title: Executive functions and theory of mind as predictors of social adjustment in childhood traumatic brain injury.
abstract: This study examined whether executive function and theory of mind mediate the effects of pediatric traumatic brain injury (TBI) on social adjustment, relative to children with orthopedic injury (OI). Participants included 19 children with severe TBI, 41 children with complicated mild/moderate TBI, and 57 children with OI. They completed measures of executive function, as well as cognitive, affective, and conative theory of mind. Parents provided ratings of children's social adjustment. Children with severe TBI performed more poorly than children with OI on executive function and theory of mind tasks and were rated by parents as having more behavioral symptoms and worse communication and social skills. Executive function and theory of mind were positively correlated with social skills and communication skills, and negatively correlated with behavioral symptoms. In multiple mediator models, theory of mind and executive function were not significant direct predictors of any measure of social adjustment, but mediated the association between injury and adjustment for children with severe TBI. Theory of mind was a significant independent mediator when predicting social skills, but executive function was not. TBI in children, particularly severe injury, is associated with poor social adjustment. The impact of TBI on children's social adjustment is likely mediated by its effects on executive function and theory of mind.
authors.affiliation: 1 Department of Pediatrics, The Ohio State University and The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Robinson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fountain-Zaragoza
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rubin
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Gerhardt
authors.forename: Terry
authors.initials: T
authors.lastname: Stancin
authors.forename: Keith Owen
authors.initials: KO
authors.lastname: Yeates
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D012917:Social Adjustment; D056345:Theory of Mind
keywords: executive function; pediatric; social adjustment; traumatic brain injury