https://www.densocialevirksomhed.dk/bcfr/Sider/default.aspxChildren Youth Center for Rehabilitation offers specialized and focused rehabilitation to children and adolescents with acquired brain injury.

https://www.densocialevirksomhed.dk/bcfr/Familien/Sider/default.aspx

To the family

The family is a central part of the child’s and the adolescent’s rehabilitation after an acquired brain injury.Children Youth Center for Rehabilitation emphasize that the family is actively involved during rehabilitation and continuously help to determine focus areas and goals for the child.

Her you can read more about offers to the family, gain insight in the daily life in the Child-adolescent center and get advice, guidance and new knowledge

https://www.densocialevirksomhed.dk/bcfr/Familien/tilbud/Sider/default.aspxOffers to the family

The Children Youth Center for Rehabilitation emphasizes on offering various forms of support and offers to the family. The family is involved in close cooperation, when defining focus areas and goals for the child.

Parents, siblings, relatives and friends can find emotional support, practical advice on how to follow-up on the rehabilitation at home, obtain more knowledge about acquired brain injury and much more through Advisory conversations, parent groups, relative evenings, education, etc.

The whole family’s daily life is affected, when a child or adolescent gets a brain injury.When children or adolescents get a brain injury either after an accident or illness, it is never only the child or the young person who is affected. The whole family is affected, and the family situation will be changed for a long time – and often for the rest of your life.

Parents, siblings and relatives become deeply involved emotionally and practically and the Child-adolescent center emphasize offering several types of support and offers. The starting point is that the closer they cooperate with the family and the better they are supported, there will be better effect for the rehabilitation. The goal is a life – for the whole family – as close to the norm as possible. Children and adolescents are going back to the day-care, school, education and friends, while the parents are going back to everyday life’s tasks, and everyone are going back to a life with content and quality of life.

Below you can see an overview over the Children-adolescent center offer for the family. You can also read more about, how you get an offer from the Children-adolescent center.

https://www.densocialevirksomhed.dk/bcfr/Familien/tilbud/Foraeldresamtaler/Sider/default.aspxParental AdvisoryParents are offered conversations of supporting and counselling characteristic with a psychologist and/other relevant professional. The purpose with the conversations is to give you insight in acceptance and knowledge on how you can support your child’s rehabilitation and development.

The parents are the most important people in the child’s life

No matter the degree of the injury, or the situation as a whole, the Child-adolescent Center consider the parents as the most important people in the child or the adolescent’s life and therefore attaches great importance on involving the parents in the effort being made.

Mum and dad often react differently

Rehabilitation is a process, where you as parents get through several phases, and where mum and dad often react differently. There can be need for support to focus on the child of the adolescent and possibly siblings, and get understanding of loss, the difficulties and the changes. The purpose with the conversations is to give insight, acceptance and knowledge about how you can support your child’s rehabilitation and developmental.

Supporting and advisory conversations

The Children Adolescent Center offer parent conversations with psychologist or other relevant professionals. The conversations are both of supporting and advisory characteristic.

The conversations can have starting point in those changes you experience, after your child has acquired a brain injury and sequelae hereof.

At the psychologist conversations you get opportunity for:

Get emotional support Discuss worries and considerations Obtain information about required brain damage and consequences hereof Discuss changes in the family members relation and way to be together after the injury

From other professionals specialized knowledge and counselling is also offered for example how the daily life with the child is best organized pedagogically and practically.

Counselling and support is based on a basic neuro-psychological understanding.

The conversations can be held individually or as a course and can be given to one or both parents. There can also be held conversations with participation from parents and child or adolescent and possibly siblings.

Editor Bodil Estmann Mølgaard

https://www.densocialevirksomhed.dk/bcfr/Familien/tilbud/foraeldreundervisning/Sider/default.aspxParent education

When your child has serious motor and cognitive difficulties, you are offered parent education often in groups with several parents. The purpose is that everyone around the child has a uniform approach to training, and that the child ultimately can become as self-reliant as possible.

When your child has serious motor and cognitive difficulties, you are offered parent education often in groups with several parents.

Focus areas can be:

Relocations Walk Eating Dress etc.

The classes typically happen on a weeknight with a duration of approx. 3 hours. The form is a mixture of theory and practical examination with basis in the parent’s wishes. Hereafter there is follow-up at home in form of guidance and support.

Teaching is carried out by ergo- and physio-therapists who are specialized in neuro-rehabilitation to children and adolescents with acquired brain injury.

Editor Bodil Estmann Mølgaard

https://www.densocialevirksomhed.dk/bcfr/Familien/tilbud/soskende/Sider/default.aspx

Offers to siblings, friends and classmates

Siblings, friends and classmates can have need for knowledge and support to understand and accept those changes, which has happened. The Children-Adolescent Center offer several offers, which can help create larger understanding and better well-being

To siblings, friends and classmates there can be offered:

Information about the acquired brain injury and the consequences hereof Emotional support Discussion about worries and considerations Discuss changes in the relation with brain injury affected brother or sister and the way to

be together after the injury Day visit on the Child-adolescent Center, if there is an intensive rehabilitation course “Brain hour” in the class or a group, where information about the injury and its

consequences is given, also questions get answered.

Siblings need knowledge and support

Especially, siblings have a need for receiving knowledge and support to understand and accept those changes that happen, when your sibling got an acquired brain injury. Often the parents have been compelled to take care of the affected in a period and the resources for the other siblings can be scarce.

For siblings the experience shows that just a few conversations with the psychologist can contribute to creating better well-being and understanding, especially if the parents also receive support and counselling.

The relation to friends is important to maintain

For the Child-adolescent Center an important part of the rehabilitation to try to keep contact to the brain injury affected friends in the local community.

Editor Bodil Estmann Mølgaard

https://www.densocialevirksomhed.dk/bcfr/Familien/tilbud/paaroerendearrangementer/Sider/default.aspx Relatives events

An acquired brain injury in a child or adolescent also hits the closest relatives and close friends, who can be affected and have many questions and worries. In a relative event the relatives can among other things receive help to, how they best can support and help the family.

The closest relatives can have many questions and worries

An acquired brain injury in a child or adolescent also hits the closest relatives and close friends, who can be affected and have many questions and worries. In a relative event the relatives can among other things receive help to, how they best can support and help the family.

It can be stressful for parents to inform relatives and near friends about the child’s or the adolescent’s condition and answer on tough questions.

Relative events with a duration of two to four hours

There can therefore be offered one to several relative events with a duration of two to four hours. As a basis the event take place at the Children-adolescent center and the parents do not attend, but select the relatives and close friends, who should be invited.

At a relative event there is opportunity for:

Receive common information about acquired brain injury and consequences hereof. Discuss how you can support and help the family and enter agreements accordingly Get answers on question that can be difficult to ask the parents.

The relative arrangements take place during the period from approx. 04:30pm – 08:30pm, and there is served tea and coffee and a light meal.

Editor Bodil Estmann Mølgaard

https://www.densocialevirksomhed.dk/bcfr/Familien/tilbud/s%C3%A5dan_f%C3%A5r_du_tilbud_fra_Boerneungecentret/Sider/default.aspxHow to get an offer from the Children Adolescent Center

Here you can read about, how you can get an offer from Child Adolescent Center for Rehabilitation

All offer from Children Adolescent Center for Rehabilitation require a municipal authorization

As a starting point you should contact your case worker or PPR psychologist in the municipality, who thereafter will contact the Children Adolescent Center for Rehabilitation. The Visitation process is free for the municipality.

Remember Rehabilitation plan

If your child is discharged from a hospital, you can ask for a copy of the rehabilitation plan from the hospital. From January the first 2015 children and adolescents with acquired brain injury should be offered a rehabilitation plan, if they have a need for rehabilitation based on medical ground, after they were discharged from the hospital.

Get help through VISO

Parents can contact VISO, which can also give advice on how to get help

Contact us for more information

Contact us, if you are in doubt about what you should do or wish more information about Children Adolescent Center for Rehabilitation and the services we offer

https://www.densocialevirksomhed.dk/bcfr/omos/tvaerfagligrehabilitering/Sider/default.aspxMultidisciplinary specialized rehabilitation

The child or the adolescent gets a multidisciplinary team assigned to them at the beginning of the rehabilitation course, who with the family establish focus areas and goals for the child and together secure the best result of the course

https://www.densocialevirksomhed.dk/bcfr/omos/tvaerfagligrehabilitering/Sider/Neuropsykolog.aspx The psychologists

The psychologist tests and observes the child’s functionality, is responsible for the child’s rehabilitation course and offers supporting and consulting conversation courses to the child, parents and other family and network

Test and observation is the basis for the further rehabilitation

The psychologist tests and observes the child’s functionality to assess cognitive resources and difficulties as well as the child’s emotional condition and social cognitive functionality level.

Based on test and observation the child psychologist formulates recommendations to supporting/compensating strategies, which can help the child to function better.

These recommendations were also used, when the child’s further rehabilitation should be planned. It is the child neuro-psychologist, which has responsibility to have an overview over the individual rehabilitation in a multidisciplinary cooperation.

The child and the family can get help to accept and handle the new situation

The psychologist assesses the child’s and family’s psychological treatment need and offer consulting conversations after need, which can help the family with understanding and accept the new situation. The consulting conversations is an offer to both the child or the adolescent, parents, siblings and other family and network.

The consulting conversations can be in the form of:

Psychoeducation Brain hours Relative evenings Conversations/ counselling Parent or sibling groups

The psychologist’s other work assignments

Child neuro-psychological teaching assignments Supervision/counselling to the cooperation partners

Editor Bodil Estmann Mølgaard

https://www.densocialevirksomhed.dk/bcfr/omos/tvaerfagligrehabilitering/Sider/Fysioterapeut.aspxPhysio-therapists

Physio-therapists’ objective is to make the child and the adolescent as self-reliant as possible. Through an intensive and individual organized training achieves the greatest possible independence in the daily life of the child and young person. The physio-therapists have focus on that the skills can be used in the child’s and the adolescent’s daily life and close cooperation with parents as well as other specialists in the child’s local community is heavily emphasized.

Training course, which is individually adjusted

The physio-therapists organize and implement a highly intensive training and treatment, which is individually adjusted to the individual child. The training is continuously adjusted according to the child’s needs, and is rehabilitated specifically and functionally, so the skills are transferred as much as possible to daily life and other life.

Before the first training session is completed, the physio-therapists reveal the child’s earlier functionality level, the current physical resources, and what motivates the child in the motor training.

The child and the adolescent are tested for difficulties in relation to:

Walk/stand/run function Relocation

Balance Pains Tonus changes Joint-condition Strength Sensibility Condition Constraints (muscular, neurogenic, contractures).

The training is organized according to the child’s age, needs and motivation, and can happen on local playgrounds, in the forest, in gym hall, pool, on running track and in motor room, where we among other things train with litegait.

Parents and other specialists are involved in the child’s training

The physio-therapists cooperate with parents and other relevant specialists in the child’s local community. There is held parent lessons, where the parents receive counselling and guidance on how they stimulate the child’s motor development in the daily life. If it is considered relevant, the physio-therapists can also go on home visits.

The family can get help by the physio-therapists to adjust, test and apply for help supplies such as for example chair, stand rack, walking gear and bicycle.

Neuro-professional expertise and experience

The physio-therapists and Children Adolescent Center for rehabilitation have a huge neuro-professional knowledge about children and adolescents with acquired brain injury. Many years of practical experience coupled with continuous qualification on courses, network meetings and through the newest research, which gives a solid basis to organize and complete intensive training courses.

Editor Bodil Estmann Mølgaard

https://www.densocialevirksomhed.dk/bcfr/omos/tvaerfagligrehabilitering/Sider/Ergoterapeut.aspxOccupational therapists

The occupational therapists support the child and the adolescent to be able to master everyday activities and achieve the greatest possible independence in daily

life. The training focuses partly on the motor difficulties and partly on the child’s and adolescent’s difficulties in getting overview, planning and problem solving.

Focus on daily activities, which are important for the child and the family

The occupational therapist organizes the effort with basis in the children and the adolescents’ individual needs to be able to perform daily activities such as for example eating, undressing and dressing, movement and shopping. Activities which are important for the child, the adolescent and their families.

The goal is to achieve biggest possible independence in the everyday life,

The training focuses partly on the motor difficulties and partly on the child’s and adolescent’s difficulties in getting overview, planning and problem solving. The occupational therapeutic training happens primarily through practical activities such as cooking, workshop activities, small task in the garden, shopping, trips and similar.

The child’s need for help supplies is assessed

The occupational therapist assesses the child and the adolescent’s need for help supplies. She also examines if the equipment the child or the adolescent already has should be adjusted. It can be aids to eating, writing tools and/or hand rails. When assessing aids for children or young people there is emphasis on the child or the adolescent as far as possible can gain independence in the daily life.

Fine motor in praxis

By hand motor and eye-hand coordination training the occupational therapist focuses on precision, coordination and the strength in the grab, which can be used at e.g. eating, undressing and dressing and use of keyboard.

Challenges with sight or visual perception

For the child or the adolescent, who has challenges with sight or visual perception (to recognize and interpret visual impressions and to integrate these impressions with motor movements, as for example to put puzzles or us PC), the occupational therapist finds compensating tools or strategies e.g. correct lighting, appropriate working position and correct PC setting.

Mouth and face

The occupational therapist treats children and adolescents who have difficulties with chew function and sinking function, as well as mimic. Mouth stimulation, mimic practices, tongue motor and similar.

Sensory processing

The occupational therapist create structure and organizing the frameworks, so the child or the adolescent is secured the right amount of sensory impressions, to function in everyday life. Some children need to be screened, while others have need for increased stimulation.

https://www.densocialevirksomhed.dk/bcfr/omos/tvaerfagligrehabilitering/Sider/Neurop%C3%A6dagog.aspxNeuro-educators

Neuro-educators create structure in the child’s rehabilitation and work with developing the child’s social competences. Well-being, communication, communication, social interaction and play and imagination are key words in the educators’ work, and the child is supported in taking initiatives and participate in the community. The child can meet the neuro-educators one on one and in groups of children and adolescents, in both planned structured activities and in breaks.

Structure creates the right frames for the child to learn and rehabilitate

The neuro-educators work with securing a structure in the day-care, which is recognizable and predictable for the child. It is important that the child experience that what happens makes sense, and that it has a feeling of being able to participate and to master the challenges. On a well-organized day, the child gets the most energy to learn and train as well as avoid being overstimulated or worn out.

Accept of own resources and limitations as well as the biggest possible independence

The neuro-educators train the child in daily activities both individually and in groups in order that the child is so self-sufficient and independent as possible. Work is being done to clarify the child’s resources and limitations, personally, socially and academic as well as future support need.

The child is supported in achieving insight into and accept of own resources and limitations as well as new living conditions.

In breaks and in group context the educators act like good role-models. The child gains support to communicate and actively participate in the community and get insight in general norms for meeting and dining.

Advice and guidance for parents and professionals

The neuro-educator describes the child’s competences socially and communicative based on observations in the everyday life. Meanwhile those strategies are described that the child themselves use to compensate for own difficulties. The measures, which are necessary to enable the child to participate socially and to utilize their competences as best possibly described, and there is provided advice and guidance is given to parents as well as professionals in the child’s current or future school offerings.

Multidisciplinary cooperation

The neuro-educator works supporting with other professionals, either in a close cooperation or by joining a group, which is trained by another specialist. The Educator works supportive in relation to e.g.:

School abilities Communication Fine- and gross motor abilities Well-being Support to participate in in the social with other children and adolescents.

https://www.densocialevirksomhed.dk/bcfr/omos/tvaerfagligrehabilitering/Sider/l%C3%A6rer.aspxThe Special Educators

The special educator work with the child’s and the adolescent’s academic development. The child works with rehabilitating lost abilities as well as possibly learn new things. The teacher provides advice and guidance for parents and specialists in the child’s local community, and help the child with learning strategies and methods, which can be an aid in the daily school work.

In school in an intensive rehabilitation course

When the child and the adolescent have school modules in an intensive rehabilitation course, it is taught by a teacher in Danish and Math and sometimes also in English.

The teacher begins with making a thorough examination of the child’s or the adolescent’s academic abilities in Danish (reading) and Math. The examination shows, what level the child is on academically in Danish and Math.

Based on the examination, a plan for the child’s academic rehabilitation is being prepared, and concrete goals are set.

The child and the adolescent will work to relearn lost skills and possibly learn new things.

The education starts where the child is academically right now, and the child gets the opportunity to work with what motivates them (E.g. the child can read about horses or about American football, if that is what is the child’s largest interest).

If the child or the adolescent due to the injury has difficulties remembering or difficulties getting began on an assignment, we can help the child with learning strategies and methods, which can support the child, when it does school work.

Well on the way back to a future school or educational offer

When the child or the adolescent ends their rehabilitation course, they should either go back to their old school or to a new school or education offer. If the child should return to their old school, there will through the whole rehabilitation course be close cooperation with the school.

In the rehabilitation course there will be focus on, how the (re)learned can be transferred to the child’s future school offer. When the child stops in the Children Adolescent Center, the course is ended with a professional handover to the new school offer. Children Adolescent Center’s educators have a close cooperation with the child’s and the adolescent’s UU-guidance counsellor and advisor and supervisor in relation to school and education choice. All to ensure the good transition to the new place.

In some cases, the child/the adolescent needs a smooth transition to a new school offer, where the child continues to be in the Children Adolescent Center and at the same time starts up quietly and carefully in the new offer.

The educator’s other tasks:

The educator advises and assists parents and other relevant specialists of children and adolescents, who are rehabilitated locally in the child’s local environment.

The educator makes the tests… and subsequently writes a report in local-based cases and VISO-cases.

The educator makes re-evaluations of previous children/adolescents and subsequently write a report with scholarly recommendations

https://www.densocialevirksomhed.dk/bcfr/Familien/hverdagen_paa_BUCR/Sider/default.aspxEveryday life in the Children Adolescent Center

What does a typical schedule look like? What are the meeting times? Do I get food served for lunch and in the breaks? Get answers to these and many other questions and read more about the daily life in the Children Adolescent Center here.

https://www.densocialevirksomhed.dk/bcfr/Familien/hverdagen_paa_BUCR/dagligdagenBUCR/Sider/default.aspxThe daily life in the Children Adolescent Center

When should you meet up in the morning, and what does a schedule for the day look like? Here you can read more about the daily life in Children Adolescent Center.

Meeting hours

You can meet up from 8.15, where the intensive day offer is open. You must be here at the latest 8.30, where the first module begins.

You are free at 14.20 Monday to Thursday and at 12.20 on Fridays.

Arrival and assembly

It’s up to the individual, whether you come by taxi or are transported their parents. You get your own wardrobe closet, where you can hang your jacket, bag and clothes. When you arrive in the morning, you meet-up with the other children and adolescents in the assembly room. Here you get a bit to drink and eat as well as your schedule for the day.

Your own personal schedule

You have your very own individual schedule tailored to your needs and wishes. The schedule is adjusted to ongoing goals and focus areas in your rehabilitation plan. Below you can see, how a schedule for a week is constructed.

O’clock Monday Tuesday Wednesday Thursday Friday8.15 – 8.30 Arrival and

assemblyArrival and assembly

Arrival and assembly

Arrival and assembly

Arrival and assembly

8.30 1. Module 1. Module 1. Module 1. Module 1. Module9.15 2. Module 2. Module 2. Module 2. Module 2. Module

10.00 Break Break Break Break Break10.30 3. Module 3. Module 3. Module 3. Module 3. Module11.15 4. Module 4. Module 4. Module 4. Module 4. Module

12.00 Lunch Lunch Lunch Lunch Lunch11.45 O’clock

12.45 5. Module 5. Module 5. Module 5. Module Home 12.20 O’clock

13.30 6. Module 6. Module 6. Module 6. Module

14.15 - 14.20 Assembly and end for today

Assembly and end for today

Assembly and end for today

Assembly and end for today

In the individual modules you meet the specialists (Physio-therapists, occupational therapists, speech-educators, psychologist, educators and pedagogues), who are responsible for your training during the week and give support to you and your family. You can have modules with training individually and in a group of children and adolescents.

Breaks and lunch

During the day there are breaks, where you can get a bit to eat and drink and having the opportunity to be together with other children and adolescents, who are in a training course at the Children Adolescent Center.

In the before noon break there is offer fresh-baked buns, various cold cuts, fruit, vegetables and water.

In the lunch break all children and adolescents meet in the assembly room and eat lunch. The lunch is made by the Children Adolescent Center’s kitchen assistant.

In the last part of the breaks you could possibly play games, go outsid and get some fresh air or rest.

In school in the intensive day-care

School is an integrated part of a training course at the Children Adolescent Center. You are taught Danish, Math and optionally English. The objective is to relearn lost abilities and possibly train new ones. We start schooling, where you are currently and having the opportunity to work with those subjects, which has your interest.

You meet other children and adolescents

You participate in a group of other children and adolescents, who also are in a training course at the Children Adolescent Center. It provides fertile ground for new friendships and opportunities to be together with other children and adolescents, who have experienced something similar as you.

Closing days 2018

The Children Adolescent Center is closed in fixed periods, where you get the opportunity for a holiday and spend more time together with their family. During longer vacations for example the summer vacation the multidisciplinary team will advice and assist your parents in relation to the important focus areas during the vacation.

Christmas Holiday 23. December 2017 – 1. January 2018Easter Holiday 26. March – 2. AprilGreat Prayer Day 27. AprilChrist’s Ascension 10 – 11. May2nd Day of Pentecost 21. MayDanish Constitution Day 5. JuneSummer Holiday closed 9 – 27. July

(Week 28-29-30)Autumn Holiday 15-19 October

https://www.densocialevirksomhed.dk/bcfr/Familien/hverdagen_paa_BUCR/koekken/Sider/default.aspxFood and meals

The Children Adolescent Center has its own kitchen and has employed a kitchen assistant, who makes healthy and nutritious food to the children and the adolescents every day.

