Friends after traumatic brain injury in children

Objective: To determine whether a dose-response relation exists between the number of reported close friends and traumatic brain injury (TBI) severity in the postacute phase in school-age children. Design: A retrospective relational study. Setting and Participants: Primary care hospital/medical center-based study on parental perspectives of recovery following TBI in school-age children (14 with severe TBI; 10 with moderate TBI; 36 with mild TBI; and 16 trauma controls). Main Outcome Measures: Parental ratings on the Child Behavior Checklist and selected neuropsychological test findings and ratings of academic performance. Results: Seventy-five percent of trauma controls but only 38.9% of children with mild and 20% of children with moderate TBI reportedly had 4 or more friends. Only 14.3% of children with severe TBI reportedly had 4 or more friends. Glasgow Coma Scale score at admission correlated with the number of friends postacutely (by parental reports) (r = +0.307, N = 76, P = .007). Conclusion: More severe brain injury is associated with fewer friends in the postacute phase following TBI. The relation, however, was not purely linear and the hypothesis was supported only partially. Broadening the social network of children with moderate and severe TBI should be a major goal of neuropsychological rehabilitation.