Educational support needs of injured children and their families: A qualitative study


  • Samantha Jones Trauma Office, Royal Manchester Children’s Hospital, Oxford Road, Manchester, UK
  • Sarah Tyson
  • Naomi Davis
  • Janelle Yorke



Objective: To explore the educational support needs of injured children and families.

Patients: Thirteen injured children and/or their
parents (n = 19) discharged from a major trauma centre within 12 months. 

Methods: Semi-structured interviews analysed with thematic analysis. 

Results: Theme 1: communication and information needs. Schools need help to understand the effects of children’s injuries and the adjustments required for their return to school, such as how to involve chil-dren in the more active elements of the curriculum. Thus, effective communication between the injur-ed child, their family, health and education professionals and outside agencies is needed. A specialist key-worker could co-ordinate communication and school return. Theme 2: Educational support needs. Injured children experience changes to their appearance, new symptoms, and altered physical and cognitive abilities. Their absence from school often
adversely affects their friendships. Consequently, injured children need continued access to education throughout recovery, support with learning, a flexible timetable, opportunities for social integration, involvement in all aspects of the curriculum, and environmen-tal adaptations to maintain their health and safety. 

Conclusion: Children with different types of injuries have similar needs for flexible learning and environmental accommodations. Social integration and participation in physical activity should be specific goals for school return.

Lay Abstract

Serious injuries in children can have significant impacts on their school life, which often result in prolonged absence, which may affect their success. Teachers and health professionals need to understand how to make the return to school as quick and easy as possible. To understand more about their needs when returning to school we interview-ed children with a variety of injuries and their families. Schools needed help to understand how to support injured children and the changes required for their return. These included: access to education throughout recovery, a flexible timetable, help to “catch up”, and changes to make the school environment safe. A health professional (key worker) could provide this advice and assist communication between the hospital and the school. Adjustments need to ensure that children remain with their friends and are involved in all types of school activities. 


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Peden M, Oyegbite K, Ozanne-Smith J, Hyder AA, Branche C, Rahman AF, et al. World report on child injury prevention. Geneva: World Health Organisation; 2008.

Levy AS, Wetzler M, Lewars M, Bromberg J, Spoo J, Whitelaw GP. The orthopedic and social outcome of open tibia fractures in children. Orthopedics 1997; 20: 593–8.

Roscigno CI, Fleig DK, Knafl KA. Parent management of the school reintegration needs of children and youth following moderate or severe traumatic brain injury. Disabil Rehabil 2015; 37: 523–33.

Shaklai S, Peretz R, Spasser R, Simantov M, Groswasser Z. Long-term functional outcome after moderate-to-severe paediatric traumatic brain injury. Brain Inj 2014; 28: 915–921.

Department for Education. The link between absence and attainment at KS2 and KS4:2013/14 academic year (Research Report). London, SAGE Publications Ltd 2016.

Brown RT. Handbook of pediatric psychology in school settings. Mahwah, NJ: Lawrence Erlbaum Associates Inc.; 2004.

Lum A, Wakefield CE, Donnan B, Burns MA, Fardell JE, Marshall GM. Understanding the school experiences of children and adolescents with serious chronic illness: a systematic meta-review. Child Care Health Dev 2017; 43: 645–662.

Smith J, Cheater F, Bekker H. Parents’ experiences of living with a child with a long-term condition: a rapid structured review of the literature. Heal Expect 2015; 18: 452–474.

Jones S, Tyson S, Young M, Gittins M, Davis N. Patterns of moderate and severe injury in children after the introduction of major trauma networks. Arch Dis Child 2019; 104: 366–371.

Gfroerer SD, Wade S, Wu M. Parent perceptions of school-based support for students with traumatic brain injuries. Brain Inj 2008; 22: 649–656.

Haarbauer-Krupa J, Ciccia A, Dodd J, Ettel D, Kurowski B, Lumba-Brown A, et al. Service delivery in the healthcare and educational systems for children following traumatic brain injury: gaps in care. J Head Trauma Rehabil 2017; 32: 367–377.

Hawley CA, Ward AB, Magnay AR, Mychalkiw W. Return to school after brain injury. Arch Dis Child 2004; 89: 136–142.

Glang A, Todis B, Thomas CW, Hood D, Bedell G, Cockrell J. Return to school following childhood TBI: who gets services? NeuroRehabilitation 2008; 23: 477–86.

Lundine JP, Todis B, Gau JM, McCart M, Wade SL, Yeates KO, et al. Return to school following TBI: educational services received 1 year after injury. J Head Trauma Rehabil 2020; 36: E89–E96.

Keenan HT, Clark AE, Holubkov R, Ewing-Cobbs L. Changing healthcare and school needs in the first year after traumatic brain injury. J Head Trauma Rehabil 2020; 35: E67–E77.

