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Adaptation of self-image in burn-disfigured children
S A Beard1, D N Herndon, M Desai
1Shriners Burns Institute, Galveston, TX 77550.
Insights
Massive burn injuries significantly impact children
Area of Science:
- Pediatric Psychology
- Burn Injury Rehabilitation
- Child Development
Background:
- Severe burn injuries profoundly affect a child's physical appearance and functional capabilities.
- These physical changes necessitate significant adjustments in a child's internal self-image and self-esteem.
- Understanding the long-term psychological adaptation of pediatric burn survivors is crucial for effective care.
Purpose of the Study:
- To prospectively track the adaptation process of primary school-aged children following massive burn injuries.
- To identify key factors influencing the development of self-image and personality post-burn disfigurement.
- To evaluate the trajectory of psychological and developmental recovery in pediatric burn survivors.
Main Methods:
- A prospective, longitudinal study following six primary school-aged children with massive burn injuries.
- Data collection over a 5.5-year period to assess developmental attainment and personality progression.
- Observation of psychological symptoms including developmental regression, phobias, and nightmares.
Main Results:
- Initially, all children exhibited pervasive developmental regression and psychological distress.
- Within two years, 50% of children returned to average developmental levels.
- By five years, five out of six children showed progressive personality development, with parental support being a key factor.
Conclusions:
- Children with massive burn injuries demonstrate significant initial psychological distress and developmental regression.
- Most children can achieve average developmental and personality progression within five years post-injury.
- Parental involvement in fostering positive self-image and active mastery is critical for successful adaptation.
Abstract:
Massive burn injury alters both the physical appearance and the functional ability of the child. The changed body necessitates concomitant alteration of the internal self-image, including feelings about the internal self or self-esteem. Six children of primary school age are being followed up in a prospective, longitudinal study to track their adaptation to burn disfigurement. Results of the first 5 1/2 years reveal that, initially, all children displayed pervasive developmental regression, accompanied by phobias, nightmares, and various other symptoms. Two years later, one half of the children had returned to the average range of development attainment. By the fifth year, five of the six children had returned to an average level of progressive personality development. The sixth child was progressing well considering cognitive and emotional deficits before the burn injury. A primary factor influencing adaptation appeared to be the role of the parent or parents in facilitating the acquisition of a positive self-image and in launching and maintaining active mastery in their children.