Options for the recovery of mental activity in children after acute brain damage

INTRODUCTION: Children with acute brain damage make up a large group of patients who require multi-stage rehabilitation. Rehabilitation requires the creation of special conditions for psychiatric care and psychological and pedagogical correction of the consequences of severe damage to the nervous system. OBJECTIVES: To identify the options for mental activity during the restoration of the level of consciousness in children after acute severe brain damage. METHODS: 210 children under the age of 18 with severe brain damage (traumatic brain injury, hypoxia, hydrocephalus). Clinical-psychopathological, pedagogical methods were used; additionally diagnostic scales, questionnaires. RESULTS: 4 groups were formed: 1st 37 (18%) patients had manifestations of mental activity with physical, cognitive and social capabilities in the minimal consciousness “+” (a- / hyperkinetic mutism with emotional reactions, understanding of addressed speech); 2nd 67 (32%) - manifestations of physical and cognitive abilities with minimal consciousness “-” (a- / hyperkinetic mutism without reactions); 3rd 95 (40%) - only the manifestation of physical capabilities at the exit from the vegetative status. 4th 11 (10%) - a low manifestation of mental activity in the form of physical capabilities with a vegetative status. CONCLUSIONS: 4 variants of mental activity in children after acute severe brain damage have been identified: from minimal involuntary reactions or their absence in vegetative status to voluntary actions according to the instructions of an adult in minimal consciousness “+”. Taking into account the variability of mental activity helps to differentiate the methods of psychiatric and psychological-pedagogical assistance in the recovery of children already in the early stages of rehabilitation.