Longitudinal trajectories of family functioning following pediatric traumatic brain injury.

Objective: To investigate the presence of specific family functioning trajectories in the 7-10 years after pediatric traumatic brain injury (TBI) and explore predictors associated with these trajectories.

Methods: One hundred and thirty-seven families of children aged 1-12 years who experienced traumatic brain injury were prospectively recruited from a single site, statewide tertiary pediatric hospital. Assessments of family functioning were undertaken using the Intimacy, Conflict and Parenting Style: Family Functioning Scale at preinjury, 6-months, 12-months, 30-months, and 7-10 years. Group-based trajectory modeling was used to identify latent trajectories of functioning. Associations with child, family, and injury characteristics were explored.

Results: We identified four distinct family intimacy profiles, four conflict profiles, and three parenting style profiles. Profiles were characterized by their level of functioning, which remained mostly stable from pre-injury levels across the 7-10 years post-injury. Trajectory membership was not reliably related to characteristics of the child, family, or injury.

Conclusions: These findings suggest that, while families operate at different levels of intimacy, conflict, and parenting flexibility, these do not change after a child's TBI. Given the established role of family functioning in shaping recovery outcomes, assessments of pre-injury family functioning may enable identification of families with children at risk for poorer outcomes post-TBI.