Longitudinal trajectories of family functioning following pediatric traumatic brain injury

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. 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. 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. 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.