Feasibility Studies
Ryan, N.P, Mihaljevic, K., Beauchamp, M.H., Catroppa, C., Crossley, L., Hearps, S., Silk, T., Godfrey, C., Yeates, K.O. Anderson, V. (2017) Examining the prospective relationship between family affective responsiveness and theory of mind in chronic paediatric traumatic brain injury Brain Impairment, 18 (1), 88-101
Ryan, N.P., Catroppa, C., Godfrey, C., Noble-Haeusslein, LJ, Shultz, S., O’Brien, T., Anderson, V.A., Semple, B. (2016). Social dysfunction after pediatric traumatic brain injury: a translational perspective. Neuroscience and Biobehavioral Reviews. doi: 10.1016/j.neubiorev.2016.02.020.
Robinson, K. E., Kaizar, E., Catroppa, C., Godfrey, C., & Yeates, K. O. (2014). A systematic review and meta-analysis of cognitive interventions for children with central nervous system disorders and neurodevelopmental disorders. Journal of Pediatric Psychology 39 (8),846-865
Di Battista, A., Soo, C., Godfrey, C., Catroppa, C., & Anderson, V. (2014) “In my before life”: Relationships, Coping and Post-Traumatic Growth in Adolescent Survivors of a Traumatic Brain Injury. Journal of Rehabilitation Medicine 46 (10), 975-983
Woods, D., Catroppa, C., Godfrey, C., Giallo, R., Matthews, J., & Anderson, V. (2014). Challenging behaviours following paediatric acquired brain injury: the clinical utility for a manualised behavioural intervention programme. Social Care and Neurodisability, 5 (3). 145-159.
Cooper, J.M., Catroppa, C., Beauchamp, M.H., Eren, S., Godfrey, C., Ditchfield, M. & Anderson, V.A., (2014) Attentional control ten years post-childhood traumatic brain injury: The impact of lesion presence, location, and severity in adolescence and early adulthood. Journal Of Neurotrauma, 31 (8), 713-21.
Last updated 24 March 2019
POLICIES for Prevention of Mental Disorders
[3] Indicated Programs
a) Biological factors
i Brain injury
ii Chronic illness
iii Drug and alcohol abuse
iv Psychosexual and gender dysphoria
b) Psychological factors
c) Social factors
[3 a i ] Biological factors: Brain injury
Foetal Alcohol Spectrum Disorder
MHYFVic advocates strong support for initiatives to prevent FASD, heightening public awareness and providing ready access to diagnostic and treatment services.
Acquired Brain Injury
MHYFVic advocates strong support for initiatives to prevent ABI, heightening public awareness and providing ready access to diagnostic and treatment services, including specific nursing home support for young persons who require it, separate from aged care nursing homes.
Last updated 24 March 2019
BEST PRACTICE MODELS for Prevention of Mental Disorders
[3] Indicated Programs
a) Biological factors
i Brain injury
ii Chronic illness
iii Drug and alcohol abuse
iv Psychosexual and gender dysphoria
b) Psychological factors
c) Social factors
[3 a i ] Biological factors: Brain injury
Foetal Alcohol Spectrum Disorder
The Australian Guide to the diagnosis of FASD is available from the Australian Government-funded website www.fasdhub.org.au
Persons seeking referral information for diagnostic and support services can free-call 1800 860 613 or explore the NOFASD website www.nofasd.org.au
Acquired Brain Injury
The Fact Sheet by Royal Children’s Hospital on Acquired Brain Injury notes that it takes a long time to ascertain the long-term effects of ABI and that treatment needs to be by a multidisciplinary rehabilitation team. More information is available from the Brain Injury website www.braininjuryaustralia.org.au
Last updated 24 March 2019
We welcome discussion about any of the topics in our Roadmap epecially any wish to develop the information or policies.
Please send your comments by email to admin@mhyfvic.org
Speak about issues that concern you such as gaps in services, things that shouldn’t have happened, or things that ought to happen but haven’t; to make a better quality of service…….
Help achieve better access to services & better co-ordination between services together we can…….
Mental Health for the Young & their Families in Victoria is a collaborative partnership between mental health & other health professionals, service users & the general public.
MHYFVic
PO Box 206,
Parkville, Vic 3052