Focus on healthy and varied diet

The Children Adolescent Center has employed a kitchen assistant, who is responsible for food and drinks during the day. In the before noon break there is served buns, various cut outs, fruit, vegetables and water. For lunch there is served a warm dish on four of the week’s days and Rye bread with various cut outs and vegetable on one day per week. Before the child of the adolescent must go home in the afternoon, there is offered crackers, fruit and water.

Good feedstock, primarily ecological (approx. 80%), forms the basis for a healthy, tasty and nutritious diet, which can give the children and the adolescents energy to the daily activities.

Considerations for special wishes, allergies and diets

The kitchen takes special conditions like for example if the child has food allergies, is on a medically prescribed diet or other into consideration.

The kitchen has been awarded an elite-smiley by The Danish Veterinary and Food Administration inspection

As every other kitchen the Children Adolescent Center live up to the food inspection and do internal-inspection of hygiene and quality of food.

The Children Adolescent Center has been awarded an elite-smiley at the latest inspection.

https://www.densocialevirksomhed.dk/bcfr/Familien/hverdagen_paa_BUCR/opstart/Sider/default.aspxStart-up at the Children Adolescent Center

On the first visit you get to know more about the rehabilitation course at the Children Adolescent Center and meet the child’s or the adolescent’s contact person and contact psychologist.

The first visit

Before the child or the adolescent starts at the Children Adolescent Center, parents and child get invited to a first initial visit. Here you will meet the child’s contact person and contact psychologist.

The contact person is the anchor point in relation to the family, and the person you always can get in contact with, if you have things, you wish to discuss.

On the meeting you will get to know more about the rehabilitation course at the Children Adolescent Center and get answers on the questions, you possible may have. After the meeting you get on a little tour at the Children Adolescent Center and you may meet some of the other children and adolescents, who are in rehabilitation course at the Child Adolescent Center.

https://www.densocialevirksomhed.dk/bcfr/Familien/hverdagen_paa_BUCR/praktiske_oplysninger/Sider/default.aspxPractical Information

Here is a variety of practical information, you should be aware of, when your start at the Children Adolescent Center.

Practical information:

School bag: Every day the school bag should contain a pencil case, a change of clothes and optionally school material

Wardrobe: The child/the adolescent gets their own closet, jacket and change of clothes.

Things from home: The child/the adolescent should not take things from home. The Children Adolescent Center has those thing, which are needed in for example the breaks.

Food and drinks: The Children Adolescent Center has its own kitchen and serve a healthy and varied supply of food and drinks.

Meeting times: The child/the adolescent can meet-up from 8.15 and should be present at 8.30, when 1. module begins.

Contact book: The child/the adolescent receives a contact book, where you can read about the training of the day as well as other relevant information. As a parent you also have the opportunity to write messages to the Children Adolescent Center in the contact book e.g. how your child has felt at home, or if the child has experienced something special.

Telephone Contact: Parents can always contact us on telephone. 45115110 or 45115100 in the Children Adolescent Center’s opening hours. You can also write in the child’s contact book that you wish to be contacted.

Contact people: At the first visit your child receives a contact person and contact psychologist.

Birthday: When it is your child’s birthday, he/she may share something to the other children and adolescents. We celebrate the child/the adolescent in the before noon break, and agree with the child individually with the child, how he/she wish to be celebrated.

Transport: It is individual if the child is driven in taxi or by their parents. Transport with taxi should be agreed upon and be granted by the child’s home municipality. It is the parents, who has the contact to the taxi company and should call them, when there is changes, cancellations or delays.

Ill child: If your child has become ill, you must call the Children Adolescent Center on telephone 45115110 and put a message on the answering machine before 7.45 O’clock.

Child holiday/free: If your child should have vacation or free from the center in addition to the normal holidays/closing days, please inform the child’s contact person.

Medicine: If your child must take medicine during the day, the Children Adolescent Center’s employees can help with it. The medicine must include full name, CPR number, name of the preparation and instruction from the prescribing doctor about how, when and how much there should be given, as well as which disorder.https://www.densocialevirksomhed.dk/bcfr/Familien/vejledninger_og_gode_raad/Sider/default.aspxInstructions and good advice

Here you can find instructions and tips on what you as parents and family can do in connection to those difficulties, which the child of the adolescent can have because of an acquired brain injury.

The whole family is affected

When a child or young person gets an acquire brain injury the whole family is affected. The uncertainty about the future can be huge, and the family often meets a confusing and challenging time, where the child’s or the adolescent’s injury fill much for the whole family. Siblings can be alarmed and worried and wish to ask questions about their brother or sister’s situation. They can feel a “loss” by not getting the same attention from the parents as before. Grandparents and other relatives may be confused about how they can best support and help the family and the child through the rehabilitation course.

The parents support, patience and understanding are the most important for the child and the family to be able to move forward.

It is important to understand some of those changes that may exist after the injury, and how you as parents and family can help and support the child or the adolescent through the rehabilitation process.

Instructions and tips to understand and act on the child’s difficulties

In the following you can find an instruction with information and tips to what you can do in relation to those difficulties, the child or the adolescent can have because of acquired brain damage. The guide is developed by PABICOP (Paediatric Acquired Injury Community Outreach Program), Ontario, Canada (original title: Family Resource Guide) and translated to Danish by Henrik Nilsson in 2010 (Source: The Children Braincase).Because of acquired brain injury you child can have problems with:

Fatigue What can you do: The most common consequence after

brain injury Declines usually over time Return to school and other activities Can lead to irritation, headache and

bad concentration

Make small breaks in your child’s daily life

Be attentive on fatigue signs like e.g. reduced tolerance, irritation, and suggest breaks, when these signs occur

Ensure regular sleep routine

May be persistent for up to several months

May affect many aspects of the child’s life

Try to reduce noise level and stimulation, if the child is clearly tired and overwhelmed to make room for breaks

Do not expect the same from the child/the adolescent as before the injury

Let the child/adolescent gradually return to school and to other activities

Maks sure that mentally strenuous activities are held in the morning, where the child/adolescent is most healthy and rested for example mathematics and reading

Headache What can you do: Many children complain about

headache because of an acquired brain injury

Headache may have been caused by overstimulation or fatigue

Noise and strong light can cause headaches

Make sure that the child/adolescent gets enough rest and time to disconnect

Avoid excessively noisy or stimulating activities

Try to find patterns in, when the child/adolescent gets headaches e.g. after school or in the morning

Always tell your doctor or neurologist about ongoing and strong headaches

Note date, times and duration of headache

Ask the doctor for advice about possible medicine

Changes in sleep pattern What can you do: The child/adolescent waking up often

at night of having difficulty falling asleep

Restless sleep (The bed looks like after a fight)

Nightmare or other disturbances Increased need for a nap or increased

sleep need at all

Try to establish a silent rhythm, when the child is going to bed

Try to keep a fixed bedtime Try to keep all disturbances and noise

from the child’s/adolescent’s room Turn on something “white noise” (For

example an electrical fan) Notify the school psychologist, if the

child has frequent nightmares; There may be post-traumatic stress

Notify the doctor, if your sleep problems persist

Changing emotions What can you do: An otherwise well-adjusted

child/adolescent can become very Find out if the child/adolescent is

exhausted

emotional and unpredictable Frequent outbreaks of anger Frequent crying fits Sudden and apparently unexplained

mood swings The child/adolescent may be enclosed

of depressed The child/adolescent becomes easier or

frustrated

Try to avoid overstimulating situations Calm the child/adolescent that it is

normal to be emotional after an acquired brain injury

Give the child/adolescent “time-out”, if he/she is aggressive or out of control

Encourage the child/adolescent to talk about what he/she feels

Encourage the child/adolescent to talk about, what he/she feels

Inform the child’s doctor or PPR-psychologist

Inform the child’s doctor or PRR psychologist, if the child/adolescent is depressed or worried about the incident that caused the brain injury

Memory What can you do: It is normal that children/adolescent

have memory difficulties after an acquired brain injury

The child/adolescent maybe does not remember previously acquired knowledge, e.g. the road to a friend or literary skills

The child/adolescent can have difficulties with remembering, what he/she just got told, e.g. what they should get from the bedroom, or what they just learned at school

Fatigue can worsen the memory Too much information at once can also

worsen the memory

Try to maintain routines as much as possible

Make sure the child/adolescent is well rested

Use a schedule or make a list over the day’s chores

Break tasks into smaller parts and encourage the child/adolescent to do one thing at a time

Give one message at a time It can be necessary to often remind the

child/adolescent It may be helpful to use a “memory-

book” Make a schedule, for example a day

schedule, about the day to help the child remember what is going to happen

Overstimulation What can you do: The child/adolescent feels

overwhelmed or disturbed by noise or intense light

It can be difficult to return to school or a noisy classroom

Large malls, supermarkets and amusement parks can often cause

Avoid overstimulating places for example large malls and supermarkets

Ensure that there is a quiet area in the house, where the child/adolescent can be, when they feel overwhelmed

Encourage frequent breaks with peace and quiet

overstimulation Frequent headache may be indicative

of overstimulation

Make things simple – one message at a time

Impulsive behaviour What can you do: Impulsive behaviour is often seen after

a brain injury The child/adolescent acts before

thinking The child/adolescent buses out with

thing in class or other social contexts Impulsive behaviour and lacking

discernment can cause problems with friends and the school

Impulsive behaviour can pose a safety hazard

Supervision may be required Encourage and train the

child/adolescent stop, before they speak or do something e.g. “count to three” or “stop, look and listen”

Acknowledge that the child/adolescent’s behaviour maybe in not something, he/she can control right now, but that he/she will become better over time

Continue to guide the child/adolescent to the correct behaviour in class and other social contexts

Try to make siblings understand that the child/adolescent’s impulsive behaviour is not always conscious

Concentration and very easily distracted What can you do: The child/adolescent’s ability to

concentrate may have changed The child/adolescent can possibly not

concentrate for a long time and thus have sustained attention

Perhaps, the child/adolescent is much more easily distracted than before

The concentration can become worse, when the child/adolescent is tired, or when there is noise and disturbances

The difficulties can be more noticeable in school than at home

Ensure that the child/adolescent is well rested, when he/she do homework or other activities, which require attention and concentration, e.g. do Mathematics in the morning

Break tasks into smaller parts and encourage the child/adolescent

Ensure a quiet room, where there is the least amount of disturbance possible

Give the child/adolescent frequent rest breaks

Give one message at a time and write them down

Organization of everyday life What can you do: Difficulty in planning activities Difficulties in putting thing in the right

order Difficulties in seeing when something is

in incorrect order General ability to organize can be

weakened Homework and organizing of work task

can become harder

Write a step-for-step guide to the child or draw small drawings

Allow only one activity at a time Use a schedule, e.g. a daily schedule to

help the child/adolescent with organizing the day

Use a watch that beeps, when the child/adolescent must do certain activities or tasks

A bigger assignment can become difficult, if it consists of many smaller parts

Problems with beginning on an assignment can be linked to problems with structuring thoughts

Break tasks up into smaller parts Use ten minutes at the start of every

day to speak with the child/adolescent about what should happen during the day

Efforts in school What can you do: Many children/adolescents experience

problems in the school after an acquired brain injury

The child/adolescent will in the beginning possibly deliver worse presentations in the school

There can be cognitive changes or changes in the child’s/adolescent’s ability to understand or do their homework

Maybe the child/adolescent will not be able to do the same amount of homework on a day or an hour

The child/adolescent may be struggling to keep up with Mathmatics and reading after the brain damage

There can also occur persistent problems later in the child’s/adolescent’s schooling especially when switching e.g. from kindergarten to school or from school to gymnasium or similar.

The puberty can be extra challenging after a brain injury

Inform the headmaster and the child/adolescent’s teachers about that he/she has gotten a brain injury

Inform them, if the child/adolescent experience one or more of the above-mentioned problems, which can make it even harder for him/her to keep up in school

Let the child/adolescent gradually begin school again and in the beginning just in short periods

Keep good contact with the child/adolescent’s teachers to monitor progress and be wary of potential problems

It can become necessary to adjust the child/youth’s school schedule and activities. Contact the child/adolescent’s teachers or the headmaster to discuss and agree upon this

https://www.densocialevirksomhed.dk/bcfr/Familien/minilex/Sider/default.aspxMinilex

Executive difficulties, cognition, tone and aphasia. The list with words, you can encounter is long. Here you find an alphabetical minilex, which gives you a description of a wide range of words, which you can meet in assessment and status reports, and when you search other knowledge about the area.

ABI: See acquired brain damage

ODL: An abbreviation for “Ordinary Daily Life”. A collective term for daily chores. ODL is often used in reports regarding description of the child’s or the youth’s abilities to perform daily chores, including dressing yourself, cook and eat food, take a shower etc.

Adaptive: Adaptive means that you learn to adapt to a given context

Aphasia: An acquired linguistic communication disorder due to a neurological disorder or injury. As a rule, several linguistic areas are affected. Split into non-fluent aphasia (Broca’s aphasia) and fluent aphasia (Wernicke’s aphasia).

Affect: Used for severe emotional impact, which both can be negative or positive. Distinguished from emotions.

Apopleksi: Synonym for stroke. Collective description of blood clots and brain bleedings.

Blood clot: The blood clot stops blood and oxygen supply to brain cells in the blood vessel’s supply area.

Broca’s aphasia – no-fluent aphasia: Spontaneous speech is heavily influenced and sparse. Short sentences characterized by nouns and grammatical difficulties. Unwarranted breaks between words and sentences.

The inferior area: Used about assessment of the child’s or the adolescent’s talent. In an intelligence test the average area lies in the normal range between IQ 85-115. The inferior area is between index score 70-85 and therefore corresponds to a slightly reduced performance relative to the normal range.

Dysarthria: Disturbance of the speech production due to an injury (disorder) of the peripheral (nerves which goes from the brain and the spinal cord to the rest of the body) or the central (brain egg and spinal cord) nervous system. It is not a linguistic and cognitive disturbance.

Expressive speech: Synonym for speech or spoken language.

Executive difficulties: Executive functions is the brain’s controlling functions. They control and regulate all willed behaviour. To understand their function, some choose to call them for the brain’s conductor or director.

Executive functions are an umbrella term, which by Anne-Vibeke Fleischer is defined such as: “Initiative and planning of complex, organized, sequential course of action, which is carried out under continuous assessment and adjustment and consider the environment’s requirements and expectations. So that the person’s own needs are met, and which results in achieving a goal (process or product), in the nearest or in a distant future”.

Difficulties with executive functions can therefore be expressed in many ways. When talking about children and young people, who have difficulties with their executive functions, one of the most

typical daily example will probably be that the child or the young person has difficulties to switch from one strategy to another in relation to solving a given problem, which can be anything from calculus assignment to preparing dinner or to get motivated. You also distinguish between “cold” and “warm” executive functions (see below).

“Cold” executive functions: Also called those “cognitive” executive functions, including work memory, planning and problem solving. Come into play, when the assignment does not involve emotions, but requires logic and reasoning.

“Warm” executive functions. The warm executive functions come into play, when there is connection between what is presented to you and the reward associated with it. Those warm executive functions is therefore connected with emotions, including reinforcement or extinction of a given behaviour as a function of reward.

See also video about executive function difficulties with neuro-psychologist Annemarie Aarestrup from Norwegian Statped.

Emotions: Synonym for feelings. Is typically used about the 6 basic feelings: joy, anger, fear, disgust, sadness and surprise

Acquired brain injury (abbreviation ABI): You are talking about an acquired brain injury, if the injury has occurred after the 28th day after the birth. An acquired brain injury can have many causes, but is often due to tumours, oxygen deficiency, cerebral haemorrhage or blood clot. The reason for this can also be varied. The injury can for example have occurred as part of a traffic accident or a fall from a great height but can also be suddenly occurred or caused by serious illness.

Phonology: The language sounds function and pronunciation

Global aphasia: All linguistic is affected, often to a very high degree. Spontaneous speech can be completely lacking in the acute phase. Reading and writing is affected in the same way as those linguistic functions.

Cerebral haemorrhage: A cerebral haemorrhage occurs, if a blood vessel in the brain breaks/cracks

Memory: The term is used to denote the ability to recall information. A distinction is made between short-term, working and long-term memory. The short-term memory is for example used to remember the six numbers in Nem-ID immediately after reading them. Work memory is used, when you manipulate with information e.g. is asked to go down to the kitchen, take a cup in the drawer and fill it with milk and put the newspaper on the table. Long-term memory cover over all knowledge you can recall or apply. This can be everything from, how you ride a bike to know the capital of Paris or remember the camping trip with the family last summer.

Impressive language: Synonym for language understanding, i.e. ability to understand the content of the language

Index score: An Index Score is typically used in connection with reporting of test results. An index score is a converted raw score, which is used to clarify, where on a normal distribution a given test person is located

Information processing: An expression of how fast you can process stimuli. It is comparable to a computer’s processing power.

Cognition: Recognition, thinking, application of knowledge. Cognition is an umbrella term, which cover over mental functions or processes, including e.g. memory and attention.

Cognitive flexibility: A description for the ability to be flexible in their thinking. This translates to for example in the ability to change strategy, when solving tasks or relate to changed plans.

Cognitive communication disorders: Includes difficulties with all aspects of communication that is affected by interference with communication.

Communication: Can be verbal (oral) or non-verbal and includes to listen, speak, gesture, read and write in all of language domains (phenology, morphology, syntax, semantics and pragmatics).

Context: A description for a context in which something takes place.

Latency time: Latency time is the time, which goes from the beginning of an impact, and until the reaction comes. After an acquired brain injury there can in many cases occur extended latency time. This means in everyday life that the child or the young person will take longer to for example answering a question.

Morphology: Word comparisons. The rules for word’s comparisons.

Neologism: A new (nonsense) word is formed, in which a smaller portion of the target word is maintained, for example “monks” instead of “priests”.

Normal Distribution: Normal distribution is used as a “model” for how a vast number of statistical elements distribute themselves around their average. If you e.g. measure the height or weight of every individual person in a huge, uniform group of people, then mast will be located at a certain average, while very large or small people are rarer. In the same way, you use a normal distribution to place people’s results in a test.

Norm group: The description is often used in context of tests. A norm group is the group, which the test results are held against. In the development of a test one has thus tested it on several people, and it is these people who make up the standard material.

Attention: Attention is the ability to focus on something specific, while opting out of something else. It is thus impossible to be attentive on everything the whole time. A distinction is made between selective, sustained and divided attention. Selective attention is the ability you focus on something specific, while you ignore something else. Sustainable attention is the ability to maintain the attention on for example a task (Also called concentration), while divided attention is the ability to divide your attention between two equally important tasks.

Attention Control: See “Attention”

Word mobilization: Ability to find the word you need sufficiently fast, both with simple word and in spontaneous speech.

Paraphasia: The speech is fluent and follow the normal language rules but contain replacements either audio portions of the words (phonological paraphasia) for example “dale” instead of “tale” (talk) or word confusion (semantic paraphasia) “spoon” instead of “fork”.

Percentile: Is used often in reports to describe the common language rules, where the test subject places themselves in relation to the norm group. If the test subject for example is at percentile 20, it means that the person is better than 20% of the norm, but worse than the other 80% of the norm group. The higher a percentile the better.

Perception: The ability to perceive something through the senses. It is thus a term for what we through our senses can perceive and therefore interpret.

Post commotional syndrome (abbreviated PCS): Post commotional syndrome is a diagnosis, which can be set one year after the original commotio (synonym for headache). The symptoms are different, but the most typical symptoms are an excessive fatigue, nausea, headache, difficulties with integrating sensory input, light- and sound sensitivity as well as concentration difficulties. The reason for PCS is currently unknown.

Post traumatic amnesia syndrome (PTA): Occurs very often after an acquired brain injury. The PTA period is a transient period of confusion, which is characterized as an intellectual and behavioural disorder. One of the most typical features in a PTA period is an inability to remember events after the accident. In addition, restlessness, agitation and fatigue are often seen. Additionally, the patient will often tend to imagine things and events to fill the holes in the memory. In very rare cases additional serious behavioural and even psychotic symptoms occur. The PTA period often has a huge influence on the subsequent prognosis in relation to recovery of previous level of functionality.

Pragmatic speech: How each of us use the language. The term is used e.g. to describe the way we use the language in social contexts. If a person therefore has difficulties with the pragmatic language it will give rise to his/her application of the language appearing conspicuous in the given social context.

Prompt: Ready, prepared. Is often used in reports to describe that the person for example needs help to initiate or continue task solving.

Rehabilitation: Rehabilitation of people with impaired functioning is a series of efforts, which aims to enable the individual to achieve and maintain the best possible physical, sensory, intellectual, psychological and social functioning. Rehabilitation gives people with impaired functioning the tools, which are necessary to achieve independence and self-determination. (source WHO, translated by the Danish board of heath 2010)

Raw score: A raw score is a score, typically in a test, which has not yet been converted into a percentile, scale score or index score. If a person gets 20 correct in a test, then the raw score is 20.

Scale score: A scale score is a converted raw score. You use scale scores to compare with the test’s norm group. If a person for example gets 20 correct in a test, then the raw score is 20. These 20 are converted to for example to scale score 10. If the normal area in the test is between scale score 7-12, so that means that the person has a performance in the average area in the test without being in either the high or low end of the average area.

Semantic: Words and sentences meaning

Social Cognition: Is used about the cognitive processes, which has to do with our ability to understand and reflect on our own and other’s social behaviour.

Spasticity: Spasticity is increased tonus in the musculature. This tonus is affected by what we sense (touch, movement, light, feelings). In the longer term, spasticity may result in less elastic muscles.

Stimulus, stimuli (plural): An expression of an impression that affects the senses.

Syntax: Sentence Formation. Rules for forming sentences.

