Developmental and behavioural associations of burns and scalds in children: a prospective population-based study

Objective To investigate child developmental and behavioural characteristics and risk of burns and scalds. Design Data on burns in children up to 11 years from 12 966 participants in the Avon Longitudinal Study of Parents and Children were linked to developmental profiles measured before the burn injury. Measures Preinjury profiles of the children derived from maternal questionnaires completed in pregnancy, and at 6, 18, 42, 47 and 54 months. Injury data collected by questionnaire at 6, 15 and 24 months and 3.5, 4.5, 5.5, 6.5, 8.5 and 11 years of age. Results Incidence: Burn rates were as follows: birth-2 years 71.9/1000/year; 2-4.5 years 42.2/1000/ year; 5-11 years 14.3/1000/year. Boys < 2 years were more likely to sustain burns, and girls had more burns between age 5 and 11 years. Medical attention was sought for 11% of burn injuries. Development: Up to age 2 years, burns were more likely in children with the most advanced gross motor developmental scores and the slowest fine motor development. Children with coordination problems at 4.5 years of age had increased risk of burns between 5 and 11 years. No associations were observed with cognitive skills. Behaviour: At 3.5 years, the Strengths and Difficulties Questionnaire scores and reported frequent temper tantrums predicted subsequent burns in primary school age. After adjustment for confounders, burns in the preschool period were related to gender and motor development, and in school-aged children, to frequent temper tantrums, hyperactivity and coordination difficulties. Conclusion Child factors associated with increased risk of burns were male gender in infancy and female gender at school age, advanced gross motor development, coordination difficulties, hyperactivity and problems with emotional regulation.