Research Reports - Social competence at 2 years following child traumatic brain injury

J Neurotrauma. 2017 Feb 8. doi: 10.1089/neu.2016.4692. [Epub ahead of print]

Anderson V(1), Beauchamp MH(2), Yeates KO(3), Crossley L(4), Ryan NP(5,)(6),
Hearps SJ(7), Catroppa C(8,)(9).

Children with traumatic brain injury (TBI) are at risk of social impairment, but
research is yet to document the trajectory of these skills post-injury and
factors that may predict social problems. The study addressed these gaps in
knowledge, reporting on findings from a prospective, longitudinal follow-up study
which investigated social outcomes post injury and explored factors contributing
to these outcomes at 2 years post-injury. The sample included 113 children, 74
with TBI and 39 typically developing (TD) controls. TBI participants were
recruited on presentation to hospital. Parents rated pre-injury function at that
time and all children underwent magnetic resonance imaging (MRI) scan.
Participants were followed up at 2 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 2 years). Reduced social adjustment (p=.011) and social
participation (p<.001) were evident in children with TBI compared to TD controls.
Poor social adjustment was predicted by externalizing behaviour 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, while age at injury predicted
social cognition. Within the TBI group, 23% of children exhibited social
impairment: younger age at injury, greater pre-injury and current behavior
problems and family dysfunction, poorer 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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