Social-emotional behaviour in infants and toddlers with mild traumatic brain injury

Background: Paediatric head trauma is a serious health concern often leading to neurological, behavioural and cognitive impairments. In Estonia head trauma incidence is especially high in children up to 4 years. Objective: The aim was to investigate young children's pre-injury social-emotional behaviour to discover potential risk signs for brain trauma and to study social-emotional outcome 9 months post-injury. Methods: Thirty-five 3-65 month old children with mild traumatic brain injury (MTBI) and 70 matched controls were retrospectively assessed with child monitoring system Ages and Stages Questionnaires: Social-Emotional. During follow-up 27 patients and 54 controls were re-assessed after 9 months. Results: Children with MTBI showed altered social-emotional development already before the injury. Deficits were evident in self-regulation and autonomy. Age-specific social-emotional risk signs for MTBI were found. Compared to controls more pre-injury affective problems were seen in 12-month olds, self-regulation, and communication difficulties in 30-month olds and autonomy disturbances in 60-month old children. 9 months post-injury impairments in autonomy and self-regulation were still present and new difficulties in interaction had developed. Conclusions: Childhood MTBI has a serious negative effect on further development of interaction skills. To prevent possible traumas, parents should be informed of different age-specific pre-injury social-emotional risk signs.