Research Reports - Social competence at two years after child traumatic brain injury

J Neurotrauma. 2017 Apr 26. doi: 10.1089/neu.2016.4692. [Epub ahead of print]

Anderson V(1,)(2,)(3), Beauchamp MH(4,)(5), Yeates KO(6,)(7), Crossley L(1), Ryan
N(1,)(3), Hearps SJC(1), Catroppa C(1,)(2,)(3).

Children with traumatic brain injury (TBI) are at risk for social impairment, but
research has yet to document the trajectory of these skills post-injury and
factors that may predict social problems. This study addressed these gaps in
knowledge, reporting on findings from a prospective, longitudinal follow-up study
that investigated social outcomes post-injury and explored factors contributing
to these outcomes at two years post-injury. The sample included 113 children, 74
with TBI and 39 typically developing (TD) controls. TBI participants were
recruited on presentation to the hospital. Parents rated pre-injury function at
that time, and all children underwent magnetic resonance imaging (MRI).
Participants were followed up at two years post-injury. Outcomes were social
adjustment, social participation, social relationships, and social cognition.
Predictors of social outcomes examined included brain lesion characteristics,
child cognition (6 months post-TBI), and behavior and environmental factors
(pre-injury and two years). Reduced social adjustment (p = 0.011) and social
participation (p < 0.001) were evident in children with TBI compared with TD
controls. Poor social adjustment was predicted by externalizing behavior problems
and younger age at injury. Reduced social participation was linked to
internalizing behavior problems. Greater lesion volume, lower socioeconomic
status, and family burden contributed to poorer social relationships, whereas age
at injury predicted social cognition. Within the TBI group, 23% of children
exhibited social impairments. Younger age at injury, greater pre-injury, and
current behavior problems and family dysfunction, and poorer intelligence
quotient (IQ), processing speed, and empathy were linked to impairment. Further
follow-up is required to track social recovery and the influences of cognition,
brain, and environment over time. 

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