Minney MJ, Roberts RM, Mathias JL, Raftos J, Kochar A. Service and support needs following pediatric brain injury: perspectives of children with mild traumatic brain injury and their parents. Brain Inj 2019; 33: 168–182.

Andersson K, Bellon M, Walker R. Parents’ experiences of their child’s return to school following acquired brain injury (ABI): a systematic review of qualitative studies. Brain Inj 2016; 30: 829–38.

Roscigno CI, Swanson KM. Parents’ experiences following children’s moderate to severe traumatic brain injury: a clash of cultures. Qual Health Res 2011; 21: 1413–26.

Johnson L, Messner J, Igoe EJ, Foster P, Harwood P. Quality of life and post-traumatic stress symptoms in paediatric patients with tibial fractures during treatment with cast or Ilizarov frame. Injury 2019; 51: 199–206.

Jones S, Tyson S, Davis N, Yorke J. Qualitative study of the needs of injured children and their families after a child’s traumatic injury. BMJ Open 2020; 10: e036682.

Jones S, Tyson S, Yorke J, Davis N. The impact of injury: The experiences of children and families after a child’s traumatic injury. Clin Rehabil 2021; 35: 614–625.

Ritchie J, Lewis J, McNaughton Nicholls C, Ormston R. Qualitative research practice: a guide for social science students and researchers. London: SAGE Publications Inc: 2013.

NHS Commissioning Board. NHS Standard contract for major trauma service (all ages): Schedule 2 – The services A. Service specifications. Leeds: NHS Commissioning Board; 2013.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77–101.

Department for Education. Ensuring a good education for children who cannot attend school because of health needs: statutory guidance for local authorities. Leeds: NHS Commissioning Board; 2013.

Kirk S, Fallon D, Fraser C, Robinson G, Vassallo G. Supporting parents following childhood traumatic brain injury: a qualitative study to examine information and emotional support needs across key care transitions. Child Care Health Dev 2015; 41: 303–313.

Curtis K, Foster K, Mitchell R, Van C. How is care provided for patients with paediatric trauma and their families in Australia? A mixed–method study. J Paediatr Child Health 2016; 52: 832–836.

Mcroberts CM, Bohlen N, Wills HE. Bridging the gap: utilizing a pediatric trauma care coordinator to reduce disparities for pediatric trauma follow-up care. J Trauma Nurs 2019; 26: 193–198.

Isba R, Roscoe D, Davis N. Potential for schools-focussed long-term rehabilitation of children following complex trauma: learning opportunities following the May 2017 Manchester Arena bombing (APHA 2019 Annual meeting). (2018, accessed 3 June 2020). Available from:

Aitken ME, McCarthy ML, Slomine BS, Ding R, Durbin DR, Jaffe KM, et al. Family burden after traumatic brain injury in children. Pediatrics 2009; 123: 199–206.

Ryan NP, van Bijnen L, Catroppa C, Beauchamp MH, Crossley L, Hearps S, et al. Longitudinal outcome and recovery of social problems after pediatric traumatic brain injury (TBI): contribution of brain insult and family environment. Int J Dev Neurosci 2016; 49: 23–30.

Yeates KO, Swift E, Taylor HG, Wade SL, Drotar D, Stancin T, et al. Short- and long-term social outcomes following pediatric traumatic brain injury. J Int Neuropsychol Soc 2004; 10: 412–426.

Wade DT, Halligan PW. The biopsychosocial model of illness: a model whose time has come. Clin Rehabil 2017; 31: 995–1004.

Woodgate RL, Gonzalez M, Demczuk L, Snow WM, Barriage S, Kirk S. How do peers promote social inclusion of children with disabilities? A mixed-methods systematic review. Disabil Rehabil 2019; 1–27.

Lipkin PH, Okamoto J, Council on Children with Disabilities, Council on School Health. The Individuals With Disabilities Education Act (IDEA) for children with special educational needs. Pediatrics 2015; 136: e1650-62.

Hills AP, Dengel DR, Lubans DR. Supporting public health priorities: recommendations for physical education and physical activity promotion in schools. Prog Cardiovasc Dis 2015; 57: 368–74.

Public Health England. The link between pupil health and wellbeing and attainment: a briefing for head teachers, governors and staff in education settings. London, 2014.

Reilly JJ, Hughes AR, Gillespie J, Malden S, Martin A. Physical activity interventions in early life aimed at reducing later risk of obesity and related non-communicable diseases: a rapid review of systematic reviews. Obes Rev 2019; 20 Suppl 1: 61–73.

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How to Cite

Jones, S., Tyson, S., Davis, N., & Yorke, J. (2022). Educational support needs of injured children and their families: A qualitative study. Journal of Rehabilitation Medicine, 54, jrm00246.



Original Report