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Diminished adaptive behaviors among pediatric survivors of burns
W J Meyer1, P Blakeney, J LeDoux
1Shriners Burns Institute, University of Texas Medical Branch, Galveston 77555-0133, USA.
Insights
Pediatric burn survivors often face challenges, with parents reporting significant behavioral issues. This study highlights difficulties in adaptive behavior and coping skills, underscoring the need for targeted psychosocial support.
Area of Science:
- Pediatric Psychology
- Burn Rehabilitation
- Child Development
Background:
- Pediatric burn survivors frequently experience long-term difficulties.
- Parental reports indicate significant behavioral problems in approximately 30% of these children.
- Previous research suggests challenges in personal and social functioning post-burn.
Purpose of the Study:
- To assess the adaptive behavior and personal/social sufficiency of pediatric burn survivors.
- To differentiate specific areas of difficulty in life adaptation for these children.
- To identify targets for psychosocial rehabilitation interventions.
Main Methods:
- Utilized the Child Behavior Checklist (CBCL) and Vineland Adaptive Behavior Scales.
- Stratified random sampling selected 34 pediatric burn survivors (ages 9-19).
- Compared survivor scores to reference populations and analyzed correlations between behavioral and adaptive measures.
Main Results:
- Ten of 14 Vineland scales showed significant differences from the reference population (p < 0.05).
- Parents perceived survivors as less personally and socially sufficient.
- Children with significant behavioral problems (CBCL T score ≥ 60) exhibited less adaptive behavior and coping skills, and more maladaptive behavior.
Conclusions:
- Parental perceptions of difficulties in pediatric burn survivors are affirmed.
- Specific deficits in adaptive behavior, coping, and increased maladaptive behaviors are identified.
- Findings emphasize the importance of parental input and guide targeted psychosocial rehabilitation strategies for burn survivors.
Abstract:
Life for pediatric survivors of burns appears difficult to most observers. In an assessment by use of the Child Behavior Checklist (CBCL), survivors' parents reported that approximately 30% of the children had significant problems. The Vineland Adaptive Behavior Scales were used to gather further information concerning the children's personal and social sufficiency and functioning. Thirty-four pediatric burn survivors (28 boys and 6 girls, ages 9 to 19, 1 to 5 years after burn, with burn sizes ranging from 3% to 92% total body surface area) were selected by use of a stratified random sampling technique. Ten of the 14 scales are significantly different (p < 0.05, paired t) from the reference population in the Vineland manual. The Vineland scores indicate that parents view their burned children as being less personally or socially sufficient. Subjects with significant behavior problems as measured by use of the CBCL (T score > or = 60) differed from their peers with fewer problems by having less overall adaptive behavior (p = 0.07), fewer coping skills (p = 0.06), and significantly more maladaptive behavior (p = 0.005). The Vineland adaptive behavior domains correlated positively with the CBCL total competence scores, whereas the Vineland maladaptive behavior correlated positively with the CBCL total behavior score. Although it supports previous findings that parents of burned children see them as having problems after burn, this study elaborates on and differentiates among their difficulties in adapting to their life situations. These findings not only affirm the importance of attending to parental perceptions of burned children but also identify specific areas to be targeted for psychosocial rehabilitation of burned children.