in Brain Injury Group News, News.

All Brain Injury Group training events book up quickly, but one of the most popular year after year is Child Brain Injury.

The speakers at the April 2018 event represented a breadth of interests as usual, and offered expertise and insight that appealed to an equally diverse audience that included claimant and defendant solicitors as well as health and social care professionals.

Drawing on 25 years’ experience of catastrophic injury cases, Gerard Martin QC addressed the question of when it’s safe to settle a case that involves a child. As you would expect, it very much depends on the severity of the case, although it is no longer standard practice to wait until a severely injured child reaches adulthood when it’s clear from early on that 24/7 care is likely to be required; he suggested that a good time to settle in this instance would be as the child transitioned from primary to secondary school age enabling families to move on.  Earlier settlements achieved through consensual litigation which is co-operative rather than adversarial also reduces the ultimate cost to the insurer, which provides another incentive to settle.

Less severe injuries are often more complex to settle because the future is more difficult to predict, and these are likely to be the ones that are deferred until the child has gone through school and would normally be entering the world of work.

Gerard also touched on other factors that affect the decision to settle including cultural issues, and the difficulties of managing the expectations of parents who always hope to see some improvement in their child’s condition.

Dr Peter Tucker, Consultant Clinical Psychologist, of Recolo together with Sarah Fleming, Specialist Neuro Speech and Language Therapist, considered the problems with assessing cognitive ability and emotional problems when a child has communication issues. They discussed the two key routes – standardised and contextual assessments – and emphasised the need to be clear about identifying the question from the outset to determine the best way of answering it.

Public funding of health and social care is a minefield navigated daily by Carole Chantler; she also spoke about the provision of Education Health & Care Plans (EHCP).  The area is further complicated by the fact that as children transition to adulthood, their support will need to be re-assessed and there are no guarantees that they will receive the same degree of assistance.  Carole stressed the need to be persistent to chase and challenge funding decisions, and the importance of approaching adult social services and CCGs when the injured child is in their mid-teens to ensure that care is not interrupted as they turn 18.

Professor Seena Fazel of the University of Oxford described the results of a number of studies looking at the long term of outcome of brain injury in childhood, and particularly in relation to crime given that 50% of men in prison complain of having suffered a brain injury.

The best sources of statistics currently are Scandinavian countries and Australia which suggest that a traumatic brain injury increases the chances of an individual being involved in crime threefold.  Research involving siblings similarly indicate a higher risk of criminal activity following a traumatic brain injury in childhood.  Professor Fazel highlighted the need for children that do present with traumatic brain injury to undergo systematic follow in respect of a number of outcomes – including education and social factors – up as they mature.

ILS’s Lindsay Oliver looked at the impact of having a child with disabilities can have on a family, and how the family can be supported.

Having a child with disabilities can lead to significant social isolation for the family with 20% of families reporting that isolation has led to the breakup of family life (Forgotten Families, Contact a Family).

Typically, families that have experienced a catastrophic injury are not only trying to manage their grief as they come to a form of acceptance of a situation and a future that they hadn’t anticipated, whilst also dealing with a personal injury claim.

Lindsay explained how good case management and communications can help to manage the family’s expectations, and that there was value to including family and couple therapy within any care package negotiated; it is also the case that rehabilitation within the daily family life delivers better outcomes for the child affected.

Finally, Court of Protection specialist Christine Bunting of Hyphen Law talked about managing interim and final payments in child brain injury cases, the use of trusts and the appointment of deputies and trustees.

The next training event in our schedule takes place on 5 June and will look particularly at hydrocephalus and clinical negligence.  You can find more information here.