Parenting styles as a predictor of long-term psychosocial outcomes after traumatic brain injury (TBI) in early childhood

Objective: This study sought to determine whether parenting styles predict long-term psychosocial outcomes after traumatic brain injury in young children. Methods: The study involved a concurrent cohort, prospective design, with longitudinal assessments up to early adolescence. Participants included 126 children with moderate to severe traumatic brain injury or orthopedic injury, ages 3 to 6 years 11 months, recruited between 2003 and 2006. Parents rated children's pre-injury behavioral adjustment, social competence, and executive functioning shortly after injury, and again 6.8 years post injury. Parents also rated their parenting styles (permissive, authoritarian, authoritative) at both occasions. Results: After controlling for pre-injury functioning, the groups differed significantly on all three outcomes (Delta R-2 0.07 to 0.13). Late but not early parenting styles predicted outcomes in all groups (Delta R-2 0.06 to 0.17): more permissive parenting predicted worse outcomes in all domains (beta= -0.18, 0.20, 0.27); and more authoritative parenting predicted better social competence and executive functioning (beta= -0.17, 0.46). Severe traumatic brain injury interacted with parenting style for several outcomes, with ineffective parenting exacerbating the negative sequelae. Conclusions: Parenting style predicts children's long-term psychosocial functioning after early childhood injury, and may moderate the effects of early traumatic brain injury.