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Developmental and behavioural associations of burns and scalds in children: a prospective population-based study
  1. Alan Emond1,
  2. Clare Sheahan2,
  3. Julie Mytton3,
  4. Linda Hollén1
  1. 1Scar Free Foundation Children's Burns Research Centre, University of Bristol, Bristol, UK
  2. 2Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
  3. 3Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
  1. Correspondence to Professor Alan Emond, Scar Free Foundation Children's Burns Research Centre, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; alan.emond{at}


Objective To investigate child developmental and behavioural characteristics and risk of burns and scalds.

Design Data on burns in children up to 11 years from 12 966 participants in the Avon Longitudinal Study of Parents and Children were linked to developmental profiles measured before the burn injury.

Measures Preinjury profiles of the children derived from maternal questionnaires completed in pregnancy, and at 6, 18, 42, 47 and 54 months. Injury data collected by questionnaire at 6, 15 and 24 months and 3.5, 4.5, 5.5, 6.5, 8.5 and 11 years of age.

Results Incidence: Burn rates were as follows: birth–2 years 71.9/1000/year; 2–4.5 years 42.2/1000/year; 5–11 years 14.3/1000/year. Boys <2 years were more likely to sustain burns, and girls had more burns between age 5 and 11 years. Medical attention was sought for 11% of burn injuries. Development: Up to age 2 years, burns were more likely in children with the most advanced gross motor developmental scores and the slowest fine motor development. Children with coordination problems at 4.5 years of age had increased risk of burns between 5 and 11 years. No associations were observed with cognitive skills. Behaviour: At 3.5 years, the Strengths and Difficulties Questionnaire scores and reported frequent temper tantrums predicted subsequent burns in primary school age. After adjustment for confounders, burns in the preschool period were related to gender and motor development, and in school-aged children, to frequent temper tantrums, hyperactivity and coordination difficulties.

Conclusion Child factors associated with increased risk of burns were male gender in infancy and female gender at school age, advanced gross motor development, coordination difficulties, hyperactivity and problems with emotional regulation.

  • burns, injury, child, development, behaviour, co-ordination, emotional regulation
  • Injury Prevention

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  • Contributors AE conceptualised and designed the study, wrote and revised the manuscript, and approved the final manuscript as submitted. CS drafted sections of the initial manuscript, and approved the final manuscript as submitted. JM reviewed and revised the manuscript, and approved the final manuscript as submitted. LH undertook the statistical modelling and analysis, reviewed and revised the manuscript, and approved the final manuscript as submitted. LH had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding The UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This research was funded by the Children's Burns Research Centre, which is part of the Burns Collective, a Scar Free Foundation initiative with additional funding from the Vocational Training Charitable Trust and the Welsh Government. The views expressed are those of the authors, and not necessarily those of the Scar Free Foundation or other funding bodies.

  • Competing interests None.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval Bristol LREC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Information about the ALSPAC study dataset is available on the website:, which contains details of all the data that are available through a fully searchable data dictionary.

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