Speech apraxia: Speech apraxia is a speech difficulty after an injury in the brain. It is a reduced ability to pronounce language sounds or to make fluid shifts from one language to another. Difficulties varies from case to case, and what one can say one time can give trouble another time. The sounds coming out of the mouth are different than planned.

Tonus: Tonus is a tension in the muscles and other tissue, including nerve tissue, which all people have. Tonus occurs, as soon as we move. When one is hit by a brain injury, this tension is increased, and it can cause spasticity.

Traumatic brain injury (abbreviated on English TBI): A traumatic brain injury occurs, when an external force damaged the brain. The reason for this can be a fall, a traffic accident or abuse. A traumatic brain injury is a complex injury, which can result in a broad spectrum of symptoms and impairments. A traumatic brain injury can therefore have consequences for the intellectual functionality, but it can also affect the injured personality or behaviour.

Tumour: A description for a swelling, which has occurred by some of the body’s tissue grows or increases in quantity.

Unintended event: An unintended event is when a person is injured or at risk of injury in the contact with the Danish Health Service. It is important to know about such incidents or mistakes, because the Danish Health Service can learn from them and avoid that others are exposed to the same. Health professionals report unintended events to the Danish Patient Security Database.As patient and relative you can also report unintended events to the Danish Patient Security Database (DPSD). You can read more in the Patient Ombuds folder: Help to learn, if something went wrong.

Wermicke Aphasia – fluent aphasia: Spontaneous speech fluent with normal length sentences. Speech production characterized by paraphasia (see this). The language understanding is highly affected and there are often word-mobilization difficulties (see this) and rewriting of function descriptions.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/Sider/default.aspx

For the municipality

Do you need support for a child or adolescent with acquired brain injury? Children Youth Center for Rehabilitation offer specialized and targeted neurorehabilitation tailored to your municipality’s needs.

The Children Youth Center works from a family-oriented approach, and actively includes parents, siblings and relatives in the rehabilitation.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/m%C3%A5lgruppe/Sider/default.aspx

Target group

The target-group consists of children and young people, which due to light, moderate and heavy injuries have difficulties with one or several competences: Cognitive, social, communicative and motor.

Which children and young people are in the target-group?

Children and youths in the age range of 1-18 years old, who have suffered a brain injury due to trauma or illness as well as their families

Children and youths with defined complex issues Youths in the age range of 18-25, who have acquired a brain injury before the adult age Children and youths who after lighter brain injury, for example. concussion, continue to

have functional impairments.

The child or the youth should have an acquired brain injury, which has occurred because of cranium trauma, illnesses in the central nervous system, brain bleeding, brain tumour and more. The brain injury should be medically proven, and there must be no hereditary progressive nerve diseases.

The Child/youth should have had primary endowment and a functional level within the normal area.

Previously known difficulties, such as for example learning disabilities or disorders in the ability to maintain attention and concentration before the injury is not an obstacle to receiving services from the Children Youth Center.

What is an acquired brain injury?Psychologist Lone Fjeldborg explains in the film what an acquired brain injury is, and why it is important to begin the rehabilitation as fast as possible.See film

https://www.densocialevirksomhed.dk/bcfr/Kommunen/ydelser/Sider/default.aspx

Services

The Children Youth Center for rehabilitation has in-depth knowledge and experience with neuro rehabilitation to children and youths with acquired brain injury. The rehabilitation is tailored the individual child’s needs and challenges and happens in a close cooperation with the child’s family.

The Children Youth Center offers highly specialized interdisciplinary study and investigation, intensive rehabilitation course, supervision, counselling and guidance to the family and those specialists, who surrounds the child and teaching courses for specialists in e.g. municipalities and hospitals.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/ydelseskatalog/Sider/default.aspx

Service catalogue

In the service catalogue you obtain a summary of all Children Youth Center services and prices.

How to get started

You make an agreement with us about the course. The course is tailored to the child or the youth together with the municipality and the family.

There are various possibilities: We can offer to clear up the child or the youth and give recommendations to how the further rehabilitation should happen. We can offer intensive neuro rehabilitation, and we can give supervision, counselling and guidance to the family and the specialists, who surround the child or the youth. Disentanglement and rehabilitation can either happen in the Children Youth Center or in the child’s own surroundings.

Contact us, if you will listen more about our services and get calculated prices in the visitation process. The visitation happens at direct inquiry to the Children Youth Center for Rehabilitation on telephone: 4511 5100.

There is visitation according to section 11.7 of the Service Act, §20.3 Act on Primary School and Section 140 of the Health Act.

Come and visit us

You and your colleagues are also very welcome to come by and see, how we live and how we work with the children.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/visitation/Sider/default.aspx

How does the visitation happen?

Before a child can get into a rehabilitation course or receive other services from the Children Youth Center, it should be referred to the offer of municipality’s case worker

How to make visitation to services from Children Youth Center

The visitation happens through municipal case worker by direct contact to the Children Youth Center on telephone. 4511 5100.

There is visitation according to section 11.7 of the Service Act, §20.3 Act on Primary School and Section 140 of the Health Act.

Come and visit us

You are always very welcome to come by and see, how we live and work with the children. Contact the Children Youth Center to arrange a time.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/indstillingspapirer/Sider/default.aspx

Setting Schedule

Here you can find setting schedule to the Children Youth Center for Rehabilitation

Here you can download setting papers to Children Youth Center for Rehabilitation services. The document includes a guide as well as prices.

You are always welcome to contact Children Youth Center for Rehabilitation, if any questions about the setting papers, prices, the visitation process, etc. on phone 4511 5100.

There is visitation according to section 11.7 of the Service Act, §20.3 Act on Primary School and Section 140 of the Health Act and according to law about active employment initiatives §32 for youths who are 18 years old.

https://www.densocialevirksomhed.dk/bcfr/nyheder/Sider/B%C3%B8rneungecentret-s%C3%A6nker-taksterne-i-2016.aspx

The Children Youth Center lowers the rates in 2016

The Children Youth Center for Rehabilitation lowers for second year in a row the rates on the intensive rehabilitation including elucidation, consultation services and multidisciplinary reassessment (retest).

14. December 2015, 12:35 o’clock

Children Youth Center for Rehabilitation lowers the rates in 2016

Children Youth Center for Rehabilitation lowers once more the rates in intensive rehabilitation including elucidation, consultation services and multidisciplinary reassessment (retest). The rates lower with approx. 5%.

High professional quality combined with an efficient operation, optimal use of the resources and an administrative minimum consumption has contributed to the reason that the rates can be lowered again this year.

You can see the new rates for 2016 in our service Catalogue and Setting schedule

https://www.densocialevirksomhed.dk/bcfr/Kommunen/Documents/Ydelseskatalog%202016.pdf

Children Youth Center for RehabilitationService catalogue 2016

Children Youth Center for RehabilitationKongevejen 2562830 Virumwww.buer.dk

Administration Monday to Friday 8-14 Phone. 45 11 51 00Visitatation Phone. 45 11 51 08Center leader Lisbeth Harre Phone. 20 51 31 04 Secure mail bcfr@hav1.regionh.dkChildren and youth with acquired brain injuryChildren and youths with acquired brain injury often experience a wide range of problems, which affects their life, family, schooling and their entire development and future. They can have mental problems, their personality can change, they can have difficulties with moving, become tired quickly, have difficulties with communicating. All in all, something, which causes that they cannot live, play and develop the same way as other children and youths.

Children and youths can get brain injury after accidents, serious concussions or after illnesses such as meningitis, brain bleeding or cancer. The brain injury may also be due to anoxia as with drowning accidents and cardiac arrest, or it may be due to poisonings.

What we can offerIn Children Youth Center for Rehabilitation we have in-depth knowledge about and experience with neuro rehabilitation to children and youths with acquired brain injury. In the rehabilitation course we work closely together with the parents. We have employed both neuro psychologists, neuro pedagogues, teacher, ergo- and physio therapists and speech therapists with specialization in the field, and we work from the newest and best knowledge about

neuro rehabilitation to children and youths. We work with a wide range of neuro pedagogic methods and adjust our approach to the individual children and youth’s needs.

The results is well-functioning families – children and youths who have regained abilities, parents who can perform daily life’s tasks, and surroundings which has gotten knowledge and insight, so those good results can be maintained.

The waiting time is short, and the child can usually start within a few weeks.

How we do itWe make an appointment with the social worker about the course, and then we begin. We tailor every individual course to the individual children or youths together with the municipality and the family. We assist in describing services and calculating prices in the visitation process.

There are various possibilities. We can offer to elucidate the child or the youth thoroughly and give recommendations to how the further rehabilitation should happen. We can offer intensive neuro rehabilitation, and we can give supervision, counselling and guidance to the family and those specialists, who surround the child or the youth. Elucidation and rehabilitation can either happen in the Children Youth Center for Rehabilitation or in the child’s own surroundings.

Obtain more information about how we work on our website www.bucr.dk or call phone. 20513104.

Read more here about our services and let yourself be inspired to how you can tailor the best offer

Overview of services and pricesGeneral elucidation ………………………………………….……………...4Specific elucidation ………………………………………………………....4Reevaluation ……………………………………………………………………5Intensive rehabilitation – Short-term course ………………..….5Intensive rehabilitation – Long-term course …………………....6 Locally based rehabilitation ……………………………………………..7Supervision, counselling and guidance …………………………….7Conversation course ………………………………………………………..8Memory and attention training HOT ……………………………….8Education, theme days and development ………………….……9Guide about Legal Framework ………………………………….…...10Prices ………………………………………………………………………….…10

Services

General elucidationPrice 20,622 kr./ week (two-three weeks)GuidingLegal Framework

§11.7 The Service Act§140 The Health Act

Purpose Uncover the child or the youth’s current functioning Give recommendations to future efforts.

Description Two to three week’s multidisciplinary studies and observations within the cognitive, communicative, social and motor area.Including children neuro psychological examination

Result Elucidation report, which describes current functioning with recommendations for efforts. The report is disseminated in a network meeting with all relevant parties.

Specific elucidationPrice Agreed individually with the municipalityGuidingLegal Framework

§11.7 The Service Act§140 The Health Act

Purpose Uncover the child’s or the youth’s current functioning in one or more of following specific areas: The cognitive The communicative and linguistic The school disciplinary The social competences The motor The emotional Participation in activities and daily skills

Description The elucidation is made by relevant specialist groups – either in Children Youth Center for rehabilitation or in the child’s/the youth’s own environment,

Result Elucidation report which describes current functionality on the desired area as well as recommendations to efforts. The report can be disseminated in a network meeting with all relevant parties.

Interdisciplinary reassessmentPrice 35,938 kr. Follow-up counselling after agreement.GuidingLegal Framework

§ 11.7 The Service Act

Purpose Elucidate and reassess the child or the youth’s current functionality Give recommendations to adjusting and follow-up efforts.

Description One week’s multi-disciplinary follow-up test and examinations at the Children Youth Center for Rehabilitation.After completing an intensive rehabilitation course reassessment is offered appropriate intervals of 1 to 3 years, until the child is 18 years-old.Requires funding.It can be reassessed until the age of 25.

Result The reassessment report, which describes current functionality, with recommendations to adjusting and follow-up efforts.

Intensive rehabilitation – short-term coursePrice 2,946 kr, /day. Follow-up counselling course 12,500 kr.GuidingLegal Framework

§ 11.7 of The Service Act and §20.3 of the Act of Primary School with respectively 2/3 and 1/3§ 140 of The Health Act

Purpose Uncover the child or the youth’s current functionality for the purpose to quickly return to the local environment in an age-appropriate offer.

Neurorehabilitation with the purpose of the recovery of lost functions and skills.

Support, counsel and guide the parents Set recommendations for future action Reabsorb for further courses.

Description Three months day-care* followed by three times advice and guidance. After completing an intensive rehabilitation course reassessment is offered appropriate intervals of 1 to 3 years, until the child is 18 years-old.Requires funding.

Result The initial report describes current functioning with recommendations for efforts. Clarification of the child’s further rehabilitation course in relation to training, day-care, school and leisure time. The report is communicated at a network meeting with all relevant parties.

Intensive rehabilitation – long-term coursePriceGuidingLegal Framework

§ 11.7 The Service Act and §20.3 the Act of Primary School with respectively 2/3 and 1/3§ 140 The Health Act

Purpose Uncover the child of the youth’s current functionality. Neurorehabilitation with the purpose of the recovery of lost functions

and skills. Support, counsel and guide the parents and possibly siblings Clarify and reabsorb for further course.

Description A half to one and a half year’s day-care* with an initial elucidation including report, which is communicated at a network meeting, as well as status report every fourth month. Parent talks Sibling day Parent education Parent group talks Counselling, guidance etcFollowed by three times advice and guidance.

After completing rehabilitation course reassessment is offered appropriate of 1-3 years, until the child is 18 years-old. Require funding.

Result Reporting report and status report every fourth month, which describes current functionality with recommendations to efforts. The reports are communicated on network meetings with all relevant parties. Reabsorption and handover to training, day-care, school or education.

Local based rehabilitationPrice 868 kr. /hour excluding transport.GuidingLegal Framework

§ 11.7 The Service Act§ 140 The Health Act§ 20.3 The Act of Primary School

Purpose Advise and guide professionals from local offers and parents in relation to the child or the youth’s functionality based on current investigation.

Description A half to a whole year’s effort, where neuro-rehabilitation is handled by specialists and parents in the child’s local environment during counselling and guidance.

Result Specialists and and parents obtain knowledge about methods and strategies according to the child or the youth’s current functionality

Supervision, counselling and guidancePrice 868 kr. /hour excluding transport.GuidingLegal Framework

§ 11.7 The Service Act§ 20.3 The Act of Primary School

Purpose Supervise/advise/guide specialists from local offers or parents.Description 3 times 11/2 hours. Dissemination of specialized knowledge to parents or

specialists, who daily works with the child or the youth.Happens in the child’s or the youth’s local environment.

Result Specialists or parents get support, advise and guidance as well as specific instructions.

Conversation coursePrice 868 kr. /hour excluding transport.GuidingLegal Framework

§ 11.7 The Service Act§ 140 The Health Act§ 20.3 The Act of Primary School

Purpose Give support, insight, advice and guidanceDescription Three to five individual conversations in a course with either a parent, a

parent couple or the child/the youth. The conversations have basis in the changing situation and those difficulties which has occurred. Can happen either in the Children Youth Center for Rehabilitation or for example at home. Handled by psychologists.

Result Achieved insight into the changed situation and gotten support, advice and guidance.

Memory and attention training MATPrice 53,135 kr. excluding transportGuidingLegal Framework

§ 11.7 The Service Act§ 140 The Health Act

Purpose Intensive training of compensating memory- and attention strategiesDescription Guidance to teacher or support person once a week for 20 weeks.

Handled by psychologists or special educators. The training happens for one hour per day, 4-5 days a week, in I period of 20 weeks in total: Initial and final meeting Test before and after the training course 20 guidance sessions Status note

Result Improved memory and attention of the child or the youth, as well as compensating strategies.

Education, theme days and developmentPrice 2,170 kr. /hour excluding transport.Purpose Disseminate:

Knowledge about the brain and its functions as well as typical consequences after brain injury.

Neuro-pedagogical and rehabilitation Cognitive, Affective training – KAT. Knowledge about ICF and ICF-CY. Other as needed and agreement.

Description Can happen in the Children Youth Center for Rehabilitation or locally.Result Achieved knowledge about the target group and neuro-rehabilitation.

*Day-care: The intensive neuro-rehabilitation happen daily in the Children Youth Center for Rehabilitation in the period 8.30 – 14.30. Snack, lunch and afternoon fruit are included. The municipality grants taxi services.

Guidance on legal basisThe legal basis, which is listed in the catalogue, is a guide to the municipalities about which Act paragraphs, the municipality can give those individual services.

After you are 18 years old, the services can be given through other paragraphs. It can be relevant, if the young person becomes 18 years old during a course. The services can for example be given after: The Health Act’s § 140 if the purpose is rehabilitation. The Service Act’s § 10 and § 12, in the case of counselling, or the Service Act’s § 102, if the

purpose is to maintain or improve the citizen’s physical, psychological or social function. The Act about special education if the purpose is to give new action opportunities and

compensate for disabilities.

The same service can in principle be financed by more legislations like the children area.

PricesConsultant services 868 kr./hour.Intensiveneuro-rehabilitation

Daily rate: 2,946 kr.Applicable to the intensive rehabilitation services and for investigations.

Multi-disciplinary reassessment (retest)

35,938 kr.

Transport 500 kr./hour.Transport allowance 3.63 kr./km.

The prices are calculated, so the efforts can be as effective and economic as possible. The tariffs are calculated regarding: Focus on optimal usage of time resources Targeted savings on general operating expenses Administrative minimum usage

https://www.densocialevirksomhed.dk/bcfr/Kommunen/indstillingspapirer/Documents/Indstillingsskema%202018.pdf Children Youth Centerfor RehabilitationSetting on:Children Youth Center for RehabilitationKongevejen 2562830 Virumbcfr@hav1.regionh.dk

Date of receipt

All fields must be filled inThe Child’s name Personal ID

Address Postal code City

Municipality Name on case worker School/training offer

Father’s/Guardian’s name, address Postal code Phone number

Work phone

Mother’s/Guardian’s name, address Postal code Phone

Work phone

Reference cause (resumé of problem). Use the back if necessary. Please send relevant medical/neuro psychology papers. Tick the box

Elucidation

Intensive rehabilitation

Reassessment

Supervision/advice/guidance course

Allocation period: From ____________________________ To:___________________________

Municipal school administration according to the Public-School Act

Date and signature

Municipal Social and Health administration according to the Social Act/the Health Act

Date and signature

Grant articles Grant articles

EAN number EAN number

Setting of children and youthsChildren Youth Center for Rehabilitation is resident of the Social Business in the Capital Region of Denmark and is the Region’s neuro rehabilitation offer to children and youths with acquired brain injury.

Elucidation and neuro rehabilitation can either happen in the Children Youth Center or in the child’s own environments.

The child or the youth is set to the Children Youth Center for Rehabilitation by the home municipality. Prior to the setting of the child or the youth, the Children Youth Center can be contacted for further discussion of the offer.

The setting is mailed to the Children Youth Center secure main mailbox: bcfr@hav1.regionh.dk

Guide on legal basis Elucidation: The Social Service Act § 11.7 or § 140 in the Health Act Intensive rehabilitation: 2/3 of the Social Service Act § 11.7 and 1/3 of the Public-school Act §

20.3 or § 140 in the Health Act Reassessment (retest): The Social Service Act § 11.7 Legislation on Active Employment (LAE) § 32 (over 18 years-old)

The legal basis, which is specified is an indicative information to the municipalities about which Act paragraphs, the municipality can grant the individual benefits.

Prices 2018

Intensive neuro rehabilitation including elucidation Daily rate: 3,216 kr,/day for every day in a monthMultidisciplinary reassessment (retest) Calculated ad hoc based on hourly rate 897.00 kr./hourConsultant services (local based) 897.00 kr./hour.Transport time 500 kr./hour.Transport allowance 3.54 kr./km.

The daily rate is contained in the Children Youth Center’s holiday closure (3 weeks’ summer vacation, 1 week’s autumn vacation, closed between Christmas and New Year and the 3 days before Easter). When a child/youth is in a course over the closing periods, there is paid for the full month. In the event of termination of all intensive rehabilitation agreement, payment is required for the current month plus 30 days.

Read more about the Children Youth Center’s services and prices here:www.bucr.dk

https://www.densocialevirksomhed.dk/bcfr/Kommunen/grundigudredning/Sider/default.aspx

Thorough elucidation forms the foundation

A thorough elucidation is the foundation to understand the child or the youth’s resources and determine the areas where the child needs support, and how the child can learn to handle an existence despite lost abilities. The elucidation can make up with hypotheses and assumptions about the child or the youth’s behaviour and ensure optimal rehabilitation efforts.

With an elucidation the child’s development can be followed-upChildren and youth with acquired brain injury should be examined in a development perspective, and a thorough elucidation is central to follow up on the child or the youth’s development. Children and youths with acquired brain injury have both resources and difficulties – often in an uneven profile. A thorough elucidation gives overview of how and what level is the best possible to support and train. The elucidation can make up with hypotheses and assumptions about the child or the youth’s behaviour and ensure optimal rehabilitation efforts.

How does an elucidation happen?At the Children Youth Center, a thorough interdisciplinary elucidation for up to 14 days. It covers the child or the youth’s functionality as well as the family’s total situation and creates the foundation of the child’s rehabilitation plan. It is specialists with specialized knowledge about children and youths with acquired brain injury, who handles the elucidation.

The child or the youth is tested with the newest and most valid test and examinations on the area, is observed over time and interviews.

The child’s life history from examinations through illness or the accident process is mapped. Parents and those children and youths, who are capable of being interviewed to investigate, which issues weigh the heaviest.

Based on facts and knowledge a report is prepared.

The result is a rehabilitation plan with areas of action and objectivesThe elucidation gives a complete picture of the child or the youth’s current functionality, both before and after the injury, and the family’s overall situation and form the basis for an optimal rehabilitation plan with areas of action and objectives.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/Sider/Fejlfri-l%C3%A6ring-som-l%C3%A6ringsmetode-ved-b%C3%B8rn-og-unge-med-erhvervet-hjerneskade.aspx

Faultless learning as a learning method for children and adolescents with acquired brain injury

Faultless learning is a method, which in short aims at facilitating learning situations, where mistakes are avoided as far as possible. All research dealing with faultless learning that the method is particularly effective against all groups with learning and memory difficulties. This is because people with learning and memory difficulties are not equally capable of using previously acquired knowledge in both known and new contexts.

Faultless learning ensures that learning of wrong responses is reduced, which can subsequently be used in new learning situations, but also secure motivation and physical robustness.

What is faultless learning

Faultless learning is a method, which is used in learning situations. The method has basis in the assumption about people with a functionality loss, which affects their learning function, profit from learning situations, where errors are avoided as far as possible.

