Established in 2009, the Cambridge Centre for Paediatric Neuropsychological Rehabilitation (CCPNR) is the first NHS community-based service in the UK. The team are both clinicians and researchers, having contributed to several chapters on paediatric neuropsychological rehabilitation and a significant body of research on developing understanding of paediatric acquired brain injury processes, service development, and interventions.
Here you can read about research from our Speech and Language Therapist, Gill Shravat, presented as part of her CLAHRC fellowship at the International Paediatric Brain Injury Conference at the Vatican University in Rome.
The CCPNR won the 'Research Innovation Award' in Cambridgeshire and Peterborough NHS Foundation Trust Staff Awards in 2017.
The work that we do at the CCPNR includes running group interventions such as 'Lego group', which aims to improve social communication and 'Kung Fu group', which aims to improve executive functions and self-control in children with acquired brain injury.
Kung Fu Group
A group intervention run by the CCPNR is the 'Kung Fu group', which uses the martial art and mindfulness training to support executive functions (higher level thinking skills), promote self-awareness and self-regulation in children with a brain injury. At the same time whilst the children are doing Kung Fu, parents attend a group aimed at supporting carers with their well-being and adjustment.
Background to Kung Fu and mindfulness family-based intervention
The CCPNR wanted to develop an innovative, cost-effective intervention to address the cognitive (thinking skills) and secondary emotional consequences of an acquired brain injury whilst delivering the intervention in a manner that is sensitive to the context of a child's everyday life, by involving the parents.
The intervention of Kung Fu builds on work by Lakes and Hoyt (2004) with aims to promote self-regulation in typically developing children using martial arts training. This innovative study led to gains in cognitive-affective self-regulation and working memory. Similarly, Chan et al. (2012) used Chinese Chan mind-body exercise with a progressive muscle relaxation technique for enhancing the self-control of children with autistic spectrum disorder.
This group was funded for 2018 by Head to Toe Charity and below is a short interview discussing the group with two of our team members.
A group intervention previously run by the CCPNR was the Brick Club, which used LEGO® as a therapeutic tool to aid social communication in children with an acquired brain injury, as this is something that is often affected following the injury.
Background to LEGO®-based therapy
LEGO®-based therapy is a collaborative play therapy in which children work together to build LEGO® models. The aim of the group is to help children to develop social interaction skills in a friendly, fun setting.
The approach was developed by Dr Dan LeGoff, a Clinical Neuropsychologist from Philadelphia, USA. Instead of building LEGO® sets by themselves, children work in pairs or teams of three.
The task of building is divided into different roles, so that social interaction is necessary to participate. By doing this, children practice key skills of collaboration, joint attention, sharing, turn taking, eye contact, communication, social problem-solving and compromise.
Research and Publications
Developing the CCPNR with applied research fellowships
The team has been supported by the NIHR CLAHRC East of England with Fellowship projects over successive years to build the service and design care pathways.
Play the film below to hear from previous Fellows who developed their research skills and clinical practice.
A selection of the CCPNR team's research and publications
- The team has been supported by the NIHR CLAHRC East of England with Fellowship projects over successive years, to build the service and design care pathways. Play the film below to hear from previous Fellows who developed their research skills and clinical practice.
- Brindley, R., Bateman, A., & Gracey, F. (2011). Exploration of use of SenseCam to support autobiographical memory retrieval within a cognitive-behavioural therapeutic intervention following acquired brain injury. Memory (Hove, England), 19(7), 745–757. https://doi.org/10.1080/09658211.2010.493893
