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CINDY ELLEN RUSSELL / CRUSSELL@STARBULLETIN.COM
Five-year-old Aliyah Taimatuia, center, playing with her brother Josiah, 10, left, and sister Aisha, 7, suffered brain damage after falling more than 17 feet when she was almost 2 years old. Despite her injuries, Aliyah talks and plays with her siblings actively.



Brain injury
doesn’t stop girl

Five-year-old Aliyah Taimatuia
fell more than 17 feet when she
was nearly 2 years old


No one would think the 5-year-old girl had a brain injury as she chatted about Chuck E. Cheese restaurant or her Halloween princess costume, "a pink one."

Aliyah Taimatuia was two weeks short of her second birthday when she ran through unsecured swinging doors in a warehouse, her father's workplace, and fell more than 17 feet onto a concrete floor.

Her older sister, Aisha, was right behind her but stopped before plunging through the door, said their mother, Kisha Skeen.

Hawaii has no registry for pediatric brain injuries, but nationally, 1 million children sustain such injuries every year, said Mary Isley, medical case manager and advocate specializing in brain injury.

The leading cause of brain injury for kids under 5 is a fall, she said. The child may appear OK, and parents "don't really know there has been (brain) damage until they have a hard time reading and writing in school," Isley said. "Teachers think they have a learning disability."

Skeen said she was doing volunteer work at Kuakini Hospital when Aliyah's accident occurred March 7, 2000. The children were having lunch with their father, Amate Taimatuia, in the lunch room on the second floor of the warehouse.

The shocked father called and told her their daughter was unconscious, Skeen said. "From what they say, she was just lying there, with food in her mouth."

The child was taken to the Queen's Medical Center with a fractured skull. Skeen met her there. "For a couple days after, I blacked out," she said. "I couldn't remember driving."

The morning after the accident, she said, a doctor suggested surgery to remove part of the brain to relieve swelling putting pressure on it. A big blood clot and some brain tissue already had been removed.

The surgeon said Aliyah could die if the pressure was not relieved but that he could not guarantee she would survive the surgery, and if she did, her left side could be paralyzed, Skeen said.

"He gave us an hour to decide. Both of us agreed to wait it out and hope and pray it wouldn't swell up more."

Aliyah was transferred to Kapiolani Medical Center for Women & Children, where she was unconscious for two weeks, her mother said.

Skeen put aside plans to attend college and study to become a medical assistant and stayed home to care for her daughter.

She had to learn to feed Aliyah through a tube in the nose. "She would scream every time."

Aliyah landed on the right side of her head, which caused the left side of her body to be weak but not paralyzed, Isley said. "She can't use her arm. It just hangs there. She does walk, but with a lopsided gait."

She wears an ankle brace to hold her left foot up so she won't trip over it, Isley said.

The left side of each eye is blind, and she has had to learn how to scan the environment from the right side of her eyes to make sure it's safe for walking, Isley said.

But none of those disabilities seems to hold her back. "She's an absolutely beautiful, social little girl," Isley said. "She has a terrific personality."

She attends Manana Elementary with her sister, Aisha, 7, and brother, Josiah, 10.

"We're starting her in regular ed (classes) to see how she does," her mother said.

Isley said Aliyah loves school and is doing well. But the outcome from a pediatric brain injury can rarely be predicted because, unlike a brain-injured adult, a child does not have information to draw on, she said. "A lot of things she's learning for the first time."

The girl has received intensive physical, occupational and speech therapy at the hospital, at home and continuously at school, Isley said.

She also goes to Shriners Hospital for X-rays and evaluation to make sure her spine is straight. "It's more difficult as she grows because her body is kind of off balance."

As Aliyah matures, Isley said, she will probably experience anxiety, irritability and depression because she will go through the regular things every kid goes through, with the added complications of physical disabilities and brain injury.

Memory is always a problem with brain injury, she said, adding that she is working with the therapists and school on different strategies to address that.

Aliyah also has a mind of her own, Isley noted, recalling how she and Skeen tried to get her to use a child walker with a wheel in front and she refused.

"She's a little boss," her mother said, as the child demanded, "Call me tita."

Skeen said Aisha and Josiah have helped a lot with their sister, playing with her when she was younger so she would not be lonely or bored.

But Aisha came to her crying once because she was not getting as much attention, Skeen said. "She said she wished she had fallen so we would love her like Aliyah."

Now that Aliyah is in kindergarten, Skeen hopes to return to college but said: "I always want myself to be near in case I get a call. She is at risk of having seizures and falling."

She fell over a ball in the house, whacked her head on the corner of a table and had to have her head stitched, Skeen said. "Little things like that scare me. I want to be nearby."

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Brain injury and children

>> About one-third of all pediatric injury cases are related to brain injury -- the most frequent cause of disability and death among children in the United States.
>> Falls from changing tables, cribs, furniture, windows, balconies, porches, playground equipment and other sources are the leading cause of brain injury for children under 5 years old.
>> More than 89 percent of injuries from falls for children age 4 and younger occur in the home.
>> Motor vehicle crashes are the No. 1 cause of brain injury among children ages 4 to 14.

To prevent a brain-damaging fall

>> Never leave infants unattended on changing tables or furniture.
>> Never use baby walkers on wheels.
>> Use safety gates at the top and bottom of all stairs.
>> Lock all unopened windows. Move chairs and furniture away from windows.
>> Always supervise children, and do not allow them to sit on ledges.

To prevent motor vehicle injuries

>> Use correctly installed child safety seats.
>> Place infants and children under 12 in the back seat.
>> Infants age 1 and under or weighing less than 20 pounds should ride in rear-facing child safety seats in the back seat.
>> Never put an infant in the front seat of a car with passenger-side airbags.
>> Children weighing 20 to 40 pounds should ride in approved car seats facing forward in the back seat.
>> Children weighing 40 to 80 pounds should ride in approved car booster seats in the back seat.


Source: Brain Injury Association. For more information or support services, call the Hawaii association, 524-9399, or visit www.biausa.org/Hawaii

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