Sibling Behaviours and Relationships Following Mild to Moderate Childhood Traumatic Brain Injury: Preliminary Findings

Abstract

Recent attention has begun to focus on the impact of childhood traumatic brain injury (TBI) on the family. This study examined the impact of mild to moderate childhood TBI on parental ratings of well and injured siblings' behaviours in relation to well siblings' ratings of the impact of injury and the sibling relationship. Parents of 10 children with TBI and 10 children with orthopaedic injury rated both injured and well siblings' behaviours using the Child Behaviour Checklist (CBCL). Well siblings completed the Sibling Impact Questionnaire (SIQ) and Sibling Relationship Questionnaire (SRQ). Results indicated that children with TBI exhibited significantly more externalising and total behaviours than children with orthopaedic injury, while well siblings of children with TBI exhibited more internalising behaviours than siblings of children with orthopaedic injury. Well siblings' ratings of the impact of the injury and sibling relationship did not differ significantly across groups. The behaviours of well siblings and their ratings of injury impact and sibling relationship are examined in relation to the behaviours of the injured siblings for the two groups. The implications of the findings are examined in terms of the need to involve siblings in the rehabilitation process.

Paediatric traumatic brain injury: A review of siblings’ outcome

“…Moreover, emotional-behavioural outcome of siblings whose brother or sister sustained Paediatric traumatic brain injury: A review of siblings' outcome moderate-to-severe TBI was found to be comparable to controls in studies conducted by McMahon et al [45] and Swift et al [46]. On the other hand, in a most recent study that included siblings of children who sustained TBI of lesser severity (mild-tomoderate rather than moderate-to-severe), Fay and Barker-Collo [47] found that these siblings exhibited significantly more (internalizing but not externalizing) behavioural difficulties than control siblings. The reasons for this discrepancy are not entirely clear.…”

“…Finally, none of these papers contained information on pre-accident sibling behaviour. Fay and BarkerCollo [47] argued that a high level of internalizing behavioural difficulties found in their sample was secondary to the significantly higher level of externalizing behavioural problems reported by parents in the TBI group. McMahon et al [45] did not report on the behavioural features of the TBI group.…”

“…In addition, this question was asked 6-24 months post-accident, which could have reduced the reliability of the parent report. Neither Fay and Barker-Collo [47] nor McMahon et al [45] reported any information about pre-morbid family functioning. McMahon et al [45] had no information about the injured children's pre-injury behavioural status.…”

“…Three of the subsequent studies examining sibling outcomes have used the same, standardized, but indirect measure of psychological adjustment; parental responses on the Child Behavioural Checklist (CBCL; [45][46][47]). They all included a control group of children; siblings of children who sustained orthopaedic injuries or randomly selected classmates.…”

“…On average the results indicated that injured children's behaviour and family functioning were within the normal range before the accident. Fay and Barker-Collo [47] asked parents to indicate whether injured children had any pre-existing behavioural difficulties but did not administer any formal measures of pre-accident behavioural functioning. In addition, this question was asked 6-24 months post-accident, which could have reduced the reliability of the parent report.…”