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).
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Author ManuscriptMethod-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.Keywords early childhood; traumatic brain injury; parent-child interaction; family impactResearch has clearly documented the central role during early childhood that parenting behaviors play in a child's social, emotional, and cognitive development (Bornstein & Tamis-LeMonda, 1989;Landry, Smith, Swank, Assel, & Vellet, 2001;Weizman & Snow, 2001). These findings suggest that warm and responsive parenting, together with verbal stimulation and cognitive support, contributes to optimal cognitive and behavioral development in typically developing children. However, less is known about how medical conditions that affect the health and functioning of the child, such as traumatic brain injury (TBI), influence the quality and nature of the parent-child relationship. Some studies suggest that parents of young children with health problems display more negativity (PippSiegal & Biringen, 1998) and directiveness (Landry, Chapieski, Richardson, Palmer, & Hall, 1990) than parents of typically developing children in their interactions. However, research with other populations and somewhat older samples (e.g., preadolescents with spina bifida) found no differences in parent-child interactions as a function of the child's diagnosis (Seefeldt et al., 1997). Findings differ as a function of the methodology (e.g., parent report vs. observation) and population of interest, making it difficult to draw inferences regarding how specific health conditions affect the parent-child relationship.Research regarding children with mental retardation (MR) has provided some of the best and most extensive evidence regarding the potential effects of child cognitive status on parentchild interactions. This body of literature also underscores the potential complexity of these relati...