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Early Brain Injury and Adaptive Functioning in Middle Childhood: The Mediating Role of Pragmatic Language

Published online by Cambridge University Press:  27 April 2020

Cassandra L. Hendrix ,
Tricia Z. King Open the ORCID record for Tricia Z. King [Opens in a new window] ,
Justin Wise  and
Juliet Haarbauer-Krupa
Cassandra L. Hendrix
Affiliation:
Psychology Department, Emory University, Atlanta, GA, USA
Tricia Z. King*
Affiliation:
Psychology Department and the Neuroscience Institute, Georgia State University, Atlanta, GA, USA
Justin Wise
Affiliation:
Psychology Department, Oglethorpe University, Atlanta, GA, USA
Juliet Haarbauer-Krupa
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
*
*Correspondence and reprint requests to: Tricia Z. King, Ph.D., Department of Psychology, Georgia State University, 140 Decatur Street, Urban Life Building Suite 1150, Atlanta, GA30303. E-mail: [email protected]
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Abstract

Objective:

Traumatic brain injuries (TBIs) often adversely affect adaptive functioning (AF). However, the cognitive mechanisms by which AF is disrupted are not well understood in young children who sustain TBI. This study examined pragmatic language (PL) and executive functioning (EF) as potential mechanisms for AF disruption in children with early, predominantly mild-complicated, TBI.

Method:

The sample consisted of 76 children between the ages of 6 and 10 years old who sustained a TBI (n = 36) or orthopedic injury (OI; n = 40) before 6 years of age and at least 1 year prior to testing (M = 4.86 years, SD = 1.59). Children’s performance on a PL and an expressive vocabulary task (which served as a control task), and parent report of child’s EF and AF were examined at two time points 1 year apart (i.e., at age 8 and at age 9 years).

Results:

Injury type (TBI vs. OI) significantly predicted child’s social and conceptual, but not practical, AF. Results indicated that PL, and not expressive vocabulary or EF at time 1, mediated the relationship between injury type and both social and conceptual AF at time 2.

Conclusions:

A TBI during early childhood appears to subtly, but uniquely, disrupt complex language skills (i.e., PL), which in turn may disrupt subsequent social and conceptual AF in middle childhood. Additional longitudinal research that examines different aspects of PL and adaptive outcomes into adolescence is warranted.

Keywords

Traumatic brain injuriesAdaptive behaviorCommunicationLanguageChild development
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 9 , October 2020 , pp. 835 - 850
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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