Citation

Ryan NP, Reyes J, Crossley L, Beauchamp MH, Catroppa C, Anderson V. J. Neurotrauma 2019; ePub(ePub): ePub.

Affiliation

Murdoch Childrens Research Institute, Child Neuropsychology, Critical Care and Neurosciences, Parkville, Victoria, Australia ; vicki.anderson@rch.org.au.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.6308

PMID

31038001

Abstract

Social dysfunction is a common and disabling outcome of childhood traumatic brain injury (TBI); however the mechanisms that link early brain injury to impaired social behavior are unclear. This longitudinal prospective study involved 129 children, including 86 children with TBI (53 mild, 33 moderate-severe TBI) and 43 age-matched typically developing control children (TDCs). Children with TBI were recruited via consecutive admissions to the emergency department of the Royal Children's Hospital, Melbourne Australia. At 6-months post-injury, all participants were assessed on measures of intellectual functioning and parents provided ratings of children's self-regulation skills using gold standard measures of everyday executive function. At 12-month follow up, parents rated children's social adjustment using standardized measures of social skills, communication and behavior. As expected, children with moderate-severe TBI were rated by parents as having greater self-regulation problems, worse social skills, and poorer communication than the mild TBI and TDC groups. In mediation models, greater self-regulation problems at 6-months post injury were predictive of poorer social skills and worse overall social adjustment at 12-month follow-up. Moreover, self-regulation skills mediated the effect of moderate-severe TBI, but not mild TBI, on social skills and overall social adjustment. Our findings show that while deficits in social adjustment are common at 12-months post moderate-severe child TBI, the impact of TBI on these outcomes is likely mediated by its effect on self-regulation skills. Evidence for robust prospective associations between self-regulation deficits and later social adjustment difficulties have implications for early identification of children at high-risk for chronic social problems.

Language: en

Keywords

NEUROPSYCHOLOGY; OUTCOME MEASURES; PEDIATRIC BRAIN INJURY