This differs from the traditional “trial-and-error” learning, where you invite the student to just guess or give reason to a given answer.

Faultless learning has in many years been a recognized learning method in the work with people, who suffers from aphasia (loss of speech abilities) and/or amnesia (loss of memory abilities) (Middleton & Schwartz, 2012). This is because of these neurological disorders experience having learning difficulties, because you either have reduced memory or has reduced ability to learn material with a verbal component.

The Children Youth Center for Rehabilitation uses flawless learning in the rehabilitation

The Children Youth Center for Rehabilitation uses flawless learning as part of an evidence-based approach to rehabilitation. When the child or the youth experience having learning or memory difficulties. We do this to ensure that the child or the youth gets the best out of their rehabilitation potential.

Flawless learning in praxis

In praxis flawless learning for example occurs by presenting the word train station and subsequently removing the last letter and encouraging the student to guess the word. In this way you will with almost certain security be able to say that the student will be able to guess the word. Next week you can remove a letter more and so on. Something similar can be used in mathematical contexts, where you for example can present the following addition formula for the student: 231 + 421 = 65(?). Here the student must calculate the missing number 2. The week after you will present the same task, where both the number 2 and the number 5 is removed from the solution.

The same method can also be used in relation to visual material. Here you can for example show a picture of an elephant, where almost all the lines, which make up the elephant are visible in the first week. After this you can silently and calmly over many weeks work towards that the student can identify the elephant with significantly fewer lines. This differs from “trial-and-error” learning, where you do it the opposite way. Another usage of flawless learning in this context can for example be to teach the student to draw a line from “red to red” and “green to green” one week, while the next week you ask the student about draw a line from “red to red mailbox” and “green to green leaf”.

Flawless learning and everyday skills

The method can be used to teach everyday skills, where you can secure that the person gets sufficient help from the specialist to complete the assignment. This can for example be to give the student a “driving map” with 5 points to cook rice. Where you as teacher perform 4 of the points and ask the student to perform the last. The week after you as teacher perform 3 of the points and ask the student to perform the last two etc. This is done until you finally to get the student to cook rice completely without help and “roadmap”.

The reason why flawless learning is an effective method for students with learning difficulties is primarily because the student not learning incorrect responses and uses these in subsequent learning situations.

Flawless learning is effective in learning difficulties

The reason why flawless learning is an effective method for students with learning difficulties is primarily because the student not learning incorrect responses and uses these in subsequent learning situations. This is very typical for people with learning difficulties, because they “store” erroneous information, which subsequently becomes more accessible to them, which causes stagnation in the academic development.

The motivation for school work can be increase

With flawless learning the student experiences mastery. It increases the motivation of the school work, which can be difficult to maintain after a function loss. In line with this, the method is an advantage, because it is preventive of various mental illnesses, which can occur after a function loss, including anxiety and depression.

Flawless teaching should not be used against people with a normal functionality level

Flawless teaching should not be used against people with a normal functionality level. Here the “trial-and-error” teaching form is still preferable, because in the long term it will provide a deeper understanding of work tasks and at the same time, the normally functioning student could learn more in less time.

https://www.densocialevirksomhed.dk/bcfr/nyheder/Sider/Undervisningsforl%C3%B8b.aspx

Five southern Zealand municipalities obtained new knowledge about children and youths with acquired brain injury

What is an acquired brain injury and which physical, linguistic and cognitive challenges the child can suffer due to brain injury? A wide range of subjects were on the program, when the Children Youth Center performed an intensive training session for five southern Zealand municipalities. New knowledge and vigilance in the area was some of the beneficial effects of the process.

16. November 2015, 10:30

A tailored training course targeting 5 municipalities

The Children Youth Center for Rehabilitation has completed a tailored training course for five south Danish municipalities. Five brain injury coordinators from Næstved, Faxe, Vordingborg, Guldborgssund and Lolland municipality coordinated and planned the course in a close cooperation with the Children Youth Center. The purpose was to obtain new knowledge about children and youths acquired brain injury and spread this knowledge to a wide range of professionals in the municipalities. Specialists, who in the daily meetings with those children and youths, who have or potentially could have an acquired brain injury.

What did the training course contain?

The training course was built on a kickoff day, 3 days intensive training as well as a closing day.

During the training the participants gets among other things insight into:

What is an acquired brain injury The significance of the injury time Phases after an acquired brain injury How it affects siblings and the family to have a child with acquired brain injury Why it is important to take care of the whole family Processing of sorrow and crisis Education and school Physical, linguistic and cognitive challenges etc.

The course has provided increased attention to the area

The municipalities have subsequently expressed great satisfaction with satisfaction with the course and seen beneficial effects among other things in the shape of that several children and

youths are tracked and get a previous effort. “Several of the people, who participated in the course has obtained an increased attention in the area, and takes that into consideration, if they encounter a child or youth, who shows signs of an acquired brain injury” brain injury coordinator Tine Malmros from Næstved Municipality says.

At the same time, it has helped the individual case worker, who is better dressed to handle the cases that comes in.

Are you interested in a training course targeted your municipality’s needs?

Contact center manager Lisbeth Harre on phone. 2051 3104 or e-mail: lisbet.harre@regionh.dk and hear more about the possibilities.

https://www.densocialevirksomhed.dk/bcfr/ydelser/Sider/default.aspx

Services

The Children Youth Center for Rehabilitation has an in-depth knowledge and experience with neurorehabilitation to children and youths with acquired brain injury. The rehabilitation is tailored to the individual child’s need and challenges and happen in a close cooperation with the child’s family.

The Children Youth Center offers highly specialized interdisciplinary examination and elucidation, intensive rehabilitation course, supervision, advice and guidance to the family and those specialists, who surround the child and training course for specialists in for example municipalities and in hospitals.

Read more about the services in the Children Youth Center’s service catalogue

https://www.densocialevirksomhed.dk/bcfr/cases/Sider/default.aspx

Children and parents tell

Meet children and youths, who have been through a rehabilitation course in the Children Youth Center for Rehabilitation. See also video with a parent couple, which gives insight into the life with a brain injured child and tells about their experiences with the Children Youth Center.

Jessica has gotten the spark back

Sara’s story

> Interview with Sara> Interview with Sara’s parents> Sara has gotten profit

Frederik’s story

> Interview with Frederik> Interview with Frederik’s mother> Frederik has reached far> Frederik talks about youth life

Amalie’s story

> Interview with Amalia’s parents> Now Amalie can walk> The princess’ heart

Here you can see an interview with Jessica’s parents. Jessica has been in intensive rehabilitation in the Children Youth Center and has gained zest for life again. http://region-hovedstaden-ekstern.23video.com/interview-med-foraeldre-borneungecenter-for

Link to other videosHere you can among other things to see a video with Rasmus, who as a young man was involved in a traffic accident and acquired a brain injury

Rasmus – Restart after acquired brain injury

https://www.densocialevirksomhed.dk/bcfr/cases/andre_videoer/Sider/default.aspx

Link to other videosHere you can meet Rasmus from Hedensted Municipality, who talks about how he has gone on with life after a traffic accident, which gave him an acquired brain injury. You can also watch a video with Karin Mørch, who is author to the book: “Can I die from it mother” and mother to a daughter, who acquired a brain injury after illness

Rasmus – Restart after brain injury

To recognize a brain injury

https://www.densocialevirksomhed.dk/bcfr/cases/sara/Sider/default.aspx

Sara’s story

I have been struggling to get normal, but today I know that have scar in the brain. It has taken a long time to acknowledge, Sara 17 years old says. She is going out into the adult world.

Interview with Sara

Sara, 17 years old, has been operated two times for a brain tumor, first in 2001 and then in 2002. The operations triggered a brain injury in her, and today she remembers nothing from the time before her illness, which she prefers to call her acquired brain injury.

Interview with Sara’s parents

Karin and Brian, parents to 17-year old Sara, have been through a long and tough process to get their daughter’s acquired brain injury recognized, both with specialists and with family and friends. The Children Youth Center for Rehabilitation has been an anchor in a long course

Sara has gotten excess

Deputy Headmaster Tina, Waldermarbo Boarding school, highlights the close cooperation with Children Youth Center for Rehabilitation an anchor in a long course.

https://www.densocialevirksomhed.dk/bcfr/cases/sara/Sider/Interview-med-Sara.aspx

Interview with Sara

Sara, 17 years old, has been operated two times for a brain tumor, first in 2001 and then in 2002. The operations triggered a brain injury in her, and today she remembers nothing from the time before her illness, which she prefers to call her acquired brain injury.

- I have struggled with becoming normal, and it has taken a long time to acknowledge that I am as I am. I totally denied it for many years, but today I know that I have scar in the brain. This is how Eva explains (Fischer, psychologist in the Children Youth Center for Rehabilitation my illness. Ed.) my illness. Both in the public school and in the little school, I was moved to, the classmates distanced themselves from me. Maybe they were afraid to become infected. At the time, I was not aware that I was different, Sara says.

The Children Youth Center has been an anchor for her in all the years, in the first half year of 2009 in intensive and the rest of the time in local based rehabilitation. In August 2009 she continued to Waldemarsbo special boarding school in Faxe Ladeplads, which has shown to be the right shelf for her. Now she is considering the next major step, namely how to move on in the adult world.

The last eight-nine years has not been a dance on roses, neither for Sara herself or her family.

Watch interview with Sara’s parents

- However, the Children Youth Center has helped me a lot with support to grow up to become the girl, who I am today. It was an enjoyable experience to go to the Children Youth Center every day

(In 2009, Ed.), because there I met youths of my own age, likewise it has been good for me to go to Waldemarsbo, because here all the students have problems that are like my own.

Sara highlights her progress, not just academically, but also practically and socially. For example, she does laundry herself. And, above all, The Children’s Center is top priority, tight structure, have been specifically put into practice at the boarding school.

- Here the daily life consists of regular routines, so I always knew, what I had to do. Even though I hate schedules and small sticky notes, I understand that it has helped me. I also hated the Boardmaker (a communication system with pictograms, ed.), because that kind of thing was not necessary for the classmates, she says.

- I think, I have become more social, and I am good at school subjects also English. I have gotten a boyfriend/girlfriend and a very good female friend here.

When fatigue hits and the memory fail

Sara sees her own memory and her tendency to get tired quickly as the worst effects of the brain injury: - If I cannot remember, where I have put for example my wallet, I become easily upset and hysterical. I imagine the worst, and I cannot avoid that the thoughts fly, and I get palpation. Then it is about taking a deep breath and turning freezing water into the blood. Else my day is destroyed.

- Both my best female friend, my roommate and my boyfriend/girlfriend are good at supporting me with remembering and find things. My byfriend/girlfriend has nothing against structure in their life, so it is a major help.

Sara is a “bookish girl”, as she expresses itself. As an example, she mentions that she can swallow a book with 800 pages, for example the series Twilight, during a few days.

- I read and hear music, when I must relax, and I need to do that occasionally, because I become easily tired. I think that I have become much better to go down to my room, when the fatigue hits.

I have struggled with becoming normal, and it has taken a long time to acknowledge that I am as I am.

In the past, I couldn’t feel that I had to lay down and rest. I can do that now.

It does that for example, if I am together with other people for a long time. My friend was recently at my home for a whole weekend, and it was becoming too much, she tells.

Occasionally Sara is hit by throbbing headache, and then there is nothing else to do than lay down and wait for it to go over.

- In the past, I couldn’t feel that I had to lay down and rest. I can do that now.

Exercise and fixed duties

Despite the reluctance against schedules Sara is nevertheless well pleased with that her life is laid out in fixed frames. Morning assembly, joint exercise and fixed duties as for example cleaning is timed.

- I can easily figure out how to set the alarm clock, and I am also very good at traveling alone, home to Greve from Faxe Ladeplads, where Waldermarsbo is located. I planned the trip with train and bus shifts and for example dare ask strangers about which platform the train is going from.

Sara knows that she must make sure she stays in shape – I go to the fitness center once a week and participate in the morning exercise every day. I can also ride a bike, even though my balance is not very good.

The production school and/or STU

Sara and her family are currently (January 2011) in the process of considering, what is going to happen, when she turns 18 in June and leaves Waldemarsbo.

- The closest dream for me is to come in the production school in Greve, and in the long run, I would like to educate myself as a pedagogue. I am fond of children – care has been a big part of my life, she tells.

In December she was in an internship as assistant in the kindergarten Søstjernen at Faxe Ladeplads. Nor is she reluctant to follow the three year education STU, specially designed education for young people with disabilities/severe diagnosis.

- Otherwise, I am happy with the main subjects that I have followed here at Waldemarsbo, wood & metal and animals & nature. I enjoy using my hands for something practical, for example changing wheels on the garden tractor or create candlesticks in the metal workshop, Sara says.

A driver’s license is part of becoming an adult. This is why Sara has decided on trying to get it.

The children youth center’s activities in connection with Sara’s rehabilitation during 2010

10 guidance meetings with the parents Regular telephone and E-mail with parents, contact teacher/school and municipal partners

(case worker and UU-counsellor (UU=Youth education) during the period. Eight meeting with Sara. The sister is offered meetings with psychologist and participation in sibling group. The parents are offered participation in parent meeting group. Five guidance and supervision meetings with the boarding school Waldemarsbo Meeting with case-worker Line Bruun, Greve municipality Two status meetings at Waldemarsbo boarding school Network meeting in regards to Sara’s education. Completion of progress agreements and status descriptions.

https://www.densocialevirksomhed.dk/bcfr/cases/sara/Sider/Interview-med-Saras-for%C3%A6ldre.aspx

Interview with Sara’s parents

Karin and Brian, parents’ to 17 year-old Sara , have been through a long and difficult process to get theire daughter’s brain injury acknowledged, both with specialists and with family and friends. The Children Youth Center has been a fixed point in a long process.

The parents took action and got Sara’s acquired brain injury acknowledged

- It has been a long and tough process to get Sara’s acquired brain injury acknowledged with the specialists that we have met e.g. at Rigshospitalet and in those school she went to. Lack of

understanding has also been a problem with some family members and friends. “She looks quite ordinary” and “My child does that too”, were typical reactions

We only got in contact with the Children Youth Center at that time, because we created contact ourselves and a family member pushed to get Sara inside. Without the Children Youth Center’s effort it would have been more difficult to complete this whole process, the parents say.

A fixed point in a new daily life

The Children Youth Center for Rehabilitation has since 2002 been a fixed point for Karin and Brian, who are very thankful for that Greve municipality has proved itself accommodating and has granted rehabilitation throughout the whole period.

Sara was on the operation table two times in 2001 and 2002 to get a brain tumour removed. This caused her brain injury, which has completely changed the family’s life. It must be calm, because the family has trouble with spontaneity.

- We had to say goodbye to the “old” Sara and hello to the “new”, Karin and Brian explain.

Just after the operations she could neither spear nor control her movements. She, according to the parents, was stuck by what in academic language is called the Fossa Posterior-syndrome. Today, more than eight years later, she has regained many skills through swimming, horseback riding for people with disabilities, ergo- and physio therapy.

Rules, routines and rhythms has given great results

- The big win for us was that we got support from the Children Youth Center to establish a structure and introduce rules, routines and rhythms in Sara’s, and thereby our own lives, the parents tell. In the beginning after we had left Rigshospitalet, Sara’s daily life was scheduled in every detail, under instruction from the Children Youth Center’s therapists and pedagogues. At that time it was even necessary to hold Sara physically, until she calmed down.

- At the same time it has made a world of difference that there is progress agreements, so we and the school always know, what will happen in the future. The fiery souls at the Children Youth Center have put great emphasis on this the whole time.

We had to say goodbye to the “old” Sara and hello to the “new”, Karin and Brian explain

Give clear instructions, explain in short sentences and make concrete agreements with her, is good advice that we have followed, Karin and Brian say

- Therefore, it is a pity that the Children Youth Center has to let go of Sara in the summer of 2011, where she turns 18 and therefore is defined as an adult. However, she will still be dependant of support, also in her adult life that has to be structured. Luckily she has gotten a more realistic self-image, so now she is more able to judge, what she can do.

According to the parents Sara’s rehabilitation has been successful, because The Children Youth Center’s strategy around structure, predictability and scheduled daily programs has been at the center.

Great tool and trick for rehabilitation

- Give clear instructions, explain in short sentences and make concrete agreements with her, is good advice that we have followed, Karin and Brian say

They have obtained many great tools and tricks on how Sara can rehabilitate and compensate for both motor and cognitive difficulties – e.g. Boardmaker, which is a system with pictograms, which helped Sara to get an overview of her daily life, when she was younger. The Children Youth Center has also introduced the parents to HOT – a special program for Memory and Attention Training.

The Children Youth Center has guided both parents and institutions

- Sara has also benefited from those meetings, she had with the Children Youth Center’s psychologist, and in general the staff has been available when we need, they say.

The Children Youth Center has functioned as counsellors of respectively the parents, but also those institutions that Sara has frequented over the years. For example the center has assisted, when something goes wrong at school, the parents tell.An experiment put another girl with acquired brain injury together with Sara in a special 7 grade because only those two turned out to be flawed, because Sara lost the social belonging to her original class. Subsequently Sara went to the Children Youth Center’s intensive rehabilitation from January 2009 to the summer of the same year, afterwards began going to Boarding School.

Karin and Brian have participated in parent meetings, which the Children Youth Center offers, and Sara’s 15 year old little sister Nanna has participated in a sibling group.

Sara’s link to the Children Youth Center has spanned for more than eight year. Except for half a year in 2009, where she went to the intensive rehabilitation every day, she has belonged to the local base rehabilitation.

The parents emphasize Greve Municipality’s willingness to help: - They have been on our side and funded money to Sara’s rehabilitation in the Children Youth Center.https://www.densocialevirksomhed.dk/bcfr/cases/sara/Sider/default.aspx

Sara has gained resources

Vice principal Tine Kjøller, Waldemarsbo Boarding school, emphasizes the close cooperation with the Children Youth Center for Rehabilitation

- It is the first time, we have had such close cooperation with an institution such as the Children Youth Center on one student, and it has been a great process. Currently Sara has gained more resources and better overview, then when she came in August 2009, the vice principal of Waldemarsbo Boarding School says.

- We, i.e. Sara’s parents, psychologist Eva Fischer from the Children Center, Sara’s contact teacher Katrine Aavang and I, regularly meet up to what could be called evaluation meetings, and we also hold status meetings, where also others involved participate.

- The process has meant that Sara is currently better equipped physically, academically and socially to begin her adult life. She is a girl, who is well-liked, and she has a personality, which helps to balance the student crowd among themselves, Tine Kjøller explains. She has shown increased self-discovery and has learned daily habits by heart, so now she can begin to find solutions and say no, if it becomes too much and inconceivable.

- An example of this is that Sara has asked to get her cleaning duty moved from Thursday to another day, because Thursday is tough with both morning exercise, running as elective subject and voluntary Zumba. It had been unthinkable a year ago, when she would have been upset and tired with circles under the eyes. The safe predictable everyday habits, as well as the school’s framework have ensured that Sara can act according to her needs.

- It is important that she is not left alone and gets into chaos, when she soon gets out and stands on own legs. Thus, we must ensure close follow-up on her course, Tine Kjøller says.

The self-owned institution Waldermarsbo Boarding School is located at Faxe Ladeplads, it can contain 65 students and is examination free. The school is involved in a partnership between five other special boarding schools on Zealand and Falster.

https://www.densocialevirksomhed.dk/bcfr/cases/frederik/Sider/default.aspx

Frederik’s story

19 year old Frederik Lindskov Hansen suffered a severe brain injury in 2007, when he was in a moped accident. He laid in a coma and hovered between life and death for a long time, but today he is a happy guy, who can do a lot on his own – thanks to the rehabilitation.

Frederik has come a long wayFrederik has come a long way, since he woke up from the coma, in the aftermath of the moped accident. However, there is potential to learn even more, test and assessments show.

Frederik tells – My moped accidentFrederik tells his story in English

Frederik tells – youth lifeFrederik tells his story and puts focus on youth life

Interview with FrederikI like to joke about my brain injury, Frederik, who calls himself “the Mongol from Hvidovre,”. Meet Frederik, who at the age of 17 suffered a severe brain injury.

Interview with Frederik’s mother In 2007 Frederik Lindskov Hansen, 19, hovered between life and death. Currently he is a happy guy with courage towards life. Here his mother Pia Lindskov recounts the successful rehabilitation on top of Frederik’s severe brain injury.

https://www.densocialevirksomhed.dk/bcfr/cases/frederik/Sider/Frederik-er-n%C3%A5et-langt.aspx

Frederik has come a long way

Frederik has come a long way, since he woke up from the coma, in the aftermath of the moped accident. However, there is potential to learn even more, test and assessments show.

Today he has life courage

Frederik has come a long way, since he woke up from the coma, in the aftermath of the moped accident on August 17th 2007.

Both physically and mentally he has made great progress, so today he is a reasonably well-functioning young man, who has life courage. But he can get even farther – with a offer for rehabilitation in a youth environment.

It is the overall assessment in Frederik’s discharge report (Children Center for Rehabilitation 2009). It listed progress in all areas, both cognitively, linguistically, physically and socially. It is supported through tests and examinations, conducted approx. one year apart.

Structure supports Frederik in the daily life

Frederik has become significantly more independent during the rehabilitation course. The self-realization is supported by putting structure in Frederik’s life, for example by creating check lists, week and daily schedules.

However, there is still clear potential to learn more, both lost and new skills, the conclusion was. It is confirmed in the printed status that Fjordby at Vejle Fjord Neuro-center completed shortly before closing the center in September 2010.

It is especially the management of so-called executive functions that he still has trouble with. He still has a difficult time with getting ideas, take initiative, plan, control his impulses and adjust his own behaviour. Frederik also has difficulties with understanding and using abstract language.

