Rehabilitation of the head-injured child: basic research and new technology

The view that brain damage in children is less impairing than equivalent damage in adults is no longer acceptable. However, it is acknowledged that recovery following brain damage, when it does occur, owes much to the plasticity of the brain and that the young brain displays greater plasticity than the mature brain. To maximize brain damage recovery in children we need to focus both on what is known about brain plasticity and how to influence it. Research on environmental enrichment in rats has told us that enforced interaction with a complex environment can both stimulate anatomical and biochemical plasticity and ameliorate some of the behavioural consequences of brain damage. The view that environmental interaction has rehabilitative value also accords with clinical experience. However, the sensory, motor and cognitive consequences of brain damage often conspire to make environmental interaction difficult. One potential solution lies in using computers to generate virtual environments tailored to the precise sensory and motor capacities of the brain-injured child. In this way children may be enabled to benefit from environmental interaction whatever their level of disability. The use of Virtual Reality (VR) in the context of rehabilitation is discussed and relevant work reviewed.