Adaptation of self-image in burn-disfigured children.

Massive burn injury alters both the physical appearance and the functional ability of the child. The changed body necessitates concomitant alteration of the internal self-image, including feelings about the internal self or self-esteem. Six children of primary school age are being followed up in a prospective, longitudinal study to track their adaptation to burn disfigurement. Results of the first 5 1/2 years reveal that, initially, all children displayed pervasive developmental regression, accompanied by phobias, nightmares, and various other symptoms. Two years later, one half of the children had returned to the average range of development attainment. By the fifth year, five of the six children had returned to an average level of progressive personality development. The sixth child was progressing well considering cognitive and emotional deficits before the burn injury. A primary factor influencing adaptation appeared to be the role of the parent or parents in facilitating the acquisition of a positive self-image and in launching and maintaining active mastery in their children.