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Emotion Labeling and Socio-Emotional Outcomes 18 Months after Early Childhood Traumatic Brain Injury

Sarah J. Tlustos^a1, C.-Y. Peter Chiu^a1a2, Nicolay Chertkoff Walz^a3a4, H. Gerry Taylor^a5a6, Keith Owen Yeates^a7a8 and Shari L. Wade^a4a9 c1

^a1 Department of Psychology, University of Cincinnati, Cincinnati, Ohio

^a2 Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio

^a3 Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

^a4 University of Cincinnati College of Medicine, Cincinnati, Ohio

^a5 Division of Developmental and Behavioral Pediatrics and Psychology, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio

^a6 Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio

^a7 Division of Psychology, Department of Pediatrics, The Ohio State University

^a8 Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio

^a9 Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Abstract

A growing body of literature has documented evidence for emotion labeling (EL) deficits after traumatic brain injury (TBI); however, long-term effects of TBI on EL abilities, particularly among young children, are unclear. We investigated EL abilities and socio-emotional outcomes in 32 children with moderate–severe TBI, 23 with complicated-mild TBI, and 82 children with orthopedic injuries (OI), shortly after injury and at 18 months post-injury. All children were between 3:0 and 6:11 years of age at the time of injury. Repeated measures analyses indicated that all groups showed improved EL performance between acute and 18-month assessments, but that the moderate–severe TBI group improved at a slower rate than the OI group, so that the two groups showed significantly different performance at 18 months. Emotion labeling ability did not significantly contribute to the prediction of socio-emotional outcomes after controlling for pre-injury functioning. These results provide preliminary evidence of emerging EL deficits after early childhood TBI that are related to injury severity but that do not predict social and behavioral outcomes. (JINS, 2011, 17, 1132–1142)

(Received November 14 2010)

(Revised August 04 2011)

(Accepted August 04 2011)

Keywords

• Head injury;
• Emotion;
• Longitudinal studies;
• Social adjustment;
• Pediatric;
• Chronic brain injury

Correspondence:

^c1 Correspondence and reprint requests to: Shari L. Wade, Department of Rehabilitation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 4009, Cincinnati, OH 45229-3039. E-mail: shari.wade@cchmc.org