Over half of fatal pediatric traumatic brain injuries are estimated to be the result of physical abuse, i.e., abusive head trauma (AHT). Although intimate partner violence (IPV) is a well-established risk for child maltreatment, little is known about IPV as an associated risk factor specifically for AHT. We performed a single-institution, retrospective review of all patients (0–17 years) diagnosed at a Level 1 pediatric trauma center with head trauma who had been referred to an in-hospital child protection team for suspicion of AHT between 2010 and 2016. Data on patient demographics, hospitalization, injury, family characteristics, sociobehavioral characteristics, physical examination, laboratory findings, imaging, discharge, and forensic determination of AHT were extracted from the institution’s forensic registry. Descriptive statistics (mean, median), chi-square and Mann–Whitney U tests were used to compare patients with fatal head injuries to patients with nonfatal head injuries by clinical characteristics, family characteristics, and forensic determination. Multiple logistic regression was used to estimate adjusted odds ratios for the presence of IPV as an associated risk of AHT while controlling for other clinical and family factors. Of 804 patients with suspicion for AHT in the forensic registry, there were 240 patients with a forensic determination of AHT; 42 injuries were fatal. There were 101 families with a reported history of IPV; 64.4% of patients in families with reported IPV were <12 months of age. IPV was associated with a twofold increase in the risk of AHT (Exp( β) = 2.3 [ p = .02]). This study confirmed IPV was an associated risk factor for AHT in a single institution cohort of pediatric patients with both fatal and nonfatal injuries. Identifying IPV along with other family factors may improve detection and surveillance of AHT in medical settings and help reduce injury, disability, and death.

Theory of mind describes the ability to engage in perspective‐taking, understand intentions, and predict actions and emotions. Theory of mind typically achieves major developmental milestones around age of 5, coinciding with the transition to kindergarten, and is associated with a verbal ability (receptive and expressive vocabulary), executive function (inhibitory control and working memory), and emotion knowledge. Less is known about how the theory of mind operates in low‐income samples, where foundational skills (i.e., verbal ability, executive function, and emotion knowledge) tend to be delayed. Applied to classrooms, the theory of mind may support the transition to kindergarten by facilitating relationships, learning‐related behaviors, and socioemotional skills that require perspective‐taking. In a low‐income sample of 140 kindergarteners across 21 classrooms, the theory of mind was directly associated with teacher‐ratings of social and emotional skills, behavioral and academic adjustment, and closeness within the teacher–child relationship, beyond the contribution of foundational skills. Moreover, verbal ability, executive function, and emotion knowledge were indirectly associated with outcomes through the theory of mind. Findings suggest the theory of mind facilitates the transition to kindergarten and is built upon a complex set of foundational skills.

No abstract

No abstract