Specific examples of progress measured in 2009 and 2010:

Frederik is seen as suitable to take a driving license. Frederik masters own and shared cleaning (with a bit of guidance) Frederik can order ticket and take the train home alone (for example from Vejle) Frederik is socially active, is liked and create many relations

Frederik is attentive about his tiredness and understands why, it gives problems. Frederik has regained basic linguistic skills. Frederik uses his left hand much more. Frederik has increased his reading speed significantly Frederik has improved his “score” in math from 5 to 7 grade level in a year. Frederik’s Condi numbers and physical strength has significantly improved.

https://www.densocialevirksomhed.dk/bcfr/cases/frederik/Sider/Frederik-fort%C3%A6ller---My-moped-accident.aspx

Frederik tells – My moped accident

Frederik tells his story in English

By Frederik Lindskov Hansen

A little bit over a year ago I was involved in a moped accident. It was at the evening. I and some of my friends were going home to a boy who is called “Freddie” to crash his party. We were going to go at about ten p.m. We talked about how to get quickly home to Freddie, so we took our mopeds. On the way over to him, we made some kind of race. Simon that I was sitting behind was in front of the others. But, when we were at the next road where you can turn right or left, he didn’t see the shark teeth. So he didn’t stop. Then suddenly it was all black.

Simon didn’t stop when we were at the shark’s teeth, because he didn’t see them and then BAAM. What happened right after was that we got hit by a car at 50/km. What I was told was that Simon got 4-5 meter up in the air, and then fell down to the ground. He passed out for about 2 minutes. Now that was Simon. I got told that when we got hit by the car my leg broke just right under my

knee. Then I flew 2 times into the windscreen with my head, then I flew 5-6 meters up in the air, at last I landed, and I was just lying there on the ground.

When all of this happened our friends were 1- 2 meters away. It was just the biggest shock for them. They couldn’t do anything else than just walk in circles and shout out loudly. People in the houses could hear them, and they called the hospital. Because my friends just could not do it, they were in shock.

Then about 15 minutes later some of my friends called Victor’s mom, (Victor was my best old friend). When she heard what had happened to me, she ran directly home to my house. She just hammered on our door and my parents just thought it was me who just should pee like hell.

When my mom opened the door, she saw Victor’s mom crying, and she told my family what had happened to me. When they heard that, they just ran out the door without locking it and drove over there. When they came over where it happened they saw me lying on the road with an ambulance right next to me, and my sister called our dad and said what had happened to me. My mom just ran over there with tears in her whole face. She just wanted to hold me, but the guys from the ambulance had to pull her away, because I had to get transported in the ambulance. My mom was sitting right next to me, in the ambulance, on the way to the hospital.

It was first when I got in there that they called my dad, and told him what had happened to me that night. What I got told was that when my dad heard that, he just went out to his car and then drove to the hospital. Even though he didn't know, if I was dead or alive, he just took the way to the hospital at slow speed. It was because he didn't want to get stopped by the officers.

Then when he got to the hospital he saw my other family, and they were all crying. There were nurses who pulled me in to be operated. When I had been operated, I was still alive but my blood pressure could easily go down or up, so it was very critical. So the first week was really critical.

It was like that for almost 4 weeks, then it all got much better and I was alive. They just did not know how I would be when I woke up. Then on the 14th of September I got moved to Hvidovre Hospital, and it was there I began to wake up. But it was not like I just woke up just like that, and was just as fresh as I am now. No, it began very slowly. For example, I began to open my eyes and moved my legs and arms. But just a little bit.

The 22nd of September my psychologist had been sitting right next to me and asked a question. She said "Frederik what is your father’s name?" I answered: ”Karsten". Thereafter she asked: ”What is your mother’s name?" and I answered " iaa". The funny thing about it is that it sounded a little bit like I answered; ”Ian" (Ian is the name of the doctor). When I said that, my mother was just crying. But that was really good, because when I could answer right that meant that I could hear, remember and answer. I think that it is one of the most important things. I mean, I could have been a vegetable, like Vaugn Esgesen said, when I was lying in Rigshospitalet.

How I began to train standing normally was that there came in nurses and stranded me up on a "walking support". Then they for example said that I should throw 3-5 rings and get them to match onto some sticks. I only trained 15-20 minutes at a time in the beginning.

When I began to be more awake, I began to train my legs on some kind of bicycle. It was not on a normal bicycle. When I did that I should sit in my wheelchair and have my legs lock safety on, then I was wheeling. Even when I wasn't very fresh, I just kept on wheeling. I wheeled about 40 kilometres every day. I am really glad that I was training so much. Because training the first 6 months after you have woken up from a coma, is the most important time, because it is the easiest time to get your nerves to heal. If I did not do so much training, I would have been moving much worse, than I do now. So, I am really gratefully and my family too that I have been training so much. I am so lucky and thrilled that I firstly actually survived and I have become a better human. After a while I began to walk a little bit. When I went out and pick up my food, for example I could change to a walking support instead of a wheelchair. So I could walk, but it wasn’t very fast. You know it was really slow at the start. For example getting food changed a lot. Either it was my parents, who went out getting it, or I went either by wheelchair or with the walking support. Basically every day after I had eaten dinner, my dad and I went down to the training room to train my legs.

Then there was one night, where I did a little funny, but also evil thing. It began with my father pushing my leg it was something, which would help my leg. Then suddenly I gave my father a shock. When my dad pushed my leg, I fainted on purpose. Not like it was incontinence, but I closed my eyes and held my breath. When my dad saw it he almost yelled “Frederik, FREDERIK”. Then my dad would go out to get the nurses to help me, but before he did it I got up by myself and said: “dad relax, it was just for fun”. My dad thought it was stupid and a little evil. Because he thought it was serious, but on the other hand he was actually also a little happy. It was good that I still had a sense of humour.

Then one day my oldest brother and my dad were visiting me. My dad would train with me again, but this time he wanted me to try to walk without any kind of walking support. It happened slowly, but I did it. There was a nurse who saw it, so that nurse told it to the other nurses. So my dad got a bollocking by the nurses.

In October or November, I got that metal taken out that was put through my leg. I think it was about 10 days after the moped accident that I got 4 pieces of metal put right through my leg. The reason that I got it was that it would help my leg to heal back. To keep the pain away from my leg, I got a lot of morphine. I think it was Vaughn esgesen, who said that in all these years he had been helping people, he had never seen anyone who should have as much morphine as me.

It reminded me that I should go to the Rigshospital again. All the nurses and doctors said that they did not know how I would be, because as they said, I could wake up being a vegetable.

Now I will turn time a little backward. After I had woken up, I was very angry. You know, I said the most stupid things. For example I actually remembered one night that my dad was there visiting me. I was really angry, I spoke a lot about committing suicide. I was yelling and crying about it and suddenly I did a stupid thing. I actually hammered my leg into my bed. That was in the beginning, but my humor was and still is very different.

In Hvidovre Hospital, there were 2 people who always could make me get into a better mood. Finn and Thomas, for me they were some of the best from there. I mean they were so kind and funny, but I could also talk about serious things with them. When I visited the hospital again one of the first things I asked about in my old section was “Do you know where Finn and Thomas are?” It was always good to see these two porters from Hvidovre Hospital, and it was also good to see some of the nurses. Some of the nurses also look damn good. So when I visit Hvidovre Hospital I try to find Ian, Finn, Thomas and then all of the good nurses. Now all that I told so far is all from the hospitals. So now I am going to tell you about what I am doing now. At the 14 of January I started at “Geelsgårdsskolen” in Virum. It is a big school for a lot of people with brain damage or some people that have other problems. My section is a little part of the whole school, called “Børnecenter for Rehabilitering” but I and the other children from my section have all got a brain damage in our life. I mean we were not born with it as some of the others from the school. It is a place, where I basically train all that I did in Hvidovre hospital.

At the 14th of January I started here and the date today is the 1st of December. So in 11 months I have gotten much better physically and talking. I mean I can walk much better now, before I get tired in my leg, I can run and I can talk much better. These two things that I have been happiest about are that I can run and that I do not forget the words as much anymore. I am so grateful that I have become much better in these last 2 years.

Ian, all of the nurses, my family and my friends are so glad that after the moped accident, I have been training well and I have had this kind of spirit for training. Both I and my family are so grateful that I have got so far compared to what the doctors said. The people here in this new kind of a school is okay, but the most irritating thing is that I am the oldest here and the next oldest is 15 years old, you know just about my age. I mean he acts and looks like a 16 year old and I feel fine with him. His name is Paw. I have been at his home a couple of times. He lives a long distance from the school; it takes a little bit over an hour for him to drive to the school.

Now, a little bit about what I am going to do after I have finished at this school here in Virum. I asked for a place in some kind of boarding school at Vejle that is called “Vejlefjord”. I just got told that on Saturday me, my mom and my dad are going to see that school, and on Monday they are going to test me to see, if I will fit in. So I am really excited to go there. The funny thing is that I already know one person who stays there, and one of my friends has a cousin, who also stays there. But now I shall go there at Saturday to Monday, and then I will find out if I am sure, I want to go there. So wish me good luck.

“I like to joke about my brain damage, when we talk at home” Frederik tells

https://www.densocialevirksomhed.dk/bcfr/cases/frederik/Sider/Interview-med-Frederik.aspx

Interview with Frederik

I like to joke about my brain injury, Frederik, who calls himself “the Mongol from Hvidovre”. Meet Frederik, who at the age of 17 suffered a severe brain injury.

The brain damage meant a violent upheaval in Frederik’s life

19 year old Frederik Lindskov Hansen is an adopted child from Korea, and this is visually the only thing, which separates him from other peers, when you sit opposite to him. However, he has a brain damage, which has meant a violent upheaval in his life.

Nevertheless, he often jokes about his brain damage, because he and the family at home have a shared humorous approach to the existence. Both mum, Pia Lindskov Hansen, and the rest of the family often receive a proper amount of smoke – and opposite. For example Frederik signed his SMS to home with “the Mongol from Hvidovre”, when he was hospitalized.

He is aware that he still has after effects from the brain damage: - But I have gotten much back compared to what I could before the accident. I still have some physical difficulties, and I get easily tired. If I for example have to read many pages, I become tired and unfocused. However, I have

learned to read fluently, as long as it is not too many pages. Overall I can look lazy, but that just means that I need more breaks than other people.

Reading is just one of those skills, which Frederik has re-trained – and expanded – via the rehabilitation. In the discharge report after a year at the Children Center and in the status report after about one and half a year at Vejle Fjord, it appears that he has benefited greatly from the rehabilitation. This applies both linguistically, socially, physical and cognitively.

See Frederik has come far

The motivation is at its peak – Frederik is now able to do more himself

Frederik has gradually learned to be more self-reliant and be able to manage himself. An important part of the rehabilitation at the Children center (and at Vejle Fjord) is to restore the ability for everyday tasks like ensuring personal hygiene, to take bus and train, to cook food and wash up.

- Both Virum and Vejle Fjord have been good places for me, where I have learned to handle my everyday life better, Frederik tells.

It is his objective to find fitting work, which he can master, and where there are other youths. And on a little longer term, he wants to live at a place of his own. So he is top motivated for further rehabilitation and re-training.

It gives much to be together with other youthsAt one point in 2009 I got a depression, and I also sometimes thought about suicide. But I got out of it again i.e. by I and my parents spoke a lot about it with the staff in Virum (Children Center for Rehabilitation). I still have trouble being alone and really want to be together with other youths all the time, Frederik explains.

- Frederik was a typical teenager, who only answered us in the family with mono syllables before the accident, and then he was the girl’s friend at the time. Now he has lost many old friends and acquaintances. Today he is very contact seeking and speaking, also with us, and he has it best with people around him, Frederik’s mum Pia Lindskov Hansen says.

- I maybe have half a dozen good friends now, and we are often together. I play cards and music, go to fitness, play Playstation with them, and sometimes we go out into the city and drink beer. I believe that I have become more social, talkative and humorous than I was before, Frederik tells.

I have very satisfied with being in the Children Center, in particular after a boy of the same age as me arrived.

He is well-aware that his brain damage has caused an upheaval in his life. For example, some of those inhibitions that are natural for teenagers are gone. He is easy to say the wrong thing to the girls.

- In the past I also laughed without being able to stop again, but that is not the way it is. And I have had several girlfriends – just not now, he adds.

From sport to music

Frederik practiced sport in a big way before the accident, among other things soccer and gymnastics. This he cannot any longer, even though he still goes to fitness, plays basket, table tennis and pool.

- I can run, but it quickly hurts in left leg, and I must also tell it to my companions sometimes that they should walk a bit slower, Frederik explains, who was completely paralyzed in the left side in the beginning and still must live with a so-called foot drop. But also here there is basis for improvements via rehabilitation.

Instead of sport he is now hooked on music

- Gudrun (social pedagogue at the Children Center, ed.) taught me how to play guitar, and I have also been to plays in Vejle, Frederik tells.

- It is the intention that I have to go to guitar again. I relax very well with it, when I am alone and have to settle down. Currently (November 2010) I have also gotten a small job every Friday at the Children Center, where me and a guy of 15 years play guitar, he mentions (the 15 year old young man is now in a similar intensive rehabilitation course, which Frederik completed in 2009, ed.).

https://www.densocialevirksomhed.dk/bcfr/cases/frederik/Sider/Interview-med-Frederiks-mor.aspx

Interview with Frederik’s mum

In 2007 Frederik Lindskov Hansen, 19, hovered between life and death. Now he is a happy guy with life courage. Here his mother Pia Lindskov recounts the successful rehabilitation on top of Frederik’s severe brain injury.

A moped accident on August 17th 2007 completely changed the existence of the now 19 year old Frederik Lindskov Hansen and his family. He suffered a severe brain damage with the accident and floated subsequently between life and death. Today over three years later, Frederik and his parents can tell about a course, which must be described as a real sunshine story.

We did not even know if Frederik would wake up, if he would survive the coma that he was in for almost a month after the accident, Pia Lindskov Hansen, mum to Frederik says.

Today Frederik is a happy, humorous guy with life courage, who can handle a lot. This Pia Lindskov Hansen attributes to the rehabilitation that Frederik has completed, first at Hvidovre Hospital, then at the Children’s Center for Rehabilitation and lastly at Fjordbo II at Verjle Fjord Neuro-center, both treatment institutions for children and youths with acquired brain damage.

- We have gotten a unique treatment all the way through the institutions mentioned. Also we have had an exemplary cooperation with. Right now (November 2010) the municipality has funded Frederik a room at a housing institution on Selmervej in Hørsholm, after Frederik had to go home prematurely from Vejle Fjord, Pia Lindskov Hansen says.

The cause for the break for Frederik is that Fjordbo, which had room to 13 youths, went bankrupt in September.

- Sadly there is first an available space at Selmervej in the spring of 2011, so in the meantime we need to find a solution, in the form of some internship or school. Frederik would preferably want structure in his daily life and meet at fixed times. At the same time it is important to be together with others – he is very social. This we and Frederik’s case worker in the municipality work on now, Pia Lindskov Hansen informs.

- It is Frederik’s future connection to the labour market, it is about. The cognitive rehabilitation has meant that he does just not become early retiree, but can find a place, where he can feel equal with others. He must have a life with structure and community, but also with challenges and

responsibility. A fitting job opens the opportunity for success and life quality, and it is not least what the stay at Selmervej in Hørsholm will help clarify.

- From a purely socio-economic standpoint it is a gain that Frederik is not just sent on retirement, she continues.

Offers should be targeted at young people as age group

The term rehabilitation is connected solely with physical rehabilitation

But a successful rehabilitation is about more than retraining the ability stand, go and talk. Cognitive retaining is also required, and it must be based on the whole youth life and targeted to the age group, Pia Lindskov Hansen says.

- Frederik’s life would look completely different, and he would have been significantly more disabled, than he is now, if not he had been at the children’s center and Vejle Fjord, she states. It is really worrying that young people with acquired brain damage cannot count on getting the same treatment as Frederik, because the municipalities cannot or will not pay for it. I have heard that some of the former residents of Vejle Fjord have ended in sheltered elderly homes.

- It has been a very big plus for us that among other things the Children Center’s staff have met us with understanding for our background, where we have great feelings trapped. It has been safe, so we in the family could give more release – the Children center ensured for a fixed structure in Frederik’s daily life, which he has a big need for. And we have gotten insight in those methods, which you use in the rehabilitation, via the parent education. In addition, we have been very happy to meet parents in the same situation.

- It has generally given us in the family great security that there was the continuity. We have always known in advance, what the next station was for Frederik, except now after Fjordbos bankruptcy. In this situation it is good that the municipality immediately enters without bureaucratic and grant barriers challenges, Frederik’s mum says.

Frederik is privileged, not just due to the professional hinterland has worked well, but also because he has a big network, which supports in all ways. Both Pia Lindskov Hansen’s current husband and his twin daughters 18, Frederik’s sister 24 and Frederik’s dad, including family are active fellow players in Frederik’s life. Same for four of his old friends from his old public school, who were present, when it was at its most difficult.

- There is no doubt about the fact that Frederik’s accident has welded us together, so we are almost like one big family, Pia Lindskov Hansen says.

https://www.densocialevirksomhed.dk/bcfr/cases/Amalie/Sider/default.aspx

Amalie’s story

Would Amalie wake up at all after two cardiac arrests in January 2010? It looks bleak, they said at Riget, so we had said goodbye to her. But after rehabilitation at Hvidovre Hospital and at the Children center, the 10 year old girl can now walk, eat and say sounds, the parents Carina and Robert Barkum tells, Jægerpris.

Interview with Amelie’s parentsWould Amalie wake up at all after two cardiac arrests in January 2010? It looks bleak, they said at Riget, so we had said goodbye to her. But after rehabilitation at Hvidovre Hospital and at the Children center, the 10 year old girl can now walk, eat and say sounds, the parents Carina and Robert Barkum tells, Jægerpris.

Now Amalie can walkThe Rehabilitation at the Children Youth Center has contributed to give the ten year old brain damaged Amalie several functions back. Here you can read more about Amalie’s development.

The princess’ heartHere you can read an article with Amalie and her parents that was brought in Vestegnen May 5th 2010.

https://www.densocialevirksomhed.dk/bcfr/cases/Amalie/Sider/Interview-med-Amalies-for%C3%A6ldre.aspx

Interview with Amalie’s parents

Would Amalie wake up at all after two cardiac arrests in January 2010? It looks bleak, they said at Riget, so we had said goodbye to her. But after rehabilitation at Hvidovre Hospital and at the Children center, the 10 year old girl can now walk, eat and say sounds, the parents Carina and Robert Barkum tells, Jægerpris.

- We were prepared to say goodbye to Amalie, because the message from Rigshospitalet was that it looked bleak. Would she even wake up after two cardiac arrests January 15th 2010, we asked ourselves. The heart stood still for 45 minutes, so we thought that a life as a vegetable wopuld not be worthy.

This 10 year old Amalie’s parents Carina and Robert Barkum, Jærgerpris tell. They were despaired that an operation for a congenital heart failure had such fatal consequences. But they got the hope again, when Amalie almost two months after the cardia arrest, the first signs of life showed up. She both laughed and cried, when she heard her old classmates sing on a tape, which the class had sent her. And since then it has only moved forward.

You should never give up. She can walk now, also on stairs, eat, undress and make sounds, the parents tell. The language is formed again, and in the meantime we use sign-to-speech. This Amalie is already become really good at, the parents tell.

They are convinced that Amalie has never come as far, as she actually is, without the rehabilitation firstly at the children department at Hvidovre Hospital and since at the Children Youth Center.

The family will be involved in the rehabilitation process

- We are in daily contact with the Children Youth Center’s team of therapists, and they do nothing over our heads. We are constantly being consulted, so we are already feeling (November 2010) as part of the center. It is important for Amalie that we adopt a common strategy for how we deal with rehabilitation, for example Amalie’s eating training, Carina Barkum says. We are very pleased with the good advice and instructions, we get from the therapists at the Children Youth Center.

See Amalie can now walk

You should never give up. She can walk now, also on stairs, eat, undress and make sounds, the parents tell.

- It is important that we use the same procedures in the rehabilitation at home, which they for in the daily hours at the Children Youth Center. In this context for example, it is nice that we get insight into methods like the ABC concepts, which we have been on course at the Children Youth Center in Virum, Carina Barkum tells.

Strong will and indomitable stubbornness

Since June 14th 2010, if Amalie began to go to the Children Youth Center’s intensive rehabilitation, significant progress has been mad, Carina and Robert Barkum have registered.

- Amalie had through a strong will and indomitable stubbornness, retrieved lots of victories all the way, her parents tell. One of the largest occurred in the summer of Turkey at a vacation, where she went her first steps in a swimming pool, and she ate potatoes and drank soda pop. Until then she was in a wheelchair and was tube-fed through a so-called Mickey button in the stomach. It was removed in August.

- Amalie has even asked to avoid using diapers, even at night, and it has worked virtually without accident, they mention.

It is especially motor, Amalie has made huge progress, and there is basis for several, also on the cognitive and linguistic area.

It is clear, when you sit opposite of Amalie that she understands big part of what the conversation is about. And she is impatient to learn more, and among other things recover parts of her spoken language.

- She understands that rehabilitation for her, and her strength is that she wants to continue, even with the language and with school subjects. We are very thankful of how long she has reached on such a short time, Carina Barkum says. We hope for her that she can have a good life – for example at one point to move.

Carina Barkum’s family, both her parents and a sister live nearby. They support and join the network around Amalie just like a good friend from the old public school class, who often come to visit.

Carina and Robert Barkum are convinced that the rehabilitation, firstly at Hvidovre Hospital, where the couple lived together with Amalie, and since at the Children Youth Center for Rehabilitation in Virum, has been decisive for the positive development Amalie is in.

- We have gotten a completely fantastic treatment both places, they say.

Full-time employment to be parents of a brain damaged

The Barkum family has gotten their case, because after the now ten year old Amalie’s heart had failed and triggered a brain damage.

- It is a full-time job to be parents of a brain-damaged child, the couple say.

