Abstract
Background The reported incidence of brachial plexus birth injury (BPBI) is 0.87 to 2.2 per 1,000 live births. The psychological functioning, including self-concept and emotional-behavioral functioning, of children with BPBI has only been examined to a limited extent. Objective The purpose of this study was to describe the self-concept and emotional-behavioral functioning in children with BPBI from both the child's and parent's perspective. Methods Thirty-one children with BPBI, mean age 11 years 1 month, completed the Draw A Person: Screening Procedure for Emotional Disturbance (DAP:SPED) and Piers Harris Children's Self-Concept Scale (PHCSCS). The parents answered questions from the Behavior Assessment System for Children, Parent Rating Scales (BASC-2 PRS). Results The scores from the DAP:SPED drawings showed further evaluation was not strongly indicated in the majority of the children. The PHCSCS Total score demonstrated that the children had a strongly positive self-concept. The parental responses to the BASC-2 PRS indicated that few children were at risk or in the clinically significant range for the four composite scores and all of the component clinical or adaptive scales. Gender comparison revealed females exhibited greater anxiety than males. Conclusion Both children and parents reported a positive psychological well-being for the majority of the children. Parents had greater concerns about their child's social-emotional functioning, particularly anxiety. An interdisciplinary approach (occupational therapy evaluation, clinical observation, and parental interview) is necessary to determine the need for mental health referral.
Highlights
The estimated incidence of brachial plexus birth injury (BPBI) ranges from 0.87 to 2.2 per 1,000 live births.[1,2,3] While spontaneous recovery occurs in the majority of cases,[4,5] some children still present with residual deficits
The psychological functioning, including self-concept and emotional-behavioral functioning, of children with BPBI has only been examined to a limited extent
Thirty-one children with diagnosis of BPBI participated in this institutional review board–approved study
Summary
The estimated incidence of brachial plexus birth injury (BPBI) ranges from 0.87 to 2.2 per 1,000 live births.[1,2,3] While spontaneous recovery occurs in the majority of cases,[4,5] some children still present with residual deficits. Despite advances in identifying risk factors, and early treatment and intervention, including primary and secondary surgical techniques, this population still faces upper limb deformity, which influences aesthetics and functionality.[6] The variability in the severity of injury and clinical presentation requires a multidisciplinary, client-centered approach, which addresses the physiological and the psychological status of the child.[7]. The psychological functioning, including self-concept and emotional-behavioral functioning, of children with BPBI has only been examined to a limited extent
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