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Psychosocial function in the first year after childhood stroke
Mardee Greenham1,2, Vicki Anderson1,2,3, Stephen Hearps1
1Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic, Australia.
Insights
Childhood stroke impacts psychosocial function, with poorer social skills and increased psychological issues common in the first year. Parent mental health is a key factor influencing child outcomes.
Area of Science:
- Pediatric neurology
- Child psychology
- Neurodevelopmental disorders
Background:
- Childhood stroke significantly disrupts brain development and neural networks.
- While motor, cognitive, and language deficits are recognized, psychosocial function remains understudied.
- Understanding psychosocial outcomes is crucial for comprehensive childhood stroke care.
Purpose of the Study:
- To describe psychosocial function in children during the first year post-stroke.
- To identify factors associated with psychosocial outcomes after childhood stroke.
- To inform early intervention strategies for affected children.
Main Methods:
- Prospective, longitudinal study of 37 children following a stroke.
- Assessment of social functioning at 6 and 12 months post-stroke.
- Evaluation of psychological function at 12 months using standardized measures.
Main Results:
- Social function was poorer at 6 and 12 months compared to pre-stroke levels.
- Emotional difficulties and hyperactivity-inattention were prevalent psychological issues.
- Older age at onset, neurological impairment, and pre-stroke social issues correlated with poorer social function.
Conclusions:
- A significant minority of children experience psychosocial impairment after stroke.
- Older age, neurological deficits, pre-stroke social problems, and parent mental health predict poorer outcomes.
- Supporting families, particularly parental mental health, may improve child recovery and psychosocial well-being.
Aim:
Childhood stroke disrupts brain development and emerging neural networks. Motor, cognitive, and language deficits are well recognized, yet little is known about psychosocial function after childhood stroke. This study aims to describe psychosocial function within the first year after childhood stroke, and to identify factors associated with outcome.
Method:
Thirty-seven children were involved in a prospective, longitudinal study investigating recovery over the first year after childhood stroke. Children's social functioning was assessed at 6-months and 12-months poststroke and psychological function at 12-months poststroke, using standardized measures.
Results:
Mean social function was poorer at both 6-months and 12-months poststroke, compared to prestroke. Psychological problems were more common than expected, with emotional difficulties and hyperactivity-inattention most significantly affected. Poorer social function was associated with older age at onset, acute neurological impairment, and prestroke social impairment. Social and psychological problems were associated with parent mental health.
Interpretation:
While not all children are affected, psychosocial impairment affects a significant minority after childhood stroke. Older age at onset, acute neurological impairment, prestroke social problems, and poorer parent mental health were associated with deficits. Identifying early predictors of poorer outcome will facilitate early intervention. Of particular importance is parent mental health, suggesting support for families may improve child outcome.
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