Parent-Child Interactions During the Initial Weeks Following Brain Injury in Young Children

Objective: To understand how traumatic brain injury (TBI) affects parent–child interactions acutelyfollowinginjury. Participants: YoungchildrenhospitalizedforTBI( n 80)andorthopedicinjuries(OI;n 113). Method: Raterscodedvideotapedinteractionsduringfreeplayandstructuredtasksforparentalwarmth/responsiveness and negativity and child warmth, behavior regulation, and cooperation. Ratersalso counted parental directives, critical/restricting statements, and scaffolds. Results: Parents of childrenwith TBI exhibited less warm responsiveness and made more directive statements during a structuredtaskthanparentsintheOIgroup.ChildrenwithTBIdisplayedlessbehaviorregulationthanchildrenwithOI. Parental warm responsiveness was more strongly related to child cooperativeness in the OI groupthan in the TBI group. Child behavior also mediated group differences in parental responsiveness anddirectiveness. TBI accounted for as much variance in parental behaviors as or more than did sociode-mographic factors. Conclusion: TBI-related changes in child behavior may negatively inuence parent–child interactions and disrupt the reciprocity between parent and child.Keywords: early childhood, traumatic brain injury, parent–child interaction, family impact