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Published on: February 7, 2025
Longitudinal trajectories of family functioning following pediatric traumatic brain injury
Felicity Murphy1,2, Cathy Catroppa1,2,3,4, Elle Morrison1
1Brain and Mind Research, Murdoch Children's Research Institute, Melbourne, Australia.
Insights
Family functioning, including intimacy, conflict, and parenting, remained stable 7-10 years after pediatric traumatic brain injury (TBI). Pre-injury assessments may identify at-risk families for better TBI recovery outcomes.
Area of Science:
- Pediatric neurosurgery
- Family psychology
- Child neurology
Background:
- Pediatric traumatic brain injury (TBI) significantly impacts children and their families.
- Understanding long-term family functioning post-TBI is crucial for recovery.
- Existing research often lacks longitudinal data on family dynamics after pediatric TBI.
Purpose of the Study:
- To identify distinct family functioning trajectories in the 7-10 years following pediatric TBI.
- To explore predictors associated with these family functioning trajectories.
- To assess changes in family intimacy, conflict, and parenting styles over time post-TBI.
Main Methods:
- Prospective recruitment of 137 families with children aged 1-12 years who experienced TBI.
- Utilized the Intimacy, Conflict and Parenting Style: Family Functioning Scale at multiple time points (pre-injury to 7-10 years post-injury).
- Employed group-based trajectory modeling to identify latent functioning profiles and explored associations with child, family, and injury characteristics.
Main Results:
- Identified four distinct intimacy profiles, four conflict profiles, and three parenting style profiles.
- Family functioning levels remained largely stable from pre-injury across the 7-10 year follow-up period.
- No reliable associations were found between trajectory membership and child, family, or injury characteristics.
Conclusions:
- Family functioning (intimacy, conflict, parenting) generally does not change significantly after a child's TBI.
- Pre-injury family functioning assessments are vital for identifying children at risk for poorer TBI recovery outcomes.
- These stable family dynamics highlight the importance of early intervention and support tailored to pre-existing family characteristics.
Objective:
To investigate the presence of specific family functioning trajectories in the 7-10 years after pediatric traumatic brain injury (TBI) and explore predictors associated with these trajectories.
Methods:
One hundred and thirty-seven families of children aged 1-12 years who experienced traumatic brain injury were prospectively recruited from a single site, statewide tertiary pediatric hospital. Assessments of family functioning were undertaken using the Intimacy, Conflict and Parenting Style: Family Functioning Scale at preinjury, 6-months, 12-months, 30-months, and 7-10 years. Group-based trajectory modeling was used to identify latent trajectories of functioning. Associations with child, family, and injury characteristics were explored.
Results:
We identified four distinct family intimacy profiles, four conflict profiles, and three parenting style profiles. Profiles were characterized by their level of functioning, which remained mostly stable from pre-injury levels across the 7-10 years post-injury. Trajectory membership was not reliably related to characteristics of the child, family, or injury.
Conclusions:
These findings suggest that, while families operate at different levels of intimacy, conflict, and parenting flexibility, these do not change after a child's TBI. Given the established role of family functioning in shaping recovery outcomes, assessments of pre-injury family functioning may enable identification of families with children at risk for poorer outcomes post-TBI.
