Social communication mediates the relationship between emotion perception and externalizing behaviors in young adult survivors of pediatric traumatic brain injury (TBI)

Abstract

Traumatic brain injury (TBI) is a common cause of childhood disability, and is associated with elevated risk for long-term social impairment. Though social (pragmatic) communication deficits may be among the most debilitating consequences of childhood TBI, few studies have examined very long-term communication outcomes as children with TBI make the transition to young adulthood. In addition, the extent to which reduced social function contributes to externalizing behaviors in survivors of childhood TBI remains poorly understood. The present study aimed to evaluate the extent of social communication difficulty among young adult survivors of childhood TBI (n=34, injury age: 1.0-7.0 years; M time since injury: 16.55 years) and examine relations among aspects of social function including emotion perception, social communication and externalizing behaviors rated by close-other proxies. Compared to controls the TBI group had significantly greater social communication difficulty, which was associated with more frequent externalizing behaviors and poorer emotion perception. Analyses demonstrated that reduced social communication mediated the association between poorer emotion perception and more frequent externalizing behaviors. Our findings indicate that socio-cognitive impairments may indirectly increase the risk for externalizing behaviors among young adult survivors of childhood TBI, and underscore the need for targeted social skills interventions delivered soon after injury, and into the very long-term.

Predictors of longitudinal outcome and recovery of pragmatic language and its relation to externalizing behaviour after pediatric traumatic brain injury

“…Our findings strengthen an emerging body of evidence that pragmatic-communicative impairments contribute to real-world social behavioural functioning, including externalizing behaviour problems that are shown to persist or even worsen with time since pediatric brain injury (Li & Liu, 2013;Muscara, Catroppa, & Anderson, 2008;Ryan et al, 2013). In keeping with expectations, while there was limited evidence for relationships between pragmatic communication and externalizing behaviour at 6-months post-injury, more frequent aggression and rule breaking at Lesion load = total number of independent brain regions affected.…”

Sociosexual and Communication Deficits after Traumatic Injury to the Developing Murine Brain

“…Evidence of rehabilitation for social cognition following brain injury is sparse, and existing social skill treatment programs have shown limited efficacy [124]. Given the protracted nature of psychosocial deficits after TBI at a young age, and the delayed onset of these abnormalities, our work aligns with clinical evidence highlighting the need for both acute interventions and very long-term follow-up targeting social skills in TBI survivors [10].…”

“…In addition, brain injury at a young age is consistently predictive of poorer language and non-verbal communication [6], [7], [8], which may complicate the ongoing development of social skills [9]. These consequences persist up to 20 years after severe TBI during childhood [10], [11], [12], and compromise many areas of language competence including syntax, semantics and pragmatics [13]. Clinical studies have identified an association between deficits in social communication and the degree of white matter damage [14], thought to result from diffuse axonal injury which disrupts connectivity between regions of the distributed ‘social brain’ network [15].…”

Social dysfunction after pediatric traumatic brain injury: A translational perspective

“…Further, brain injury during early life is associated with poorer language competency and non-verbal communication, processes that are intricately linked with the development of social skills (Didus et al, 1999; Li and Liu, 2013; Sullivan and Riccio, 2010; Wells et al, 2009). Impairments in social communication may persist for many years after severe pediatric TBI (Cattelani et al, 1998; Hoofien et al, 2001; Ryan et al, 2013b). …”