Journal of the International Neuropsychological Society

Regular Articles

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

Sarah J. Tlustosa1, C.-Y. Peter Chiua1a2, Nicolay Chertkoff Walza3a4, H. Gerry Taylora5a6, Keith Owen Yeatesa7a8 and Shari L. Wadea4a9 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


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)


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


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: