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Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

Following acquired brain injury, children may require assistance with dressing and bathing because of problems with balance, changes in sensation and awareness, decreased control of their hands, or poor planning skills.

Whilst the child/young person is in the early stages of recovery (and may be confused and highly distractable) activities of daily living should occur in an environment with few distractions, and preferably somewhere that is familiar.

Knowledge of the child/young person's self-care abilities prior to the brain injury is necessary so that appropriate tasks can be chosen to incorporate into the treatment program.

Who do I see and how is it diagnosed?

Occupational therapists are able to assess children who are having difficulties in this area, and often this is done in the home environment. They will then identify the cause of the problem and work through appropriate solutions with the child and family.

What is the treatment?

  • Developing routines so that the child/young person completes these activities in a familiar way.
  • Often the child/young person needs supervision and assistance in the early stages of recovery to ensure their safety. For example they may not be able to safely monitor water temperature in the bath, or transfer in and out of the bath safely
  • As children/young people recover, it is important to encourage them to take increasing responsibility for their own self-care. The degree of independence expected will depend on the child/young persons level of functioning prior to the injury, their age, level of development and the residual physical and cognitive difficulties.
  • Repetition (frequent practice) and use of training strategies eg backward/reverse chaining, where the child/young person is trained to relearn an activity beginning with the final step and progressing backward until all steps are learnt.
  • Use of prompt sheets. These may have pictures/words to help the child/young person remember the sequence of the task.
  • Use of adaptive equipment may be necessary to accommodate for physical changes. This may include equipment such as bath seats, modifications to clothing to allow the child to more easily dress and undress (for example elastic-waisted pants) or the addition of grab rails.
  • Often the way the child/young person completes the particular activity needs to be modified - either temporarily or permanently. For example the child/young person may need to sit on a chair in the shower, if they are unable to climb into the bath. They child/young person may need to sit to dress, or learn one handed dressing techniques if they have a hemiplegia.
  • It is important to consider the safety of the carers when assisting children to complete self care tasks. For example lifting even small children, or bending over can cause a back injury to the carer which can be avoided if they are instructed as to the best way to assist the child/young person.
The Children's Hospital at Westmead Rehabilitation Department
The Children's Hospital at Westmead
Cnr Hawkesbury Rd & Hainsworth St, Westmead
Locked Bag 4001, Westmead, 2145
Tel: (02) 9845 2132 - Fax: (02) 9845 0685

© The Children's Hospital at Westmead - 1997-2013

This document was published on Friday, 6 June 2003

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