Short- and long-term social outcomes following pediatric traumatic brain injury

TLDR

Deficits in executive function, pragmatic language, and social problem‑solving after pediatric TBI likely reflect damage to brain networks underlying social cognition. The study followed 189 children (53 severe TBI, 56 moderate TBI, 80 orthopedic controls) from ages 6–12, measuring child and family functioning at baseline, 6‑ and 12‑month, and ~4‑year follow‑ups. Long‑term social outcomes after pediatric TBI are negatively impacted by low socioeconomic status, limited family resources, and poor family functioning, and are partly explained by deficits in executive function, pragmatic language, and social problem‑solving.

Abstract

The social outcomes of pediatric traumatic brain injury (TBI) were examined in a prospective, longitudinal study that included 53 children with severe TBI, 56 with moderate TBI, and 80 with orthopedic injuries, recruited between 6 and 12 years of age. Child and family functioning were assessed at baseline, at 6- and 12-month follow-ups, and at an extended follow-up a mean of 4 years post injury. Growth curve analyses revealed that pediatric TBI yields negative social outcomes that are exacerbated by family environments characterized by lower socioeconomic status, fewer family resources, and poorer family functioning. After controlling for group membership, age, race, socioeconomic status, and IQ, path analyses indicated that long-term social outcomes were accounted for in part by specific neurocognitive skills, including executive functions and pragmatic language, and by social problem-solving. Deficits in these domains among children with TBI are likely to reflect damage to a network of brain regions that have been implicated in social cognition.