Parent-Child Interactions During the Initial Weeks Following Brain Injury in Young Children.

OBJECTIVE To understand how traumatic brain injury (TBI) affects parent-child interactions acutely following injury. PARTICIPANTS Young children hospitalized for TBI (n = 80) and orthopedic injuries (OI; n = 113). METHOD Raters coded videotaped interactions during free play and structured tasks for parental warmth/responsiveness and negativity and child warmth, behavior regulation, and cooperation. Raters also counted parental directives, critical/restricting statements, and scaffolds. RESULTS Parents of children with TBI exhibited less warm responsiveness and made more directive statements during a structured task than parents in the OI group. Children with TBI displayed less behavior regulation than children with OI. Parental warm responsiveness was more strongly related to child cooperativeness in the OI group than in the TBI group. Child behavior also mediated group differences in parental responsiveness and directiveness. TBI accounted for as much variance in parental behaviors as or more than did sociodemographic factors. CONCLUSION TBI-related changes in child behavior may negatively influence parent-child interactions and disrupt the reciprocity between parent and child.

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