During the whole course in Hvidovre – until June, where she was discharged, the parents lived in the hospital. Before then they should find new handicap accessible housing, and it also succeeds with support from Frederikssund Municipality. There was neither any problem with awarding Amalie’s mother, Carina Barkum, compensation for lost earnings, provisionally until December 1st 2010.

However, a family with a child with disabilities run into many other challenges.

- We are very happy that we did not say yes to send Amalie at institution, at the time she was in coma. As we had precluded us from many support possibilities, Carina Barkum tells.

- And we were lucky that there was suddenly a free space at the riding center, where Amalie goes to riding therapy. Otherwise we had to wait until spring 2011, she continues.

Carina and Robert Barkum would like a short course in sign-to-speech, so they can better communicate with their daughter. But there is delay with the grant of the course. At the time of writing, the couple’s application to cover the daily transport from Jærgerpris to the Children Youth Center in Virum is also not met. The same applies for their desire for a disability car.

- We would rather drive Amalie herself, as long as she could not talk with the chauffeur in the disability transport, Carina Barkum says.

- It requires surplus to be parents to a child with disabilities. There is really a lot of meetings, courses and consultations, you should participate in, and you should also use much time on contact of the municipality, however, where we have generally been well treated, she mentions.

https://www.densocialevirksomhed.dk/bcfr/cases/Amalie/Sider/Nu-kan-Amalie-g%C3%A5.aspx

Now Amalie can walk

The Rehabilitation at the Children Youth Center has contributed to give the ten year old brain damaged Amalie several functions back. Here you can read more about Amalie’s development.

At the time of writing, end of 2010, it is hardly five months ago that Amalie for the first time stepped through the door at the Children Youth Center for Rehabilitation. Otherwise rather: She was driven in for paralysis that occurred due to two cardiac arrests and the subsequently brain damage meant that she could not go in June.

This she can now, where the wheelchair is put in a corner and only used over longer distances.

See interview with Amalie’s parents

It is just one of the significant results, the rehabilitation at the Children Youth Center has meant for the ten year old Amalie. She has gotten a wide range of abilities, both physical and cognitive back according to her journal. A so-called discharge report, which is made by the Children Youth Center’s team of professionals in October 2010, summarizes Amalie’s rehabilitation on a number of fields and documents through observations and interdisciplinary tests that the rehabilitation has brought her far in a short time.

However, the report also points at that there is potential for several progresses. This the home municipality Frederikssund now acknowledged, and in December 2010 the municipality has granted Amalie another six months of intensive rehabilitation at the Children Youth Center until summer 2011.

The first important steps in Amalie’s rehabilitation took place at Hvidovre Hospital’s children department, after the treatment she described her as awake and able to comply with requests,

and she could confirm or deny with humming noise, when she was discharged on June 9th. She could get into the wheelchair and stand by the stand support table. However, she was still characterized by spasticity in the legs and had generally reduced body control and vision.

End of tube-feeding

Since the stay in Hvidovre Amalie has learned to walk, also for example forward down stairs. She is not quite sure yet – the parents report fall accidents, when the balance fails sometimes.

She has had a good start with using her right arm, and current Amalie go to riding and is very happy for it. The riding therapy strengthening the muscles in the body and the arms as well as the balance and her left arm, which she otherwise almost never uses, come into play. She is also beginning cycling, initially on a tricycle to train the strength and coordination in her legs.

She started in taking food through the mouth and not by tube-feeding. The tube, a so-called Mickey button in the stomach was removed in August, and now Amalie eats and drinks normally and is not as afraid of failure swallow as previously. However, her appetite is tiny, so she should be compelled. She has trouble with cleaning the mouth effectively, due to reduced sensibility in the mouth and impaired tongue motoric. Tooth brushing is therefore an important part of the rehabilitation.

OEA (ordinary everyday activities) such as for example eating is an important part of the rehabilitation. She can now help with undressing and dressing up and she need only one helper with toilet visits, where previously two were required. She also has so much control over her bodily functions that she does not require diaper any longer.

Amalie can signal yes or no

Linguistically she has developed. The Children Youth Center notes that she now can signal clearly, if she means yes or no, she is increasingly using signs, and regulate words sometimes occur. The parents can distinguish several words – for example mum and dad. There is therefore much to be learned, when it comes to speech, while there is better progress understanding, what others say, the assessment claims. Here Amalie is on the level of a 61/2 year old.

Her skills within Danish and Math are difficult to quantify precisely. But she can do a lot, for example form rhymes if the words are said loudly, and she can point out the initial sound in a word. Amalie knows the number row from 1—10, and she is familiar with concepts such as longest, least, biggest and most.

Socially Amalie is easily distracted and is very impulsive. Her perseverance is still fluctuating, but currently she can concentrate on one assignment for 20 minutes at a time. Her limited ability to make contact with other ensures that she has difficulties by adhering to and abide by social rules and drawing experiences.

Probably suffer from blind eyesight

The brain damage has affected Amalie’s vision. And this complicates the rehabilitation in a wide range of the mentioned fields. It also prevents, along with Amalie’s small linguistic ability, the implementation of a whole lot of elements in the tests that she has been through.

Those visual difficulties she has, points in the direction of the fact that she suffers CVI (Cortical Vision Impairment), also called blind sight. Children with CVI have difficulties processing visual impressions, even if the eyes function normally.

Therefore the Children Center structurally works with Amalie’s vision, for example through simplifying the visual impressions and only shows a small piece of text at a time, when she has to re-train the reading ability.

There is need for more rehabilitation

The parents, Amalie’s sister and the rest of the family follow Amalie’s rehabilitation very closely. And Carina and Robert Barkum are daily in contact with the team at the center. They get home visits by the Children Center’s specialists, and there are conversations with the contact person in Amalie’s team two times a month, in addition to psychologist and other professionals on a regular basis. They also receive training in those methods that the center makes use of, not least in order to rehabilitate Amalie’s abilities in the same way at home, and they participate when Amalie is at for example neuro pedagogue, vision consultant or dietitian at the hospital in Hillerød. The team regularly prepares ongoing action plans with very specific content. For example there is set goals for a weight gain and methods to achieve it.

The investigation report conclude without reservation that Amalie still needs intensive, multidisciplinary rehabilitation, both physically, communicatively, socially and cognitively at the same extent as before. The potential for improvements are huge, and Amalie shows a strong will to communicate better and become more self-reliant.

https://www.densocialevirksomhed.dk/bcfr/cases/Amalie/Sider/Prinsessens_hjerte.aspx

The heart of the princess

Here you can read an article with Amalie and her parents that was published in Vestegnen May 5th 2010.

The 5th May 2010 Vestegnen published an article with Amalie and her parents.You can find the article on page 28-29: The heart of the princess

https://www.densocialevirksomhed.dk/bcfr/omos/Sider/default.aspx

About the Children Youth Center for Rehabilitation

The Children Youth Center for Rehabilitation is a multidisciplinary specialized rehabilitation center for children and youths with acquired brain damage. We offer neuro rehabilitation, which is individually adapted to the child in a close cooperation with family and professionals.

The rehabilitation and retraining happen at the center in an intensive day-care or local based in the child’s or the youth’s local environment. The Children Youth Center also offers consultant services in shape of supervision, guidance and training.

The Children Youth Center for Rehabilitation is a part of VISO’s specialist network and solves tasks in the whole country.

https://www.densocialevirksomhed.dk/bcfr/omos/Sider/Tilfredshed.aspx

We measure on satisfaction

When a child or youth finishes a course with us, the child or the youth, parents and key persons in the child’s home municipality were asked about their satisfaction with the offer.

From January 2017 all parties in intensive rehabilitation will be included in the Children Youth Center’s satisfaction survey. The questions are about the quality in the courses, the cooperation with professionals, the child’s development and the experience of participation. We process the responses anonymously and analyse the satisfaction surveys twice a year. The first question for children and youths “Overall, you have been happy to be here?” is also included in the overall Region Capital satisfaction survey.

The Questionnaires is prepared in cooperation with Denmark’s Evaluation Institute (EVA) and the first statement is expected to be completed in June 2017.

https://www.densocialevirksomhed.dk/bcfr/omos/visoleverand%C3%B8r/Sider/default.aspx

VISO supplier

The Children Youth Center for Rehabilitation is VISO supplier

The Children Youth Center for Rehabilitation is a part of VISO’s supplier network and solves task all around Denmark.

When a municipality or citizen contacts VISO and wishes advice or investigation of a child with acquired or congenital brain damage, VISO can contact the specialists in the Children Youth Center and get the task solved.

About VISO

VISO is the national Knowledge and Special Counselling Organisation on the social area and in the special training.

VISO advices citizens, municipalities, institutions and offers, when there is a need for additional expertise, knowledge and experience.

Get more knowledge about VISO here

https://www.densocialevirksomhed.dk/bcfr/omos/samarbejdspartnere/Sider/default.aspx

Cooperation partners

Here you can see, who the Children Youth Center for Rehabilitation cooperate with.

The Children Youth Center cooperate with a wide network of different specialists for example:

Children psychologists Vision consultants IKT-consultants Children neuro pediatries Foniateries Bandagists, etc.

Other cooperation partners

Selma Marie

A temporary housing and rehabilitation center for young people with acquired brain damage.

https://www.densocialevirksomhed.dk/bcfr/omos/voreshistorie/Sider/default.aspx

The history of the Children Youth Center for Rehabilitation

The Children Youth Center for Rehabilitation history begins back in 1996, where three professionally skilled enthusiasts gathered to create an offer to children and youths with acquired brain damage. Former principal of the Geelsgård School Kirsten Nielsen and the psychologists Henrik Okbøl and Marianne Verdel began the offer as a project under the then Copenhagen

County. Study trips to some of the world’s leading rehabilitation centers, Boston University in the United States of America and Tadworth (The Children’s Trust) in London, gave good inspiration to build a multidisciplinary rehabilitation center in Denmark with a high academic level.

In 1997 the first physio therapist was employed. In 1998 the first speech therapist was assigned with the place was lent with courtesy by the Speech Institute. His name is Jens Reimick, and he was a part of the Children Youth Center permanent staff until the end of 2015.

January the 1st 1999 the Children Center for Rehabilitation was established. Same year the first pedagogues were employed, and as more children were referred to rehabilitation at the Children’s Center, the staff grew steadily.

In 2011 the place changed its name to the Children Youth Center for Rehabilitation and at the same time moved into newly renovated rooms in the white villa at Kongevejen 256 in Virum.

Passion, commitment and the will to make a difference for children and youths with acquired brain damage has through all the years characterized the Children Youth Center for Rehabilitation.

https://www.densocialevirksomhed.dk/bcfr/omos/Sider/Organisation.aspx

Organisation

The Children Youth Center for Rehabilitation is an offer under the Social Enterprise, Capital Region.

The Children Youth Center for Rehabilitation is an offer under the Social Enterprise such as an enterprise in the Capital Region.

There can be granted offers from the Children Youth Center for Rehabilitation in accordance with §11.7 of the Service Act, §20.3 Act of primary school and §140 of the Health Act.

Our core task

The Children Youth Center for Rehabilitation core tasks are neuro rehabilitation based on the motivation of children and youths with acquired brain damage is individually adapted and takes place as cooperation between children and youths, the family and the professionals. For children and youths the rehabilitation is a step on the road towards an independent life, where it emphasizes on creating meaningfulness in the present.

Leaflet of the Social Business

Here you can see a leaflet about the Social Business, Frames and direction 2016-2018.

https://www.densocialevirksomhed.dk/bcfr/omos/Documents/18503%20folder%20om%20DSV_210x230_23102015_final_web.pdf

The Social Enterprise, Capital Region solves task on a highly specialized social- and special education area. The enterprise has the responsibility to run and develop 20 offers, which includes housing and day-care, counselling and special training as well as secured department for young offenders.

The target groups are children, youths and adults, who – due to disability, physical illness and/or social problems – have need for a specialised social effort in order to maintain a high life quality and opportunity for development.

THE CORE TASKThe social enterprise’s core task is to run and develop the regional social offers, so residents and users receive high quality services, while the task is solved as effectively as possible.

THE FRAMES FOR THE WORKThe specialized social task is solved for the municipalities and happens within the frames of the shared municipal and regional frame agreement on the social area, the strategy of the region (Focus and Simplification), the common regional platform for the specialised social area, including the regions’ model of quality on the social area as well as the Social Supervision quality model.

The operation of the regional offers is financed by the municipalities and is governed by the framework agreement, where capacity and need for spaces as well as shared development measures, governance principles and tariff development are agreed upon.

The enterprise has approx. 1600 employees and a yearly budget of approx. 800 million kr.

THE HIGHLY SPECIALIZED EFFORT IS AMONG OTHER THINGS CHARACTERISED BY:

Complex and multidimensional problems

Highly specialized professional competences

Overall view and coherent efforts

Interdisciplinary cooperation and cross-sectoral coordination

The social enterprise – when there is need for a highly specialised effortFrames and direction 2016-2018

THE SOCIAL ENTERPRISE – A PART OF THE CAPITAL REGIONThe specialised social area forms together with health and regional development the region’s three core areas. Both academically and organisational we use many advantages, which there is by being part of a big organisation like the Capital Region.

The Region Council has adopted four political objectives for the region, which is the basis for our work in The Social Enterprise, and which mirrors itself in the specific efforts.

“Focus and Simplification” is the Capital Region’s overall strategy. The strategy includes a number of strategic areas of action, which should support the region’s political objectives and develop the operation. The Social Enterprise cooperates with the hospitals and the other businesses and the areas of action, which are relevant for the specialized social areas.

The Regional Political Objectives:

The citizen’s (patient’s) situation steers the course High academic quality Expansive knowledge environments Green and innovative metropol

OPERATING GOALS MANAGEMENTOperating goals management is a management tool in Focus and Simplifying, which contributes creating and develop the operation. The Social Enterprise has the following measuring points and indicators:

Measuring points Indicators

Satisfaction Satisfaction rate

Delivery Occupancy rates

Quality Power applications

Well-being Sickness absence

Productivity Revenue vs. costs

EFFORT AREASThe Social Enterprise has four overall effort areas that together should secure that the offers can solve the core task the best way possible – and at the same time live up to the regional political objectives.

THE CORE TASK:

Operate and develop the regional offers, so residents and users get services of high quality, while the

task is solved as effectively as possible

PROFESSIONAL ACTION

EMPLOYEE RESOURCES

MANAGMENT AND

OPERATION

MANAGEMENT

Academic ActionThe enterprise’s offer has various target groups and therefore uses a wide range of different academically acknowledged approaches and methods. It is a shared objective that these approaches and methods must be well described and visible for both citizens and municipalities.

In these years there is a focus on the idea that social efforts should be based on research and the best current knowledge to strengthen the quality and the effect of the action to the citizen and to secure that the resources are used as best as possible. It is also increasingly sought after documentation and results from the specialized social effort – both at citizen and offer level. The Social Enterprise has through several years worked systematically with documentation and development of the academic action in a wide range of areas. The enterprise will also in the future have focus on promoting a common knowledge, and have development of knowledge and result documentation as a central area of action.

In the enterprise we are occupied with promoting innovation by reconsidering our our work approaches, processes and services to strengthen the individual user’s competence and quality of life. The Social Enterprise also works intensively with using and develops welfare technological solutions on the offers with the purpose to ensure a better and more effective solution of the core task. This is an effort that often happens in cooperation with external parties.

The offers in the enterprise have an important task in supporting the citizens’ physical and mental health and well-being for thereby promoting equality of health. The work consists of among other things supporting the citizens’ access to relevant health promoting actions and health professional competences.

In both the Health field and the social area there is huge focus on securing the coherent and coordinated courses for the individual citizen as a part of their rehabilitation. The Social Enterprise is occupied with securing that the citizens – children as well as adults – who use the enterprise’s offer, experience coherent and coordinating course in relation the other services, which the citizen receives, but also in relation to the course of life.

Objectives To visualise the connection between the offers’ objectives, target groups as well as

academic approaches and methods That the academic efforts are increasingly based on research and the best current

knowledge, and results and effects are documented, evaluated and is used in the continuous development of the efforts.

To secure coherent and coordinating rehabilitation course for the individual citizen To support inclusion and self-reliance of the individual citizen, i.e. by use of welfare

technology. To promote equality in health by supporting the citizens’ physical and mental health

and well-being

MANAGEMENTGood management is crucial for these efforts, which is decided both locally and centrally to be transformed, became transformed to action and get the desired results. The Social Enterprise emphasizes that the management on all levels are visible and result oriented. The basis for the four management actions is the regional management chain and the management areas: strategic management, academic management, operation management as well as staff management.

The Social Enterprise is continuously working to ensure coherence in the enterprise. The individual chief has an important role as translator or bridge builder in relation to create coherence, and Enterprise emphasizes on strengthening the individual chief’s opportunity to fill that role as best as possible.

“Through a highly specialised and focused academic efforts we help to support and develop citizens’ self-reliance, life competence and participation in society”, manager in The Social Enterprise Søren Bech says

Objectives: To ensure that decided efforts are transformed into action and get the desired

results That there is a strengthening coherence in the enterprise That all the managers continuously develop That the managements are visible and result oriented

User inclusion and self-determination is the basis for our services. Like out dialogue with the users build on equality and dignity”, manager in the Social Enterprise Søren Bech says.

EMPLOYEE RESOURCESThe employee is the most significant resource in order to solve the core task qualified and effectively. The Social Enterprise therefore works focused with recruiting qualified employees and maintain those, who are already in the enterprise. This we do among other things by building robust academic environments and support the employees’ competence development.

The level of social capital is high in The Social Enterprise. There has been documented a focus between good management, effective handling of the core task and high social capital. We wish to maintain the high level and at the same time launch actions, which can further strength the social capital.

In the Social Enterprise there is a huge focus on ensuring a good and secure work environment for both employees and managers. The work environment in the social offers can be stressful – both physically and mentally. The employees’ competences should therefore be continuously strengthened in order to handle difficult tasks, they can get into. This happens e.g. by do making a non-confrontational approach to the work at the offers into a shared approach in the enterprise.

High social capital and a good physical work environment also have significance for the sick leave. The social enterprise is continuously working on getter fewer sick leaves in the Enterprise’s offers.

OBJECTIVES: To maintain and strengthen the high social capital in the enterprise To recruit and maintain qualified employees through robust academic environments

and competence development To have a safe and sound working environment To have a low absence due to sickness

MANAGEMENT AND OPERATIONIn order to deliver sustainable services in the specialised social- and education area it is important to have a close and obligating cooperation with the municipalities – including CMR – but also with others both internal as well as external cooperation parties: the Danish Health-care, Danish Regions, the board of directors of the self-owned offers and other actors in the field.

The Social Enterprise has a safe and sound economic management, which gives the basis for a stable operation and a trustworthy cooperation with the municipalities. An efficient and transparent financial management is a prerequisite for the core task being solved efficiently and with high academic quality. The enterprise is based on a joint financial management model, which is supported by the necessary IT-systems, and continuously works on quality assurance and developing the financial management and the IT-support both centrally and in the individual offers.

The Social Enterprise works with operative goal management as a management tool to balance and develop our operation. The common indicators for the enterprise are listed on page 6.

OBJECTIVES: To maintain and strengthen a close and obligating cooperation with the

municipalities (including CMR), the Danish Health-care, Danish Regions, the board of directors of the self-owned offers.

To develop the enterprise’s financial management To develop the IT-support of administrative and academic work processes To implement and develop the usage of operative goal management in the

enterprise

https://www.densocialevirksomhed.dk/bcfr/omos/ledigestillinger/Sider/default.aspx

Vacancies

https://www.densocialevirksomhed.dk/bcfr/omos/medarbejdere/Sider/default.aspx

Employees

At the Children Youth Center for rehabilitation you meet experienced multidisciplinary professional staff.

Here you can see a list of all employees

Anne LindøHead of Center

T 4511 5108anne.lindoe@regionh.dk

Psychologists

Lone FjeldborgPsychologist responsible for treatmentSpecialist in clinical children neuro psychologyM 5130 5861lone.fjeldborg@regionh.dk

Anja RasmussenPsychologistT 4511 5102 M 2937 5731anja.rasmussen.02@regionh.dk

Secure mailWhen you send a mail to the Children Youth Center, it should be as secure mail – so personal information stay personal. You can send secure mail to the Children Youth Center’s main mailbox: bcfr@hav1.regionh.dk

Quality standards and supervision

On the page you can read about the standards in the Danish quality model on the social field, and in which fields the Children Youth Center gets supervision.

The Children Youth Center for Rehabilitation works according to the Danish quality model in the social field The Children Youth Center for Rehabilitation works according to the following standards:

Individual plans of action Influence on own life Communication Physical and mental health and well-being Academic methods, approaches and results Drug administration Unintended events Prevention of abuse

There will be internal audit, where the Children Youth Center will continuously control that the standards are upheld.

Food inspection and the Smiley Scheme As all other kitchens the Children Youth Center must apply to the food inspection and perform self-inspection of hygiene and quality of food.

The Children Youth Center has been awarded an elite smiley at the latest inspection in January 2018.

Other supervision, first aid and defibrillator

The Children Youth Center receives continuous fire supervision and supervision of elevator and left.Every year all employees must participate in a first-aid course.The Children Youth Center has its own defibrillator.

Pamphlets, articles and reports

Here you can find relevant articles and reports about children and youths with acquired brain damage. You can also download the Children Youth Center’s pamphlet.

Pamphlet

Here you can download folder of the Children Youth Center

Reports

Support to parents in the child’s neuro rehabilitation courseThe Children Youth Center for Rehabilitation has in cooperation with Unit of Evaluation and User Inclusion in Capital Region in 2012 completed a study, which focuses on parents’ experience of their children’s neuro rehabilitation course, as well as which needs for support the parents have in the course. The report is constructed on interviews with 13 parents to youths, who were subjected to the same kind of accident and all acquired a brain damage. In 2014 a follow-up study was conducted. You can download the two reports here.

