Research Reports - Social interaction in young children with inflicted and accidental traumatic brain injury

J Int Neuropsychol Soc. 2013 May;19(5):497-507

Ewing-Cobbs L, Prasad MR, Mendez D, Barnes MA, Swank P

Core social interaction behaviors were examined in young children 0-36 months of
age who were hospitalized for accidental (n = 61) or inflicted (n = 64) traumatic
brain injury (TBI) in comparison to typically developing children (n = 60).
Responding to and initiating gaze and joint attention (JA) were evaluated during
a semi-structured sequence of social interactions between the child and an
examiner at 2 and 12 months after injury. The accidental TBI group established
gaze less often and had an initial deficit initiating JA that resolved by the
follow-up. Contrary to expectation, children with inflicted TBI did not have
lower rates of social engagement than other groups. Responding to JA was more
strongly related than initiating JA to measures of injury severity and to later
cognitive and social outcomes. Compared to complicated-mild/moderate TBI, severe
TBI in young children was associated with less responsiveness in social
interactions and less favorable caregiver ratings of communication and social
behavior. JA response, family resources, and group interacted to predict
outcomes. Children with inflicted TBI who were less socially responsive and had
lower levels of family resources had the least favorable outcomes. Low social
responsiveness after TBI may be an early marker for later cognitive and adaptive
behavior difficulties.

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