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Social Interaction in Young Children with Inflicted and Accidental Traumatic Brain Injury: Relations with Family Resources and Social Outcomes

Published online by Cambridge University Press:  18 March 2013

Linda Ewing-Cobbs ,
Mary R. Prasad ,
Donna Mendez ,
Marcia A. Barnes  and
Paul Swank
Linda Ewing-Cobbs*
Affiliation:
Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston, Houston, Texas Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas
Mary R. Prasad
Affiliation:
Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston, Houston, Texas
Donna Mendez
Affiliation:
Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas
Marcia A. Barnes
Affiliation:
Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston, Houston, Texas
Paul Swank
Affiliation:
Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston, Houston, Texas
*
Correspondence and reprint requests to: Linda Ewing-Cobbs, Children's Learning Institute, Department of Pediatrics, 7000 Fannin, Suite 2401, Houston, TX 77030. E-mail: linda.ewing-cobbs@uth.tmc.edu
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Abstract

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. (JINS, 2013, 19, 1–11)

Keywords

Joint attentionGazeDevelopmental outcomeSocial cognitionHigh riskChild abuseCommunicationAdaptive behaviorCognitionInfants
Type
Special Series
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 5 , May 2013 , pp. 497 - 507
Copyright
Copyright © The International Neuropsychological Society 2013

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