How disabling are pediatric burns? Functional independence in Dutch pediatric patients with burns.
Most Dutch burn patients regain age-typical daily skills within six months, so early low WeeFIM scores should trigger extra support, not panic.
01Research in Context
What this study did
Doctors in the Netherlands watched kids who had bad burns. They used a short test called the WeeFIM. It asks if the child can eat, walk, wash, and talk without help.
Kids were scored at two weeks, three months, and six months after the burn. No therapy was given. The team just wanted to see how fast skills came back.
What they found
Most children returned to age-normal independence within six months. A small group, nine to twenty-two percent, still showed low scores at the early checks. By the last check, the majority caught up to peers.
How this fits with other research
Spriggs et al. (2016) also worked in the Netherlands. They taught one school-aged child with disabilities to walk with a walker. Chaining built new skills, while Capio et al. (2013) shows natural healing can bring old skills back.
Huguenin et al. (1980) tracked autistic kids for years. Their skills improved slowly and stayed behind peers. Burn kids moved faster, reaching typical levels in months, not years.
Keawutan et al. (2018) looked at preschoolers with cerebral palsy. They found that being able to walk predicted quality of life. Capio et al. (2013) adds the view that independence can bounce back quickly after injury if walking and self-care were already learned.
Why it matters
You can tell worried parents that most children regain daily-living skills within six months after a burn. Use the WeeFIM at each clinic visit to spot the few who need extra help. If scores stay low after three months, start therapy or parent coaching right away instead of waiting.
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02At a glance
03Original abstract
Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM(®) instrument in 119 pediatric patients with burns (age: 6 months-16 years; 58.8% boys) in the Netherlands. In order to identify whether functional independence was affected, participants' total scores on the WeeFIM(®) instrument were compared to American norm values. Of the participants assessed at 2 weeks post burn (n = 117), 3 months post burn (n = 68) and/or 6 months post burn (n = 38), 22, 9 and 9 participants showed affected performance, respectively. Improvements in WeeFIM(®) total scores for the total study population between 2 weeks and 6 months post burn were significant (Wilcoxon T = 2.5; p<.001, effect size = -0.59). Individual improvements were found to be significant for 30.3% of the assessed participants between 2 weeks and 3 months post burn, and for 12.1% between 3 and 6 months post burn. This study is unique in providing data on functional independence for this large and special population. However, a proportion of participants were lost to follow-up and the use of the WeeFIM(®) instrument in this specific population and setting has its limitations. To conclude, burn injury impacts functional independence in children, yet the vast majority of Dutch pediatric patients with burns returns to functional independence typical for age within 6 months post burn.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.07.012