Diminished adaptive behaviors among pediatric survivors of burns.

Life for pediatric survivors of burns appears difficult to most observers. In an assessment by use of the Child Behavior Checklist (CBCL), survivors' parents reported that approximately 30% of the children had significant problems. The Vineland Adaptive Behavior Scales were used to gather further information concerning the children's personal and social sufficiency and functioning. Thirty-four pediatric burn survivors (28 boys and 6 girls, ages 9 to 19, 1 to 5 years after burn, with burn sizes ranging from 3% to 92% total body surface area) were selected by use of a stratified random sampling technique. Ten of the 14 scales are significantly different (p < 0.05, paired t) from the reference population in the Vineland manual. The Vineland scores indicate that parents view their burned children as being less personally or socially sufficient. Subjects with significant behavior problems as measured by use of the CBCL (T score > or = 60) differed from their peers with fewer problems by having less overall adaptive behavior (p = 0.07), fewer coping skills (p = 0.06), and significantly more maladaptive behavior (p = 0.005). The Vineland adaptive behavior domains correlated positively with the CBCL total competence scores, whereas the Vineland maladaptive behavior correlated positively with the CBCL total behavior score. Although it supports previous findings that parents of burned children see them as having problems after burn, this study elaborates on and differentiates among their difficulties in adapting to their life situations. These findings not only affirm the importance of attending to parental perceptions of burned children but also identify specific areas to be targeted for psychosocial rehabilitation of burned children.