The Effects of a Child's Brain Injury
by Peter W. Welty, M.D. F.A.A.P.
October 27, 2003
Each year in the United States more than 100,000 children are hospitalized for traumatic brain injury. These are children less than 15 years of age. This traumatic event has been noted to have short and long-term effects on the rest of the family. Whether serious, moderate or mild the stress and adjustment to the injury affects everyone. Complicated stressors that threaten family relationships and functions are the result. And, it seems clear that the family is at risk for continued disruption, given the long-term cognitive, behavioral and school difficulties faced by the injured child.
The February 2003 issue of The Journal of Developmental and Behavioral Pediatrics carried an article that explored this issue. Information was gathered from the families of 34 children who had suffered severe traumatic brain injury. The families of 30 children with moderate brain injury and 39 children with orthopedic injuries with no brain involvement were included. All of the children studied were between 6 - 12 years of age at the time of their injury. Each family studied had at least one unaffected sibling six years of age or younger at the time of the injury, who participated in the study. The family and the sibling were asked to complete questionnaires, ratings and self-reports.
The results showed that the effects of the particular child’s traumatic brain injury were moderated by whether the siblings were sister-sister, brother-brother, or a brother-sister combination. It seemed that same-sex siblings adjusted better to the long-lasting effects of the brain injury than did brother-sister siblings. According to the researchers a possible explanation to this was that the brother-sister siblings may have had more conflicted relationships before the injury. This, then, would make them more vulnerable to stress in their relationship after the injury. Same-sex siblings possibly were more used to joint activities, and to cooperating and settling conflicts. Other researchers have noted that same-gender siblings demonstrate more involvement and warmth in their relationships than opposite-gender siblings do.
Poorer outcomes were seen in those families who endured behavioral problems with the impaired child before the injury. The result became higher family stress and burden. The injured child’s behavioral problems left a negative effect on the family. In turn the siblings were left with a negative impression which caused their own behavioral problems, and added to the general family stress. It appears that the post-injury burden had more of a negative impact on the functioning of the family than the injury itself. Also, sibling outcomes were related to the family’s response to the child’s traumatic brain injury, rather than as a direct consequence of the injury.
This interesting study highlights the importance of considering the functioning of the siblings and the entire family after a pediatric traumatic brain injury. The unique characteristics of the relationship between brothers and sisters allows doctors to care for and individually support the siblings when their sister or brother has a traumatic brain injury.
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