{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T05:16:50Z","timestamp":1777785410547,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T00:00:00Z","timestamp":1578441600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Am Psychiatr Nurses Assoc"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>INTRODUCTION: Concussions as a result of mild traumatic brain injury (MTBI) in youth are often associated with athletic injury; however, they can also occur as a result of intentional self-injury by head banging. Despite the known neurological sequelae secondary to MTBI, assessment, interventions, and consequences of head banging in the nonintellectually disabled populations have not been well studied. AIMS: The intent of this nurse-led intervention was to develop a brain rest protocol at a residential treatment program serving youth who were between 12 and 19 years old in order to improve the quality of care and moderate negative sequelae resulting from MTBI. METHODS: A nursing assessment guided by an adaptation of the acute concussion evaluation and a strength-based intervention protocol was developed and applied to youth who engage in head banging. RESULTS: The result was a protocol that defined the process by which a youth would be assessed and treated after head banging. There are no outcome measures that would assist to measure the effectiveness of this intervention in the short or long term. CONCLUSION: This intervention filled a need for improved assessment and appropriate interventions in youth with head-banging behavior. It is feasible that the assessment and implementation of the brain rest protocol is the first step in understanding how to best evaluate and manage the sequelae of intentional head banging resulting from MTBI.<\/jats:p>","DOI":"10.1177\/1078390319897988","type":"journal-article","created":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T03:58:20Z","timestamp":1578455900000},"page":"282-287","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Implementation of a Brain Rest Protocol in Nonintellectually Challenged Youth With Head-Banging Behaviors"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2152-073X","authenticated-orcid":false,"given":"Lori","family":"Keough","sequence":"first","affiliation":[{"name":"Lori Keough, PhD, MEd, FNP-BC, PMHNP-BC, NFI Massachusetts, Danvers, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Gardner","sequence":"additional","affiliation":[{"name":"Susan Gardner, BSN, RN, NFI Massachusetts, Danvers, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"Kirby","sequence":"additional","affiliation":[{"name":"Alyssa Kirby, BSN, RN, NFI Massachusetts, Danvers, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,1,8]]},"reference":[{"key":"bibr1-1078390319897988","unstructured":"Centers for Disease Control and Prevention. (2014). Symptoms of traumatic brain injury. Retrieved from www.cdc.gov\/traumaticbraininjury\/symptoms.html"},{"key":"bibr2-1078390319897988","unstructured":"Centers for Disease Control and Prevention. (2018). What is a concussion? Retrieved from https:\/\/www.cdc.gov\/headsup\/basics\/concussion_whatis.html"},{"key":"bibr3-1078390319897988","unstructured":"Centers for Disease Control and Prevention. (2010). A fact sheet for school nurses. Retrieved from https:\/\/www.cdc.gov\/headsup\/pdfs\/schools\/TBI_factsheet_NURSE-508-a.pdf"},{"key":"bibr4-1078390319897988","unstructured":"Gioia G., Collins M. (2006). Acute concussion evaluation (ACE): Physician\/clinician office version. Retrieved from https:\/\/www.cdc.gov\/headsup\/pdfs\/providers\/ace-a.pdf"},{"key":"bibr5-1078390319897988","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828d57dd"},{"key":"bibr6-1078390319897988","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828d57dd"},{"key":"bibr7-1078390319897988","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2017.04.016"},{"key":"bibr8-1078390319897988","unstructured":"National Conference of State Legislators. (2018). Traumatic brain injury legislation. Retrieved from http:\/\/www.ncsl.org\/research\/health\/traumatic-brain-injury-legislation.aspx"},{"key":"bibr9-1078390319897988","doi-asserted-by":"crossref","unstructured":"Prins M., Greco T., Alexander D., Giza C. C. (2013). The pathophysiology of traumatic brain injury at a glance. Disease Models & Mechanisms, 6, 1307-1315. Retrieved from https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3820255\/","DOI":"10.1242\/dmm.011585"}],"container-title":["Journal of the American Psychiatric Nurses Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078390319897988","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1078390319897988","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078390319897988","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:43:54Z","timestamp":1777491834000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1078390319897988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,8]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1177\/1078390319897988"],"URL":"https:\/\/doi.org\/10.1177\/1078390319897988","relation":{},"ISSN":["1078-3903","1532-5725"],"issn-type":[{"value":"1078-3903","type":"print"},{"value":"1532-5725","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,8]]}}}