Dialogue with the patient in low consciousness state after severe brain damages

In this work we study the possibility of children communication who suffer from long-term deep altered states of consciousness (ASC) after severe brain damage. The authors developed a scale that can be used to assess the clinical psychologist in eval¬uation of patients' signaling capabilities in a vegetative state, minimal consciousness, etc. Scale Сommunication Аctivity — Bykova, Lukyanov (SCABL) has a significant correlation with the scale of Rancho Los Amiqos Medical Center Level of Cognitive Functioning (RLAS-LCF-R) and Dobrokhotova-Zaitsev scale of recovery of con¬sciousness. Scale captures a significant amount of communication signals (104 sig¬nals), a measure of their manifestations, being a sensitive tool for the objectification of recovery of children consciousness, both with verbal communication, and with¬out it. Totally 28 children who underwent severe traumatic brain injury, hypoxic brain damage and rupture of arteriovenous malformation from 3 to 16 years were involved. Each child, starting with the stabilization of his/her vital functions in the acute period of recovery and without medical sedation was held 3—5 tests. This study allows picturing not only the picture of the recovery of various communication sig¬nals (physical, vegetative, facial, gestural, verbal) after cerebral trauma, but also shows the change in children's contact with outer world. The study reveals a differ¬ence in the restoration of communication in two groups of children: who recovered to clear consciousness and remain with profound disabilities.

1. Belova A.N. Shkaly, testy i oprosniki v medicinskoj reabilitacii / Moscow: Izdatel'stvo Antidor, 2002. 440 p.
2. Bol'shaya sovetskaya entsiklopediya. T. 16 / 3-e izd. Moscow: 1974. 791 p.
3. Bratus' B.S. Ot gumanitarnoi paradigmy v psikhologii k paradigme eskhatologicheskoi. Psikhologiya i novye idealy nauchnosti. Materialy "kruglogo stola". Voprosy filosofii. 1993. No 5. Pp. 3—43.
4. Bykova V.I., Semenova Zh.B., Fufaeva E.V., L'vova E.A. Psikhologicheskaya reabilitat­siya detei posle tyazheloi cherepno-mozgovoi travmy. Neirokhirurgiya i nevrologiya detskogo vozrasta. 2012. No 2—3 (32—33), pp 161—167.
5. Bol'shoi entsiklopedicheskii slovar' / Pod redaktsiei akad. A.M. Prokhorova. 2-e izda­nie, pererabotannoe i dopolnennoe. Moscow: "Bol'shaya Rossiiskaya entsiklope­diya", 2002. 456 p.
6. Goryanina V.A. Psikhologiya obshcheniya. Moscow: Publ. "Akademiya", 2002. 416 p.
7. Del'gado X. Mozg i soznanie / Perevod s ang. Belopol'skogo L. Ya. Pod redaktsiei i s pre­disloviem professora. Smirnova G. D. Moscow: Mir, 1971. 264 p.
8. Zaitsev O.S. Psikhopatologiya tyazheloi cherepno-mozgovoi travmy/ Moscow: MEDpress-inform, 2011. 336 p.
9. Konovalov A.N., Likhterman L.B., Potapov A.A. Cherepno-mozgovaya travma. Klinicheskoe rukovodstvo: V 3 t / Moscow: Institut neirokhirurgii im. N.N. Bur­denko, 1998—2002.
10. Leibnits G.V. Metafizika. Monadologiya. Sobranie sochinenii: V 4 t. T. 1 / Seriya: Fi­losofskoe nasledie. Moscow: Mysl', 1982. 636 p.
11. Mindell A. Koma: klyuch k probuzhdeniyu. Samostoyatel'naya rabota nad soboi: Vnutrennyaya rabota so snovidyashchim telom / Per. s angl. V. Samoilova. Moscow: AST i dr., 2005. 284 p.
12. Pakhal'ska M. Priroda soznaniya: neiropsikhologicheskaya perspektiva / Moskovskii mezhdunarodnyi kongress, posvyashchennyi 110-letiyu so dnya rozhdeniya
13. A.R. Luriya. Tezisy soobshchenii. MGU. 2012. Pp 15, 124, 125. Rubinshtein S.L. Osnovy obshchei psikhologii / Sankt-Piterburg: Piter, 2002. 720 p. Tomasello M. Istoki chelovecheskogo obshcheniya / Per. s angl. M.V. Falikman,
14. E.V. Pechenkovoi, M.V. Sinitsynoi, A.A. Kibrik, A.I. Karpukhinoi. Moscow: Yazy­
15. ki slavyanskikh kul'tur, 2011. 323 p.
16. Freid Z "Ya" i "Ono". Trudy raznykh let. V 2 t. / Tbilisi: "Merani", 1991.
17. Yung K.G. Ocherki po psikhologii bessoznatel'nogo / Moscow: "Kogito-Tsentr", 2010. 352 p.
18. Bykova V.I, Fufaeva E.V., Lvova E.A. The specific nature of psychological rehabilita­tion for children after severe traumatic brain injury at the early stages of recovering consciousness // Acta Neuropsychologica. 2013. Vol. 11. No. 3, pp. 249—253.
19. Brown F.L., Whittingham K., Boyd R., Sofronoff K. A Systematic Review of Parenting Interventions for Traumatic Brain Injury: Child and Parent Outcomes // J Head Trauma Rehabilitation. 2013 Vol. 28. No. 5, pp. 349—360.
20. Tate R.L. A Compendium of Tests, Scales and Questionnaires // The Practitioner's Guide to Measuring Outcomes after Acquired Brain Impairment — / Psychology Press. Taylor and Francis Group. Hove and New York. 2010. 746 p.