Quality of family environment predicts child perceptions of competence 12 months after pediatric traumatic brain injury - 12/11/21

Doi : 10.1016/j.rehab.2021.101606

Noor Khan, BA (Hons) ^a,^b,^⁎ , Nicholas P. Ryan, PhD ^a,^c,^d,^e, Louise Crossley, PGDipPsych ^a, Stephen Hearps, MBiostat ^a, Miriam H. Beauchamp, PhD ^f,^g, Cathy Catroppa, PhD ^a,^c,^d,^{⁎
co-senior authors}, Vicki Anderson, PhD ^a,^c,^d,^{⁎
co-senior authors}
^a Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
^b Psychological Sciences, University of Melbourne, Melbourne, Australia
^c Psychology, Royal Children's Hospital, Melbourne, Australia
^d Department of Paediatrics, University of Melbourne, Melbourne, Australia
^e Cognitive Neuroscience Unit, Deakin University, Geelong, Australia
^f Department of Psychology, University of Montreal, Montreal, QC, Canada
^g Research Centre, Ste-Justine Hospital, Montreal, QC, Canada

^⁎⁎Corresponding author: Noor Khan, Murdoch Childrens Research Institute, Level 4 West, Brain and Mind, 50 Flemington Road, Parkville, Victoria 3052, AustraliaMurdoch Childrens Research InstituteLevel 4 West, Brain and Mind, 50 Flemington RoadParkvilleVictoria3052Australia

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Highlights

•	Child perceptions of academic competence were poorer after traumatic brain injury.
•	Both demographic and family variables predicted child ratings of self-competence.
•	Greater family integration and routine may improve child perceptions of competence.

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Abstract

Background

. Demographic and environmental factors can affect child recovery after traumatic brain injury (TBI); however, little is known about their role in predicting child perceptions of competence (i.e., subjective judgments of ability or a sense of adequacy).

Objectives

. This prospective, cohort study examined the contribution of participant sex, age at assessment, socioeconomic status, parent-reported change in academic performance post-injury, and the quality of a child's relationship with their family (i.e., family affective involvement, intimacy, integration, and the nature of family roles) to child perceptions of global and academic competence 12 months after pediatric TBI.

Methods

. Participants included 127 children, 84 with a TBI (53 mild, 31 moderate-severe TBI; injury age: 5-15 years) and 43 age-matched typically developing (TD) controls. Children rated their perceptions of global and academic competence and degree of family intimacy and integration. Parents completed questionnaires measuring socioeconomic status, family affective involvement, and the nature of family roles. Parents also indicated whether they perceived a change in their child's post-injury academic performance.

Results

. Child perceptions of academic competence were significantly lower for children with moderate-severe TBI relative to TD children. In contrast, child perceptions of global competence were comparable between TBI and TD control groups. Socioeconomic status, age at assessment, parent-reported relative change in academic performance post-TBI, and family roles were associated with child perceptions of academic competence. Degree of family integration was the sole predictor of child perceptions of global competence.

Conclusions

. Child perceptions of academic competence are vulnerable to the effects of moderate-severe TBI, particularly among older children and those from low socioeconomic backgrounds. Well-defined family roles for handling family functions and greater integration of family units might enhance perceptions of global and academic competence in children with TBI.

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Keywords : traumatic brain injury, child perceptions, self-competence, environmental factors, family relationship quality