Download report

Download report

Neuro Pedagogical PraxisA description of the multidisciplinary neuro-pedagogical work at the Children Youth Center for Rehabilitation between therapists, pedagogical staff and neuro-psychologist on the one side and the child/family and other close relatives on the other. The description is an example of how the neuro pedagogic is used in praxis and is primarily addresses itself to professionals, who work with cognitive rehabilitation of children and youths with acquired brain damage.

Download the report Neuro Pedagogical Praxis

Articles

Mindfulness as intervention method after acquired brain damageThe article examines if there is evidence for usage of mindfulness as intervention method in the work with children and youths with acquired brain damage

Children with brain damage need an invisible hand on their back (p. 6-7)Hjernesagen’s membership magazine January 2013 – Theme number about children and youths

Children’s language damages can cast long shadows (p.8)Interview with Jens Reimick and Grethe Stærmose, both are speech therapists at the Children Youth Center with specialization in children’s linguistic development. Hjetesagen’s membership magazine January 2013 – Theme number about children and youths

Interview with medical consultant Ian WestphallHere you can read an interview with head doctor and children neurologist Ian Westphall from Hvidovre Hospital. Ian Westphall emphasizes that we should not among other things forget the cognitive difficulties in the rehabilitation.

Brain damage tiredness: New promising researchMedicine and mindfulness can be two good ways to go, if a person suffers brain damage tiredness. New Swedish research shows promising strokes. This, two Swedish researchers from Gøteborgs University, chief physician and professor Lars Rönnbäck and neuro psychologist Birgitta Johansson told at the Children Youth Center for Rehabilitation theme day about brain tiredness.

Articles about children and youths

Why does it not beat that heart?10 year old Olivia suffered cardiac arrest in January 2015. In this article from Berlingske Tidende you can read about Olivia’s entire course from revival, operation and hospitalization for the rehabilitation course in the Children Youth Center of Rehabilitation. Olivia is back in her old school today.

Frederik is back in his old shape (p. 9)Frederik has been in an intensive rehabilitation course at the Children Youth Center. Hjertesagen’s membership magazine January 2013 – Theme number about children and youths

https://www.densocialevirksomhed.dk/bcfr/omos/Documents/Pjece%20marts%202015.pdf

Questions and answer about

THE CHILDREN YOUTH CENTER FOR REHABILITATION

WHICH CHILDREN AND YOUTHS ARE IN THE TARGET-GROUP

Children in the age range 1-18 years, who has suffered a brain damage due to trauma or illness as well as their families

Children and youths with similar complex problems Youths in the age range 18-25 years, who has acquired a brain damage before the adult

age Children and youths, who after lighter brain damage like for example concussion, still have

functionality impairments.

HOW DO WE HELP THE CHILD OR THE YOUTH?

A rehabilitation offer at the Children Youth Center is being organised individually in close cooperation with the municipality and the family. The course can happen at the Children Youth Center or locally in the child’s immediate environment. The waiting time is short, and can be started up within a few weeks.

The Children Youth Center offers among other things: Multidisciplinary and/or neuro psychological examinations that reveals the child’s

difficulties and level of functioning Intensive rehabilitation and retraining at the Children Youth Center Local-based rehabilitation in the child’s local environment Supervision, counselling and training Preparation of action and education plans

Read more about the Children Youth Center’s services at www.bucr.dk

DID YOU KNOW:A brain damage yearly hits approx. 1000 children and youths as a consequence of trauma or illness. Out of these, approx. 175-325 children and youths need multidisciplinary.

Source: The Children Brain Case

DID YOU KNOW:Children Youth Center for Rehabilitation is VISO supplier

WHO ARE RESPONSIBLE FOR THE REHABILITATION?

The Children Youth Center has a team of experienced specialists, who handles the examination and rehabilitation on a child neuropsychological basis. Psychologists, speech therapists, special teachers, ergo therapists, physio therapists and neuro pedagogics cooperate with the rehabilitation in multidisciplinary teams and work according to the best knowledge and praxis in the area.

HOW DOES FAMILY AND ENVIRONMENT GET INVOLVED?

When children or youths gets a brain damage affect the whole family’s daily life. The Children Youth Center emphasises on offering various forms for support and offer to the family and the surroundings. The family is included in a close cooperation around establishment of areas of action and objectives of the child. Parents, siblings, relatives, friends and professionals in the child’s local environment can find emotional support, practical advice to how the rehabilitation can be followed up in the home and at education places and much more through advisory conversation course, parent groups, family reunions, education, etc.

WHAT DOES IT COST?

The price is dependent on which course is established for the individual child or youth. Contact us for initial advice or a non-binding talk about the possibilities. See also our service catalogue on the web-site.

WHERE CAN I FIND MORE INFORMATION?Visit www.bucr.dk or call on phone 45 11 51 00

https://www.densocialevirksomhed.dk/bcfr/omos/Documents/neurop%C3%A6dagogisk%20praksis.pdf

Neuro pedagogical praxis

at the Children Youth Center of Rehabilitation

ContentForeword ……………………………………………………………………………………………………………. 1Definition of neuro pedagogic …………………………………………………………………………….. 2Tools in neuro pedagogic ……………………………………………………………………………………. 2Structure: ……………………………………………………………………………………………………………. 3Neuro pedagogic praxis ………………………………………………………………………………………. 4Prerequisites and motivation ………………………………………………………………………………. 5Transfer of strategies ………………………………………………………………………………………….. 5After the Children Youth Center ………………………………………………………………………….. 5Bibliography ………………………………………………………………………………………………………… 6

Foreword

This text is addressed to colleagues and professionals, who work with cognitive neuro rehabilitation of children and youths with acquired brain damage. The text is a description of the multidisciplinary neuro pedagogical work at the Children Youth Center for Rehabilitation between therapists, pedagogical staff and neuro psychologist on the one side and the child/family and other close relatives on the other side, who all play a crucial role in rehabilitation of children and youths. The description should not be perceived as an answer list for neuro pedagogical work, but as an example of how the neuro pedagogic is used in praxis at the Children Youth Center of Rehabilitation.

The Children Youth Center of Rehabilitation provides intensive neurorehabilitation for Children and Youths, as a result of lighter, moderate or severe acquired brain injury within one or more areas; including cognitive, social, behavioural, communicative or motor functions.The brain damage is typically caused by skull trauma, diseases in the central nervous system; for example cancer or brain bleeding.To receive rehabilitation at the Children Youth Center the brain damage must have resulted in lost cognitive, social and/or motoric abilities.The child/the youth can be part of a rehabilitation course immediately after hospital discharge, but it is also possible to at a later point in time after the damage has occurred.The Children Youth Center has a local based rehabilitation course, where focus is rehabilitation in homely frames in the child’s/the youth’s specific and current working day. The course can consist of supervision, counselling and the child’s/youth’s relatives and professionals, but also by rehabilitation at home. The following description, however focuses on the intensive rehabilitation process, where the child in a longer period daily meet at the Children Youth Center.

The neuro pedagogic approaches at the Children Youth Center are based on assessments made by the interdisciplinary team on the basis of a thorough investigation as well as the team employees’ in-depth insight into the brain’s construction, development and function. This is put in relation to the individual life history and current situation, the location of the damage, time since the damage occurred and the child/youth age at the time of the injury. This gives an idea of the consequences of the damage, the child/the youth in everyday life has in order to assess how the brain damaged child/youth and the family best can be supported. This happens from the Children Youth Center’s objectives about giving the child/the youth support to regain or compensate for lost competences, gain insight into their difficulties and learn how to address these, so he or she can function to their fullest extent in everyday life.

The aim is therefore to make the children/the youths as independent as possible, and there is worked holistic and action affected. The inclusion of family and other close relatives is important in this context.

Definition of neuro pedagogic.The neuro pedagogic approach to cognitive neurorehabilitation is based on the neuropsychology. Put simply you can define neuro-pedagogics as a kind of “used neuropsychology”.All professional groups at the Children Youth Center are part of the neuro pedagogical efforts, and we regard as a direct prerequisite for working neuro pedagogical. The Children Youth Center’s vision builds on the idea to see opportunities with the individual child instead of limitations, while there is focus on transfer value and relevance for the individual.Neuro pedagogic is therefore not a method, but a way to think. – a common reference frame, which largely deals with the overall perception of man and individual child’s/ youth’s prerequisites and competences.

Tools in the neuro pedagogical work.The tools in the neuro pedagogical work builds on a multidisciplinary elucidation and consist of the preparation of areas of actions. There is used evaluation/measurement tools, which can be relevant (for example “Goal Attainment Scale). The work also consists of multidisciplinary pedagogical methods, which supports the child’s/the youth’s rehabilitation. (These are described in the section about structure).

Elucidation:When an elucidation is granted, the child/youth is examined and observed monodisciplinary by the following professionals: psychologists, speech therapists, teachers (if the child/the youth is at school age), ergo therapists, physiotherapists and pedagogics.The elucidation tells about, which meaning the damage has on the child/the youth, and which consequences the damage can have for the further development of further physical, behavioural, school work and cognitively.There is created a common multidisciplinary conclusion, which summarizes and unites the monophonic test results, and which later forms basis for formulation of the multi and monodisciplinary areas of actions.

Areas of actions:Based on the elucidation report, a joint interdisciplinary field of actions is established for the child/the youth, within which work is aimed at and focused on the individual professional group reference frames.The multidisciplinary areas of actions should be central for the child/the youth and includes wishes from both the child and the parents. There is worked with the area of action in both modules and breaks, and preferably also in and outside the home, where it is possible.The action area can be both overall and qualitative and can possibly continue beyond the rehabilitation phase. It is important that continuous evaluation of the field of action is conducted with short intervals, like using a qualitative evaluation model to adjust the effort.

As an extension of the interdisciplinary field of action 1-2 overall goals are established, which again can be divided into sub-goals, where among other things there can be worked with specific assessments, so the child’s/the youth’s results and process is assessed, and which puts focus on “the zone of immediate development”, (according to Vygotsky)

Evaluation:The child’s/the youth’s physical and cognitive development is continuously evaluated continuously interdisciplinary as well as monodisciplinary. Areas of action and goals are continuously evaluated and edited, so that the child/the youth constantly is challenged and rehabilitated relevant in relation to current needs.The whole effort around the individual child (areas of action, goal and evaluation) is illustrated, and shows how long the individual child/the youth is in a rehabilitation development and at the same time there is put focus on success also without the final goals is necessarily reached.

The structure:At the Children Youth Center structure is used as an explicit interdisciplinary neuro pedagogical method, which means that the structure is consequent throughout the child’s stay, across professional group and modules, and also carries out to the home.This creates safety for the child/the youth, who can thereby use their energy on rehabilitation and learning rather than using it to orient or create an overview of the day.

Frames and predictability:When the child/the youth begin at the Children Youth Center the interdisciplinary team is linked. The child/the youth and the family are assigned a contact psychologist and a contact person.With basis in the area of action an individual schedule is established.Children/youths with acquired brain damage need predictability. Therefore the week schedule it is the same through a longer period. Changes happen with the child’s/the youth’s rehabilitation potential changes itself, which potentially could lead to new areas of action and new goals. In case of changes, the child/the youth is prepared both verbally and visually.The predictability and the repetitions of the modules’ content lead to an automatization of the activities and areas, which is rehabilitated and thereby increase the probability of transfer to other situations.

Visualisation:

Every child/youth has a nameplate and possibly a photo on a blackboard, under which the individual schedule is put up daily with Board marker symbols or writing as well as possibly photos of the adults, there must be with the child/the youth concerned.The daily schedule is divided into three blocks with two modules in each block with breaks between every block. In the individual modules, further visualization of the module’s content can be made, if it is deemed necessary.The visualisation can consist of picture symbols (for example board maker), drawings, photos, concretes or text to those who can read. It is however individual, what the individual needs. There is focus on involving the welfare technology in the daily rehabilitation.

Master strategies:In the rehabilitation there is also worked interdisciplinary with individual strategies, which can partly be compensatory, partly supportive, but always based on the wishes and needs of the child/the youth as well as the family.

Neuro pedagogic praxisIn practice, the individual’s areas of action and management plans are worked out.There is worked with a holistic approach, but always taking into account the child’s/the youth’s prerequisites. Dialogue, susceptibility and motivation with the family/parents play a huge role in this context.

In the individual activities and course is also based on the child’s/the youth’s motivation and competences, and in all activities emphasis is placed on the possibility of interaction, and reaction both in relation to children and adults. Predictability is here a significant factor, so the child/the youth are prepared on the content.

The neuro pedagogical approach neuro pedagogical approach required a highly monodisciplinary team, so it is possible to work interdisciplinary. In addition, as mentioned there is a need for structure, but also the adults around the child are able to show empathy, care and clear communication.Specifically, this concerns among other things emotional neutrality at conflicts and relation between child/youth and adult, reward for positive behaviour, praise and recognition of the child/the youth and clear boundaries.The goal in the long run is to provide insight, recognition and acceptance of own situation with the child/the youth as well as his or her family.The pedagogical measures are realized in different ways, dependant of situations and professional groups. The individual professional groups guide and support each other to strengthen the transfer value and secure the child’s/the youth’s rehabilitation across professional boundaries.

Prerequisites and motivationDue to the lost physical and cognitive abilities, the child/the young person often experience a lot of defeats and disappointments. This may cause the desire and motivation for learning to be lost.

To turn such a negative spiral, it is necessary to create a good relation to the child/the youth by showing a real interest in wishes, frustrations and problems.It is in this process important to let the child/the youth complete some activities, which you know he or she masters.On the next step in the development the child/the youth should learn to tolerate frustrations, even if everything does not succeed the first time you try. At the same time the child is offered compensating strategies, so the ability of cognitive flexibility is strengthened. The activity should be something that the child/the youth and possibly the parents have wished for, in order to experience a wide variety of successes.

With slow rising demands with a steady focus on success experiences, attempting to change the child/youth’s development from an external motivation, where the child/youth does something for the sake of the adult, to an inner motivation where the child/the youth completes an activity for their own sake and with their own goal or sub-goal in mind.

In all the motivation course it is advantageous to involve the child/the youth’s as well as the family’s wishes, and incorporate these into the activities. Our experience show the bigger the child/youth’s motivation is, the better chance is that the rehabilitation is successful with a good result.

Transfer of strategiesAt the Children Youth Center for Rehabilitation there is partly worked with elucidation and rehabilitation of the child/the youth’s lost abilities, including compensating strategies. There has to be clear focus on the child/youth’s understanding of and usage of these abilities together with other children and adults in and outside the Children Youth Center. There is focus on transfer of abilities and adaptation to new situations using cognitive strategies and coping.

In praxis this means that there is specifically focused on the transfer value of the specific learned, the child/the youth can thus use re-acquired or newly acquired abilities at home and in the everyday life, the child/the youth is discharged to after the stay at the Children Youth Center, for example a new school or a new day-care offer.

The child/the youth is rehabilitated individually or in groups according to needs, so fundamental abilities are learned together with adults, in conjunction with peers and automated in relevant structured activities.The staff at the Children Youth Center often use learning in activities, where the rehabilitation does not focus on what should be learned, but rather on the context wherein the skill is learned and is used. Thus, the coping strategies are strengthened and learned, which the child/the youth must use in new and unknown activities also after the discharge for the Children Youth Center.

After the Children Youth CenterWhen a child/youth is going on from the Children Youth Center a huge effort is made to secure a continuation of the results obtained. The is specifically done by offering gradual discharge, where

it is relevant, transfer meetings in the new environment and guidance on further use of strategies and management plans, which is specifically produced to the child/the youth at the Children Youth Center. Additionally, it is offered to follow the child/youth in a period in a local-based rehabilitation course, where the child is followed in the specific and maybe new environment with guide to teachers, pedagogics or other professionals, follow up conversations with parents or the youth or other individual adapted actions.

Furthermore, it is encouraged to continuously carry out interdisciplinary retesting of the child/the youth, especially around selected developmental “milestones” (before school start, at the entry to the teenage age and at the age of 18) or for specific needs. In order to ensure that the best and most relevant effort is prospectively performed for the individual. Typically, the consequences after a brain injury that occurred during childhood will not be stationary until the child is adult, and it is seen frequently that the child with time, contrary to many people’s presumption, does not grow away from, but “grows into” difficulties that were not visible at an earlier time.

BibliographyPeter Thybo (2013): Neuro pedagogic-brain, life and learningKeld Fredens (2004): “The person in the brain”, a basic book in neuro pedagogy Peter Thybo: Article “About neuro pedagogy”“The handbook of neuro pedagogy” (2013) published by the Disability and Psychiatry department, Odense municipality.Vygotsky: The zone for nearest development.GAS, Goal Attainment Scale (Kiresuk & Sherman)

The pedagogical professional group at the Children Youth Center for Rehabilitation, March 2015.

https://www.densocialevirksomhed.dk/bcfr/Kommunen/Documents/Mindfulness%20som%20interventionsmetode%20FINAL.pdf

MINDFULNESS AS INTERVENTION METHOD AFTER ACQUIRED BRAIN DAMAGE

by Anne Norup, neuropsychologist, ph.d.,

Strengthened Effort for Youths with Acquired Brain Damage.

Purpose: to investigate if there is evidence for the use on mindfulness as intervention method in the work with children and youths with acquired brain damage. Alternatively, investigating evidence for the usage of mindfulness among adults with acquired brain damage, including mild acquired brain damage.

Definition: Mindfulness is a common form of intervention, which has gained ground into both diverse patient populations as well as healthy human beings. Mindfulness is used in both business and treatment contexts.

Target group: People with acquired brain damage can experience extensive problems. Mindfulness offers often aims at fatigue and depression, which are common symptoms after brain damage. At the same time it is symptoms, which can be crippling and affect the affected this year after the damage. In the population with acquired brain damage both mindfulness-based cognitive therapies as well as mindfulness-based stress reduction has been tested in several studies, and the results of these studies are reviewed below. There has not been studies identified, which has tested the method especially among children and youths. The following is therefore a brief review of the results from the adult literature.

Research results: A pilot study has examined the effect of mindfulness-based stress reduction (MBSR) after mild traumatic brain injury (mTBI). The study offered 22 people with mTBI a ten week program consisting of MBSR, where each group session lasted 2 hours. The treatment primarily focused on improving the participants’ attention. There was found clinically meaningful improvements on quality of life and self-efficacy and smaller effects on the executive aspects of work memory and attention regulation (Azulay, Smart, Mott & Cicerone, 2013).

Another study has also examined MBSR in relation to mental fatigue of 18 patients with apoplexy and 11 patients with traumatic brain injury (TBI). The MBSR program lasted eight weeks, and there was found significant effect of the program on mental fatigue by self-reporting as well as peed of information processing (Johansson, Bjuhr & Ronnback, 2012).

MBSR has also been used in a group of 9 veterans with mTBI and post-traumatic stress disorder (PTSD). In the group one found that veterans’ attention is improved both immediately after the intervention, but was also maintained for a 3 month follow-up. The same pattern can be seen in relation to reduction of symptoms of PTSD (Cole a.o., 2015).

McHugh and Wood introduced the method of a brief mindfulness induction in 12 patients with TBI experiencing stimulus over-selectivity, where the TBI-patient only focuses on one aspects of a situation ignoring others (McHugh & Wood, 2013). The level of over-selectivity was significantly reduced by the brief mindfulness intervention to a control group.

The effect of mindfulness-based cognitive therapy (MBCT) on depression after TBI has been investigated in the only randomized controlled study that has been completed. Here the participants were randomized to either a ten week cognitive course therapy program or to a waiting list control group. Intervention group experienced greater reduction in depression symptoms than the control group, and the effect was maintained by three months follow-up (Bedard a.o., 2014).

Summarization of scientific evidence: Thus, no studies have been found regarding mindfulness based treatment of child and youths with brain damage. But, on the other hand five studies, including only a single randomized and a single controlled study, which has used either MBSR or

MBCT as intervention in relation to consequences of acquired brain damage in adults. The few studies show tendency to the idea that people with acquired brain damage can profit from a mindfulness-based intervention in relation to both depression, improvement of attention as well as quality of life.Other publications: In recent years a number of specialist books have been published (for example, (Justesen, 2012)), about mindfulness-based methods used in the work with healthy children and youths, and several authors refer to positive experiences with this type of effort, but there is only built on limited scope for scientific results. Mindfulness is thus a possible tool in the context of acquired brain damage, but more studies are still necessary in order for a clear picture to be drawn of what kind of mindfulness works and for whom it works.Summary: There is no convincing evidence for either positive or negative effect, when using mindfulness based methods in the work with children and youths with acquired brain damage. Many clinics report positive experiences with the use of the methods. It may be appropriate to involve mindfulness-based methods, as one among several possible therapeutic tools in the work with children and youths. Efforts must however as always, be selected according to neuro technical and individualized analysis of the patient’s current needs.

List of references

Azulay, J., Smart, C. M., Mott, T., & Cicerone, K. D. (2013). A pilot study examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/post-

concussive syndrome. J. Head Trauma Rehabil., 28, 323-331.

Bedard, M., Felteau, M., Marshall, S., Cullen, N., Gibbons, C., Dubois, S. et al. (2014). Mindfulness-based cognitive therapy reduces symptoms of depression in people with a traumatic brain injury:

results from a randomized controlled trial. J.Head Trauma Rehabil., 29, E13-E22.

Cole M. A., Muir J. J., Gans J. J., Shin L. M., D'Esposito M. and Harel B. T. a.o. (2015). SimultaneousTreatment of Neurocognitive and Psychiatric Symptoms in Veterans with Post-Traumatic Stress Disorder and History of Mild Traumatic Brain Injury: A Pilot Study of Mindfulness-Based Stress

Reduction. Mil.Med., 180, 956-963.

Johansson B., Bjuhr H., & Ronnback L. (2012). Mindfulness-based stress reduction (MBSR) improves long-term mental fatigue after stroke or traumatic brain injury. Brain Inj., 26, 1621-1628.

