Psychosocial adjustment following acquired brain injury in childhood and adolescence: executive, behavioural and emotional contributions.

Background: A large literature documents psychosocial difficulties affecting participation in everyday activities following acquired brain injury (ABI). This study examined executive, behavioural and emotional contributions to psychosocial outcome in children with ABI.

Method: Participants with ABI (n = 35; aged 7-18 years) were recruited from a rehabilitation department. Psychosocial functioning was assessed using the Sydney Psychosocial Reintegration Scale for Children (SPRS-C). Executive, emotional and behavioural variables were examined using self and parent-report measures.

Results: Thirty-eight per cent of the sample was classified as having good psychosocial functioning, with 54% classified as limited and 8% as poor. The sample was dichotomized on executive, behavioural and emotional functioning comparing those with and without difficulties. Participants classified without behavioural difficulties had better functioning on SPRS-C compared to those with difficulties (p < 0.01). In contrast, for executive and emotional functioning, hardly any SPRS-C variable showed significant group differences. Of the total group, 15-21% had elevated levels on emotional outcome measures. This was, however, dependent on age, with 22-44% of the older sample reporting elevated levels on at least one emotional variable compared to 4-16% of the younger sample.

Discussion: The pattern of results highlight the contribution of behavioural functioning to psychosocial outcome post-childhood ABI.