Encephalitis in children is in some ways the same as encephalitis in adults but is also very different. The causes of the illness are the same although children can be more susceptible to some types such as post-infectious encephalitis. This is simply because children tend to pick up more infections than adults. It is different because any trauma to a child’s brain, which is still developing is different to an adult’s brain, which is fully developed. The implications of this are extremely important. The effects of encephalitis in a child’s brain could occur in an area which is already fully developed and functional, or it could occur in an area going through the process of development or in an area which will not develop fully for a number of years. It is also possible that a number of different areas of the brain, each at different stages of development, have been affected. It therefore follows that some problems will be evident immediately following the illness, whilst it may be years before others become noticed. As this could be many years after the illness, a connection may not be made.
As with adults, problems with the cognitive (thinking) functions of the brain are most common after encephalitis. However in children, who may have difficulty expressing themselves, this may more often result in behavioural problems.
Managing difficult behaviour, that is not typical of the child before the illness, can be very stressful for parents and disrupt family relationships. The usual parenting skills may not be sufficient to manage this behaviour. Parents may need specialist help and support to deal with the behaviour and the emotional consequences it can bring.
A Neuropsychological assessment is helpful. It will identify the type and severity of any problems, especially in cognition and behaviour. The findings will help to understand changes in behaviour and guide how that behaviour should be managed both at home and at school. Assessments will need to be repeated throughout the child’s development to determine any emerging problems and make changes to management and strategies.
Meeting the educational needs of children affected by encephalitis can also be a challenge. It is the process of new learning that is most often affected by encephalitis. Even if children regain all previously learnt skills, gaining new skills can take longer. Many children who have been ill with encephalitis are well aware of this in terms of their schoolwork appearing harder than before. The provision of extra support and strategies will need to vary according to the nature and severity of their difficulties over time. Reviewing with schools is vital at the end of each year.