title: Social competence following pediatric stroke: contributions of brain insult and family environment.
abstract: Limited information is available regarding predictors of psychosocial difficulties in children following stroke. This study aimed to (i) compare social competence of children with arterial ischemic stroke (AIS) to those with chronic illness and healthy controls and (ii) investigate the contribution of stroke pathology, neurological outcome and environment. Thirty-six children with AIS > 12 months prior to recruitment were compared with children with chronic illness (asthma) (n = 15) and healthy controls (n = 43). Children underwent intellectual assessment, and children and parents completed questionnaires to assess social competence. Children with AIS underwent MRI scan and neurological evaluation. Child AIS was associated with poorer social adjustment and participation, and children with AIS were rated as having more social problems than controls. Lesion volume was not associated with social outcome, but subcortical stroke was linked to reduced social participation and younger stroke onset predicted better social interaction and higher self-esteem. Family function was the sole predictor of social adjustment. Findings highlight the risk of social impairment following pediatric stroke, with both stroke and environmental factors influencing children's social competence in the chronic stages of recovery. They indicate the potential for intervention targeting support at the family level.
authors.affiliation: a Child Neuropsychology , Murdoch Childrens Research Institute , Melbourne , Australia.
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Alison
authors.initials: A
authors.lastname: Gomes
authors.forename: Mardee
authors.initials: M
authors.lastname: Greenham
authors.forename: Stephen
authors.initials: S
authors.lastname: Hearps
authors.forename: Anne
authors.initials: A
authors.lastname: Gordon
authors.forename: Nicole
authors.initials: N
authors.lastname: Rinehart
authors.forename: Linda
authors.initials: L
authors.lastname: Gonzalez
authors.forename: Keith Owen
authors.initials: KO
authors.lastname: Yeates
authors.forename: Christine A
authors.initials: CA
authors.lastname: Hajek
authors.forename: Warren
authors.initials: W
authors.lastname: Lo
authors.forename: Mark
authors.initials: M
authors.lastname: Mackay
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001249:Asthma / Q000523:psychology; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000473:pathology / Q000523:psychology*; D002648:Child; D002908:Chronic Disease; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012649:Self Concept; D066107:Social Skills; D020521:Stroke / Q000473:pathology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Brain; Child stroke; Family; Pediatric stroke; Recovery; Social function