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

机译：幼儿造成造成和意外创伤性脑损伤的社会互动：与家庭资源与社会成果的关系

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摘要

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.
机译：与通常发育中的儿童（n = 60）相比，在因意外（n = 61）或造成（n = 64）外伤性脑损伤（TBI）住院的0-36个月的幼儿中检查了核心社交互动行为。在受伤后2个月和12个月内，在儿童与考官之间半互动的社会互动过程中，评估了响应和引发的注视与关节注意（JA）。偶然的TBI组减少了凝视的频率，最初出现了JA缺陷，随后通过JA解决。与预期相反，患有TBI的儿童没有比其他群体更低的社会参与率。与启动JA相比，对JA的响应与伤害严重程度的度量以及后来的认知和社会后果之间的联系更紧密。与复杂的轻度/中度TBI相比，幼儿中的严重TBI与社交互动的反应性较低以及对沟通和社交行为的看护者评分较低有关。 JA的反应，家庭资源和小组进行互动以预测结果。患有TBI的儿童对社会的反应较弱，家庭资源水平较低，其结果最差。 TBI后低的社会反应能力可能是后来的认知和适应行为困难的早期标志。

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