- Cuberos-Urbano, G., Caracuel, A., Valls-Serrano, C., Garcia-Mochon, L., Gracey, F., & Verdejo-Garcia, A. (2016). A pilot investigation of the potential for incorporating lifelog technology into executive function rehabilitation for enhanced transfer of self-regulation skills to everyday life. Neuropsychological Rehabilitation, 1–13. https://doi.org/10.1080/09602011.2016.1187630
- Dawkins, N., Cloherty, M. E., Gracey, F., & Evans, J. J. (2006). The factor structure of the Hospital Anxiety and Depression Scale in acquired brain injury. Brain Injury, 20(12), 1235–1239. https://doi.org/10.1080/02699050601076414
- De Menezes, L., Mendiro, C., Tonks, J., Watson, S. (2018) Performance analysis in children with Down Syndrome through a maze game on a mobile phone, Journal of Intellectual Disability Research, in press
- De Paula, J., Monteiro, C., Da Silva, T., Capelini, C., de Menezes, L., Massetti, T., Tonks, J., Watson, S., Hervaldo Nicolai Ré, A. (2017) Motor performance of individuals with cerebral palsy in a virtual game using a mobile phone. Disability and Rehabilitation: Assistive Technology, 12, 1-5 https://doi.org/10.1080/17483107.2017.1392620
- De Silva, T., Mendiro,C., Tonks, J., Watson, S. (2017) Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne Muscular Dystrophy, Neuropsychiatric Disease and Treatment, in press
- Dewar, B.-K., & Gracey, F. (2007). “Am not was”: cognitive-behavioural therapy for adjustment and identity change following herpes simplex encephalitis. Neuropsychological Rehabilitation, 17(4–5), 602–620. https://doi.org/10.1080/09602010601051610
- Ellis-Hill, C., Gracey, F., Thomas, S., Lamont-Robinson, C., Thomas, P. W., Marques, E. M. R., … Jenkinson, D. F. (2015). “HeART of Stroke (HoS)”, a community-based Arts for Health group intervention to support self-confidence and psychological well-being following a stroke: protocol for a randomised controlled feasibility study. BMJ Open, 5(8), e008888. https://doi.org/10.1136/bmjopen-2015-008888
- Ford, C. E. L., Malley, D., Bateman, A., Clare, I. C. H., Wagner, A. P., & Gracey, F. (2016). Selection and visualisation of outcome measures for complex post-acute acquired brain injury rehabilitation interventions. NeuroRehabilitation, 39(1), 65–79. https://doi.org/10.3233/NRE-161339
- Gracey, F., Watson, S., McHugh, M., Swan, A., Humphrey, A., Adlam,A. (2014) Age of injury, emotional problems and executive functioning in understanding disrupted social relationships following childhood ABI. Journal of Social Care and Neurodisability, 5 (3), 160-170. https://doi.org/10.1108/SCN-08-2013-0030
- Gracey, F., Palmer, S., Rous, B., Psaila, K., Shaw, K., O’Dell, J., … Mohamed, S. (2008). “Feeling part of things”: personal construction of self after brain injury. Neuropsychological Rehabilitation, 18(5–6), 627–650. https://doi.org/10.1080/09602010802041238
- Gracey, F., & Ownsworth, T. (2008). Editorial. Neuropsychological Rehabilitation. England. https://doi.org/10.1080/09602010802141509
- Gracey, F., Olsen, G., Austin, L., Watson, S., Malley, D. (2015) Integrating psychological therapy into interdisciplinary neuropsychological rehabilitation of the brain injured child. In Reed, J., Byard, K., and Fine, H. (eds) Neuropsychological Rehabilitation of Childhood Brain Injury: A Practical Guide. Palgrave Macmillan, London, pp 197-215. https://link.springer.com/chapter/10.1057/9781137388
- Gracey, F., Oldham, P., & Kritzinger, R. (2007). Finding out if “The ‘me’ will shut down”: successful cognitive-behavioural therapy of seizure-related panic symptoms following subarachnoid haemorrhage: a single case report. Neuropsychological Rehabilitation, 17(1), 106–119. https://doi.org/10.1080/09602010500505260
- Gracey, F., Fish, J. E., Greenfield, E., Bateman, A., Malley, D., Hardy, G., … Manly, T. (2017). A Randomized Controlled Trial of Assisted Intention Monitoring for the Rehabilitation of Executive Impairments Following Acquired Brain Injury. Neurorehabilitation and Neural Repair, 31(4), 323–333. https://doi.org/10.1177/1545968316680484
- Gracey, F., Evans, J. J., & Malley, D. (2009). Capturing process and outcome in complex rehabilitation interventions: A “Y-shaped” model. Neuropsychological Rehabilitation, 19(6), 867–890. https://doi.org/10.1080/09602010903027763
- Hunt, S., Wight, I (2003) The Virtual Children’s Hospital. Institute of Child Health. Research Review, 2003.