Justesen S. (2012). Mindfulness for children and youths. (1 Ed.) Danish Psychological Publisher.

McHugh L. & Wood R. (2013). Stimulus over-selectivity in temporal brain injury: mindfulness as a potential intervention. Brain Inj., 27, 1595-1599.

http://www.hjernesagen.dk/media/46442/HjerneSagen-Januar-2013-faerdigt.pdf

Children with brain damage needs an invisible hand on the back- Otherwise they risk lacking important tools later in life, when the invisible damages have melted together with their identity and self-perception, center manager Lisbeth Harre from the Children Youth Center for Rehabilitation in Virum.

By Birgitte R. Sønderborg, journalist

A damaged child brain runs as a kind of double bookkeeping. It is in full swing with a normal learning concurrently with the brain having a damage, which requires support to retraining and compensation. A complicated process that periodically should be prompted and followed up by professionals with neuro professional insight and knowledge.

The municipalities can refer the children to this follow-up in the rehabilitation. BCFR, Children Center for Rehabilitation in Virum has as one of the few in the country in this offer. In addition to rehabilitation in team-based, coordinated cooperation of neuro academic educated staff, they also offer ongoing supervision of the intervals, which is deemed necessary. “But we experience that the municipalities increasingly take the tasks home to their own system.

The municipalities maybe use us, when the child’s problems have evolved violently. It is not enough, and it does not give us the opportunity to create coherence and systematic in the effort towards the child. This we need, if we have to go in and fix something in time,” she says.

A children’s life in taxiI the special offers the whole effort gathered in one place, while it often becomes “a children’s life in taxi” under the planning of the municipalities, because there can be problems with placement in school in relation to the child’s residence, and the child must be transported between different training offers.

“That in itself is of course not so fun for the children, but there is also going to be lack of environment, where they meet others of their own age in the same situation. Even if the

municipality has a healthcare center, typically older children and youths will not be near something that resembles nursing homes. We create a functional place with café, kitchen and surroundings, which they feel at home in,” she says.

She acknowledges that finance is an important factor in the distressed municipalities, but when the volume in the group of the damaged children from 1 to 18 years is so small, it makes no sense to make it a task for the 98 municipalities. “Even if many municipalities introduce brain scan coordinators, these often do not have the expertise within the children and youth area. Therefore there is no way around it. We, who manage the special offers, and the municipalities must be able to cooperate and put our skill in play at the same time that we keep ourselves within a realistic economic frame. We just

The target group for Rehabilitation is children and youths with acquired brain damage as well as children and youths with adjacent complex issues. A course is organized individually in cooperation with the municipality and the family.

An interdisciplinary team is responsible for among other things elucidation, intensive rehabilitation and rehabilitation and retraining with inclusion of family and friends, preparation of trade and education papers. The price depends on the course’s duration and intensity.Read more at www.bcfr.dk

have to lower our guard and drop some myths about each other.”

Right now, the centers are mostly used for investigation and counselling through VISO, the National Knowledge and Counselling Organization, where the specialists from the center in

Virum are affiliated as consultants. The actual referrals to the specialised children centers with longer courses becomes fewer and

fewer, which has meant a significant reduction in staffing and offer at the center in Virum. “The development should be stopped for the children’s sake. We do not keep on existing, if the municipalities only use us sporadically. Common basic research must be possible, so we can get an existence basis. This does not mean what the municipalities may fear, which is it gives carte blanche to the expensive solutions. We can also work within economic frames with for example shorter courses,” Lisbeth Harre says.

Clarification of double damageSeen from the child’s interests it sounds like a good idea. There is no time to spend on many misunderstandings between each other as an authority and specialized entity. Within the first two years it is important to rehabilitate. During that time, it must also be clarified whether an affected has other complications, such as e.g. ADHD. The school choice should happen on a well-founded basis.

“An inclusive school may need to be supplemented with something else. Otherwise it can be an unreasonable solution for a child with invisible damages. The family should also be included, so the obtain knowledge about their child’s condition, while they have a place to go to, where they know the child and have high neuro academic knowledge.”

Many of the activities at a specialised rehabilitation center for children happen over a yearlong period with shifting intensity according to need. Overall, all of these support points serve as an invisible hand on the back, until the youth has found themselves and accepted the level of functionality that has been possible to achieve. “Being young can be difficult enough, where many feel inadequate and different. Here are some children of various ages, who are actually different from their peers. How should they now create an identity, when their opportunities have been limited? The hard questions we help them to process concurrently with the specific rehabilitation”, Lisbeth Harre says.

- The municipalities maybe use us, when the child’s problems have evolved violently. It is not enough, and it does not give us the opportunity to create coherence and systematic in the effort towards the child, Center chief Libeth Harre says.

http://www.hjernesagen.dk/media/46442/HjerneSagen-Januar-2013-faerdigt.pdf

Children’s language damages can cast long shadowsThe problems appear years after the damage occurred, and often the speech therapeutic effort towards children with acquired brain damage too scattered and delayed

Just a few years ago, it was common assumption that children fared better through a brain damage than adults due to the child brain’s major plasticity. Today neuropsychologist and children speech therapists moderated this view “Damages, which hit an immature brain in development, cause bigger disturbances than a similar damage in an adult. When the linguistic competences is reduced, the child does not

have as many skills and experiences to fall back on,” Grethe Stærmose and Jens Reimick, both speech therapists at Children Center for Rehabilitation, tell.

Out of 1000 children, who are hospitalised as a result of an accident or disease in the brain, between 175 and 324 of them get brain damage and thereby need rehabilitation, the Danish Health Authority writes in course programs in 2011.

These children are spread among 98 municipalities, which inherently cannot by themselves offer this group a highly specialised neuro academic treatment. As an aid, the individual municipality can obtain elucidation and advice from VISO, The national Knowledge and Specialist counselling organisation, where the Children Center for Rehabilitation is VISO supplier.

Lack of specialists Even if VISO in its counselling points at the need of speech therapeutic rehabilitation, the individual municipality does not usually have this specialist on the payroll. All municipalities has speech pedagogics with knowledge and experience on Children’s linguistic development in the preschool age and can offer the parents a language screening of their 3 year old children. When a child in the school age gets brain damage, then in most municipalities there is not large enough knowledge and experience with cover and rehabilitation of linguistic difficulties. It is often an invisible disability, and it gets overlooked that the linguistic difficulties can be a significant reason for later difficulties at school.

Children with linguistic difficulties can therefore grow into the problems, if their language and speech is not assessed as immediately noticeable. They get an invisible disability, and no one around the child knows where it originates from. Nor do the municipalities that avoid to follow-up on children, who are brain damaged, and whose rehabilitation they are responsible of.

Fatal consequences can happen later in life, when children lack linguistic tools both socially and in the education system. “A child obtains an injury in the age range 6-7. After a period with training there are maybe no linguistic problems in this child’s everyday life. When the child reaches the age of 12 the difficulties appear, because here new requirements emerge the abstract language. You must be able to read between the lines and understand figure of speech e.g. “The time is running”, know that with division and multiplication you have to know the approach and understand the text in the problem-solving tasks. A brain damaged child can have

difficulties with compared to their peers,” Grethe Stærmose tells.

Cases are closed too earlyOften the school does not connect these difficulties with the previous brain damage, and then it can be really difficult for the child, who e.g. got gated inti the normal school system after the first rehabilitation. This happens in particular at lighter brain damages. Now the child is identified as healed but without actually being it. An ongoing contract with a speech therapist that has experience with linguistic difficulties of bigger children can eventually identify any language difficulties that the child can grow into. “If our suggestions are followed, we invite the children to re-test at school-start, at the age of 12 and at the end of public school or before youth education. If they lack linguistically behind, we can identify the problems and suggest a compensating effort in the child’s local environment,” Jens Reimick says.

Socially it can cause a serious break, especially when you reach puberty, where the youth can have difficulties by perceiving and understanding social codes,

- Fatal consequences can happen, when children lack linguistic tools both socially and in the education system, Grethe Stærmose and Jens Reimick says, both being speech therapists with specialisation in children’s linguistic development

humour and irony. Comments fly quickly between the children/the youths, and to function socially, you must be able to catch what is happening.

First you try to manage in smaller groups, but eventually buddies begin to

withdraw, and then the seed is sown to the social isolation, which can become a pattern for the rest of life.“Puberty is a sensitive period and the risk to develop in an unfortunate direction is huge, when you struggle with difficulties with the social language. We can

remedy it by equipping them to live with these limitations, find compensating strategies for these weaknesses and of course train to the extent it is possible,” the two speech therapists say.

https://www.densocialevirksomhed.dk/bcfr/omos/materiale/Sider/Interview-med-l%C3%A6gefaglig-konsulent-Ian-Westphall.aspx

Interview with medical profession consultant Ian Westphall

Here you can read an interview with chief physician and children neurologist Ian Westphall from Hvidovre Hospital

- Sometimes we have to start completely from scratch to convince especially the smaller municipalities that rehabilitation is not just about the physical, but also about the cognitive. Some case workers lack knowledge about brain damage and experience with the treatment of them, so it can be hard to get running, especially in the most fragile part in the treatment course of a child with severe acquired brain damage, namely the period just after discharge for the hospital. But luckily it normally works.

This chief physician and children neurologist of Hvidovre Hospital children department, Ian Westphall says. Here he is connected to the Department of Highly Specialised Rehabilitation/Traumatic Brain injury, and at the same time he is medical profession consultant of the Children Center for Rehabilitation. Half a dozen children and youths with severe acquired brain damages are hospitalised at the department during a year.

- The municipalities do not always get a rehabilitation offer established just after the discharge from the hospital, Ian West phall says. It maybe happens once a year, and we have in very few cases experience that the municipality has said no the rehabilitation course, we have recommended.

In that situation the children cannot stay hospitalise, when they are finished being treated in Hvidovre. Then they must be discharged to the home, without agreements on rehabilitation and financing.

According to Ian Westphall it is worst for children and youths at school age, when they just have to sit at home. It is stressful for both the brain damaged and the family. Only very few are discharged to instituation – the majority gets sent home after the treatment.

Municipal caseworkers are involved from the outset- We keep focus on involving the municipal case workers from the outset, also to avoid breaks in the rehabilitation after discharge. We cannot decide, what will happen after the discharge, but we can clarify the individual child’s need to municipality and parents.

- Do not be content with the fact that most recover reasonably in physical context. It is important to understand that the cognitive problems of brain damaged children often first becomes clear gradually, for example when the child is at the school age, and there are greater demands for cognitive abilities, Ian Westphall says.

- We try – just like the Children Youth Center in Virum – to use the whole palette so the children are not just treated medically and physically, but also trained in cognitive abilities, for example linguistically and socially. Therefore we are happy that there exist institutions such as the Children Youth Center, we can recommend parents – and municipalities – to send children with severe acquired brain damage to.

Parents get involved in the rehabilitation - We can document that children and youths with acquired brain damages feel better and become more healthy, when they have been through a holistic oriented rehabilitation as the one we offer, Ian Westphall emphasizes

- Sometimes you have to wait for a long time, both months and years, before the children get better. But they tend to gradually, so you should never take the hope from the parent, he says.

Ian Westphall puts huge emphasis on involving the parents in the rehabilitation of the children. The philosophy is the same as at the Children Youth Center for Rehabilitation: That the chance for a successful rehabilitation is bigger, the more the parents are involved, so they can use the same methods at home, which has proven itself effective at the hospital.

- While the children are hospitalised here, the parents almost always also live here, either in the department, especially in the beginning, or later at the patient hotel. We try to ensure a smooth transition until the discharge – i.e. that the children are home at weekend leave to get the family used to it, he tells.

Ian Westphall does not release the children, when they have been discharged. For example he follows by reading the status reports for the individual children, the Children Youth Center for Rehabilitation send him, and he also regurlarly visits Virum as a medical consultant.

Facts about the department for traumatic brain damageIt is only a few years ago that you seriously recognized the need to specialize and centralize the rehabilitation of children with severe acquired brain damages. One of the results was the

establishment in 2000 of a number of beds for children at the Department for Highly Specialized Rehabilitation/Traumatic Brain damage as it is called officially.

The department has 22 beds, of which are four to children, and it receives patients from the whole of Eastern Denmark and from Greenland/Faroe Islands. Hammel Neurocenter has the corresponding function to the west of the Great Belt.

Half a dozen of severely brain damaged children and adolescents aged 1-18 years are treated at the department annually. They have typically been out for:

Traffic accident Choking Drowning accident Bleeding/blood clot in the brain Cardiac arrest Meningitis

At the hospitalization, the children are consciousness affected and can have pronounced neurological symptoms for example paralysis and lifted sink function. Most children are moved to Hvidovre after a primary hospitalization at Rigshospitalet e.g. neurosurgery department

Additionally to the medical treatment, the department offers rehabilitation both physically, linguistic, school wise, socially and communicative.

The Children Department I Hvidovre runs research e.g. in therapeutic treatment of brain damages in cooperation with American colleagues, and education of children physicians (podiatry – a highly sought after speciality) is another important work task for the department.

A big part of the children and youths, who initiate a course at the Children Youth Center for Rehabilitation, come from the department for traumatic brain damage in Hvidovre.

https://www.b.dk/nationalt/hvorfor-slaar-det-ikke-det-hjerte

Why does it not beat that heart?The story about Olivia Priomdahl Lund is the story about people, who made the right choices at the right time and saved a small girl’s life. Two of them are nominated to the Heart Association’s price, »the year’s heart saver«.

By Peter Berhøi pbu@berlingske.dk and, Photo: Linda Kastrup, lih@berlingske.dk

Six unanswered calls.

Andreas look at the message on his phone. He will call up quickly.

»Karina, what is going on?«

»It is Olivia. I do not know. Stay there, I am on my way,« his ex-wife says, the mother to his daughter Olivia, in the tube.

They put on, but Karina will call back a few minutes later. Something serious has happened.

The second after Andreas Lund jumps down the stairs, out on Islands Brygge, into a taxi, over the bridge, through the city towards Østerbro and Rigshospitalet.

He runs down a long hallway. It feels endless. Bursting through the door at the end.

»You should wait here, no, you should wait her,« the physicians and nurses say.

Those are not the words that Andreas wants to hear.

In the hall Wednesday the 6. January 2015 is a silent winter day as most, but in the Virum hall north of Copenhagen the pulse is high.

»Water break,« the class teacher Sven Frederikswen yells at the youths from 4.B at Fuglesanggårdsskolen in Virum, then he puts teams to floorball. »Engage.«

After a few minutes, Olivia a dark-blond ten-year old with glasses and a great love for horses comes out to her class teacher on the sidelines, sits down beside his side and quietly leans on him. Normally she is energetic. Always moving.

»Well, are you tired,« he asks.

»Yes, I have to sit down a bit,« she answers.

There they sit beside each other and look. Suddenly Olivia leans her head further over Sven Frederiksen. Then she falls down into the lap of him.

»What is going on, Olivia. What is going on?«

He raises his voice – »come on Olivia!« - But she did not react. Sven takes a closer look, Olivia remains lying. Now he sees the froth around the mouth. Is it a seizure? She should be in recovery position.

Olivia, wake up. Wake up, he thinks.

He turns Olivia around and lays her on the back on some chairs in the hall. The class mates continue playing. Is there a pulse? Does she breathe? He is unsure. He does a harder approach, nudging her, shaking her, puts his hands together and puts them on Olivia’s chest. And pushes. Again. And then again. She reacts! Ssshhhhphuuuhh. Ssshhhhphuuuhh. Huge, deep sighs hisses out of the small girl’s mouth.

»What is happening,« the class mates ask. The game has stopped.

Sven Frederiksen needs help. »Get help.«

Deep sighs.

It is crazy, he thinks.

He continues with pushing Olivia on the chest. One-two-three.

Come on it must not be this way, he thinks.

»No reaction«»Is the teacher not down there,« asks Jan Garben, a hall employee in Virumhallen.

»Yes, but they must come,« the children who were sent to get him answer.

Inside the hall Jan Garben sees a teacher sit with Olivia on one of the chair rows.

»What is wrong?« he asks. But he knows, Olivia is completely grey in the face.

Jan Garben takes over, rubbing the girl on the thorax. The seconds pass. No reaction. Down on the floor, she must lie flat, he thinks. Jan Garben has been on a course for CPR three weeks earlier.

“We must do CPR. Has she swallowed the tongue?” he says loudly.

Jan Garben continues with massaging the heart, while Sven Frederiksen calls 112.

Two employees in the hall come in with a defilibrator. Jan Garben puts it on. And then peace. The defilibrator takes over. Analyses the heart. Measures the pulse. Looking for heartbeat. It encounter. New analysis.

“No reaction – continue heart massage,” it appears on the display. “No reaction.”

Can I arrive?

At her job Olivia’s mother, Karina Primdahl has just come back from lunch. She checks her telephone. Ah, it is Olivia’s teacher, she sees at the display. Maybe Olivia is a bit ill?

“Sven, Sven, can I arrive?” she asks.

On her way in the car, she calls again and again to Olivia’s father. Occupied. Occupied. Occupied. She put the telephone up to the ear, clamps it between cheek and shoulder. Hands on the wheel. From Herlev towards Virum, it takes a few minutes she knows. The telephone beeps occupied. Hang up Andreas. Later she will only be able to remember the drive in fragments. She drives way too fast. Ends on the lawn outside Virumhallen. There is a big ambulance – and a small one. Shit. This right here cannot be good. A small ambulance brings the ambulance physicians faster around at serious cases, this she knows. The Hal employees guide. The school’s principal stops her five metres from Olivia.

“You cannot do anything Karina,” he says.

There she stands. She sees the Falck-men working on her daughter. She freezes her gaze at Olivia and discovers that her lips are blue. The same are her toes.

https://www.densocialevirksomhed.dk/bcfr/omos/kontakt/Sider/default.aspx

Contact usHere you can find contact information at the Children Youth Center for Rehabilitation

Secure mail

When you send mail to the Children Youth Center, it should be as secure mail – so personal information stay personal. You can send mail to the Children Youth Center’s main mailbox: bcfr@hav1.regionh.dk

AddressThe Children Youth Center for RehabilitationKongevejen 2562830 Virumbcfr@hav1.regionh.dk

EAN no.: 5798001480598

TelephonePhone: 45 11 51 00Monday – Thursday 8.00 – 14.00Friday 8.00 – 13.00

Find route

Contact to the employees

The employees at the Children Youth Center for Rehabilitationhttps://www.densocialevirksomhed.dk/bcfr/omos/kontakt/findvej/Sider/default.aspx

Find routeFind route to the Children Youth Center for Rehabilitation

How to find your way to the Children Youth Center

See the map

With public transport

Virum S-train station is approx. 10 min. walk from the Children Youth Center

The bus lines 184 and 190 stops close at the Children Youth Center.

Bus line 184 drives between Nørreport st. and Holte st. Bus stop: Frederiksdalsvej. It drives every 20 minutes during the daytime..

Bus line 190 drives between Lyngby st. and Holte st. Bus stop: Kongevejen. It drives every 30 min. during the daytime.

With car:

The Children Youth Center has own parking space. Parking is free.

https://www.densocialevirksomhed.dk/bcfr/nyheder/Sider/default.aspx

NewsHere you can read news from the Children Youth Center for Rehabilitation.Life with brain damageTogether with their families, Silas and Christina give an insight into the life with brain damage

7. APRIL 2017 / 13:24

The Children Youth Center is at the top of the municipal satisfaction surveyThe Children Youth Center has participated in a bigger satisfaction survey, where caseworkers from visitation municipalities are asked into their satisfaction with e.g. services, competences and cooperation.

17. JANUARY 2017 / 10:35

Visit from HjernesagenHjernesagen came to visit and had construction toys for the children

5. SEPTEMBER 2016 / 9:50

The Children Youth Center lowers the rates in 2016The Children Youth Center for Rehabilitation lowers the taxes in second year in a row on intensive rehabilitation including elucidation, consultancy and interdisciplinary reassessment (retest).

14. December 2015 / 12:35

RSS

https://www.densocialevirksomhed.dk/bcfr/nyheder/Sider/Silas-og-Christina-givet-et-indblik-i-livet-med-hjerneskade.aspx

Life with brain damage Together with their families, Silas and Christina give an insight into life with brain damage

7. April 2017, KL 13:24

In cooperation with the Capital Region – Grasp Life gives Silas and Christina who both come daily at the Children Youth Center for Rehabilitation, an insight into life with brain damage. Together with their families, they tell about how they tackle everyday life, about the struggle for a normal life, and what has been important for the family. See the films here.

https://www.densocialevirksomhed.dk/bcfr/nyheder/Sider/Stor-kommunal-tilfredshed-med-B%C3%B8rneungecenteret.aspx

The Children Youth Center is at the top of the municipal satisfaction surveyThe Children Youth Center has participated in a bigger satisfaction survey, where caseworkers from visitation municipalities are asked into their satisfaction with e.g. services, competences and cooperation.

17. January 2017, KL 10:35

The survey shows that the Children Youth Center’s cooperation municipalities are satisfied with the quality and the cooperation with the Children Youth Center around the child or the youth’s rehabilitation course. As a whole 86 percent respond that they to a high degree are satisfied with the cooperation and 14 percent are satisfied to a huge degree.

Read all the result here:https://www.densocialevirksomhed.dk/bcfr/nyheder/Documents/B%C3%B8rneungecenter%20for%20Rehabilitering_2016%20(2)_rapport.pdf

https://www.densocialevirksomhed.dk/bcfr/nyheder/Sider/Bes%C3%B8g-fra-Hjernesagen.aspx

Visit from HjernesagenHjernesagen came to visit and had construction toys for the children

5. September 2016, 9:50 o’clock

It brought the children in the playgroup, when Hjernesagens chairman, Lisa Beha Erichsen was visiting and shared new construction toys from the Danish firm BAKOBA. Read more about the visit at Hjernesagens website (Danish).