Psychosocial functioning at 4-years after pediatric mild traumatic brain injury

ABSTRACT

Objective: Behavioral and emotional difficulties are reported following pediatric mild traumatic brain injury (TBI). But few studies have used a broad conceptual approach to examine children’s long-term psychosocial outcomes. This study examines children’s psychosocial outcomes at 4-years after mild TBI and associated factors.

Methods: Parents of 93 children (<16 years) with mild TBI completed subscales of age-appropriate versions of the Strengths and Difficulties Questionnaire, the Behavior Rating Inventory of Executive Function, the Pediatric Quality of Life Inventory, and the Adolescent Scale of Participation questionnaire at 4-years post-injury.

Results: Mean group-level scores were statistically significantly higher for hyperactivity/inattention and lower for emotional functioning than published norms. Levels of participation were greater compared to those observed in normative samples. More than 19% met published criteria for clinically significant hyperactivity/inattention, emotional functioning problems, peer relationship problems, and social functioning difficulties. Lower family socio-economic status and greater parental anxiety and depression were associated with overall psychosocial difficulties.

Conclusions: Findings indicate that as a group, children with mild TBI are characterized by elevated rates of behavioral, emotional, and social difficulties at 4-years post-injury. Parent mental health may be an untapped opportunity to support children’s psychosocial development following mild TBI, with replication required in larger samples.

KEYWORDS:

• Mild traumatic brain injury
• children
• behavioral adjustment
• emotional adjustment
• social competence
• participation

Acknowledgments

We are indebted to the research team for their dedication and performance. Members of the BIONIC study group* include: Valery Feigin (Principal Investigator), Suzanne Barker-Collo, Kathryn McPherson, Robert Kydd, P. Alan Barber, Varsha Parag, Paul Brown, Nicola Starkey, Anthony Dowell, Michael Kahan, Alice Theadom, Shanthi Ameratunga, Grant Christey, Kelly Jones, Amy Jones, Natalie Hardaker, and Braden Te Ao. We also thank research assistants Moray Carr, Dawn Willix-Payne, Helen Clark, Jessica Hannah, Loretta Westbrook, Maree O’Connor, Sapphire Martin, Chas Whetu and Vivien Feng for their valuable contributions. A full list of members of the BIONIC team is available at www.nisan.aut.ac.nz.

Declaration of interest

The authors report no conflict of interest.

Additional information

Funding

This research was funded by the Health Research Council of New Zealand [project grants 09/063A, 11/192, 13/408].