- Kapur, N., Cole, J., Manly, T., Viskontas, I., Ninteman, A., Hasher, L., & Pascual-Leone, A. (2013). Positive clinical neuroscience: explorations in positive neurology. The Neuroscientist : A Review Journal Bringing Neurobiology, Neurology and Psychiatry, 19(4), 354–369. https://doi.org/10.1177/1073858412470976
- Longworth, C., Deakins, J., Rose, D., & Gracey, F. (2016). The nature of self-esteem and its relationship to anxiety and depression in adult acquired brain injury. Neuropsychological Rehabilitation, 1–17. https://doi.org/10.1080/09602011.2016.1226185
- Morgan, C. J., Duffin, S., Hunt, S., Monaghan, L., Mason, O., Curran, H. V. (2012). Neurocognitive Function and Schizophrenia-Proneness in Individuals Dependent on Ketamine, on High Potency Cannabis ('Skunk') or on Cocaine. Pharmacopsychiatry. https://doi.org/10.1055/s-0032-1306310
- Morris, E., Le Huray, C., Skagerberg, E., Gomes, R., & Ninteman, A. (2014). Families changing families: the protective function of multi-family therapy for children in education. Clinical Child Psychology and Psychiatry, 19(4), 617–632. https://doi.org/10.1177/1359104513493429
- Pooni, J., Ninteman, A., Bryant-Waugh, R., Nicholls, D., & Mandy, W. (2012). Investigating autism spectrum disorder and autistic traits in early onset eating disorder. The International Journal of Eating Disorders, 45(4), 583–591. https://doi.org/10.1002/eat.20980
- Simblett, S. K., Gracey, F., Ring, H., & Bateman, A. (2015). Measuring coping style following acquired brain injury: a modification of the Coping Inventory for Stressful Situations Using Rasch analysis. The British Journal of Clinical Psychology, 54(3), 249–265. https://doi.org/10.1111/bjc.12070
- Simblett, S. K., Yates, M., Wagner, A. P., Watson, P., Gracey, F., Ring, H., & Bateman, A. (2017). Computerized Cognitive Behavioral Therapy to Treat Emotional Distress After Stroke: A Feasibility Randomized Controlled Trial. JMIR Mental Health, 4(2), e16. https://doi.org/10.2196/mental.6022
- Watson, S. & Gracey, F. (2018) Assessment of children with acquired brain injury. In Helps S., Jim, J., and Cohen (eds) Interventions for children with acquired brain injury. Karnac. London. In press
- Watson, S., Reed, J., and Byard, K. (2015) Helping children with brain injury and behavioural problems: the importance of antecedent regulation. In Reed, J., Byard, K., and Fine, H. (eds) Neuropsychological Rehabilitation of Childhood Brain Injury: A Practical Guide. Palgrave Macmillan, London, pp 106-131. https://link.springer.com/chapter/10.1057/9781137388223_6
- Watson, S. (2016) "What do children with brain injuries want? An analysis of children’s goals according to the ICF." International Paediatric Brain Injury Symposium.
- Wilson, B. A., Berry, E., Gracey, F., Harrison, C., Stow, I., Macniven, J., … Young, A. W. (2005). Egocentric disorientation following bilateral parietal lobe damage. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, 41(4), 547–554.
- Yeates, G. N., Gracey, F., & McGrath, J. C. (2008). A biopsychosocial deconstruction of “personality change” following acquired brain injury. Neuropsychological Rehabilitation, 18(5–6), 566–589. https://doi.org/10.1080/09602010802151532
- Yeates, G., Henwood, K., Gracey, F., & Evans, J. (2007). Awareness of disability after acquired brain injury and the family context. Neuropsychological Rehabilitation, 17(2), 151–173. https://doi.org/10.1080/09602010600696423
The CCPNR works closely with other local services including acute services, the Child Brain Injury Trust (CBIT), social, educational and community services, as well as other voluntary and private organisations.
The Child Brain Injury Trust (CBIT) has created a Brain Injury Information Card, suitable for young people aged 11-18. The idea behind the card is that young people can carry the card as they go about daily life, and present it in situations where they need a little help and understanding, which you can find here.
See 'Further information' at the bottom of the page for a 'resource list' of relevant organisations.
Disclaimer: Please note this document is not updated regularly and so you may find some of the websites or contact details are no longer in use. We apologise for any inconvenience this may cause.
December 2018 - Dr Suzanna Watson presents findings from her 2018 CLAHRC Fellowship project
Children with acquired brain injury (ABI) can have complex needs that require specialist intervention but the delivery of support in their own community is essential. In order to best meet the needs of children with brain injury, this project sought to scope the local service provision in the different East of England CCGs. We hope that this will enable the service to develop better pathways for children with ABI and think with commissioners about how we best meet these children’s needs.
November 2018 - Elizabeth's Story
Read about one of our young service users Elizabeth who was featured in the Brentwood Gazette (below) and The Sun newspapers on 28th November 2018 after winning the national Life After Stroke Adult Courage Award from The Stroke Association. You can also watch a moving video of Elizabeth's incredible story with Elizabeth and her mum Danielle on the Stroke Association website here.
July 2018 - NHS70: Celebrating 70 years of the NHS
Some of the CCPNR team members taking part in celebrating our fantastic NHS!
April 2018 - Jordan's Story
Read about one of our young service users Jordan in Issue 5 of B21 Magazine Coping with Brain and Spinal Injury in the 21st Century, below or download it from the 'further information' section at the bottom of the page.