Family Functioning

The role of family functioning during the recovery from pediatric TBI is often overlooked, despite evidence that family functioning is often negatively affected after TBI and may play an important role in moderating the outcomes of TBI. For example, Yeates et al. (1997) investigated the role of pre-injury family functioning in the expression of cognitive and behavioral outcomes after pediatric TBI. These authors found that the effects of TBI on memory and adaptive functioning were buffered by above-average family functioning and exacerbated by below-average family functioning. In addition, children with severe TBI who came from lower-functioning families showed less rapid rates of recovery than those from higher-functioning families (Yeates et al. 1997).

Wade et al. (1998) found that parents of children with severe TBI reported higher levels of parental stress and psychological symptoms in the first year postinjury than did parents of children with orthopedic injuries. The long-term consequences of

TBI on family functioning have also been investigated. Wade et al. (2002) found that injury-related family stress and burden declined from baseline but were still evident in families with severe TBI 4 years postinjury. Wade et al. (2003) investigated the rate of conflict and criticism in parent-adolescent interactions after TBI and found that the rate of these negative interactions increased as injury severity increased. This line of research suggests that health care professionals who consult with children with TBI should consider a family-centered approach when providing recommendations regarding medical and psychosocial interventions.

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