Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioural outcomes in
Mirja Helen Hemmi1, Dieter Wolke, Silvia Schneider
1Swiss Etiological Study of Adjustment and Mental Health, National Centre of Competence in Research, Institute of Psychology, University of Basel, Birmannsgasse 8, Basel, Switzerland. mirja.hemmi@unibas.ch
Insights
Infant regulatory problems like excessive crying or feeding issues predict childhood behavioral issues. Children with these early problems show increased externalizing and attention-deficit/hyperactivity disorder (ADHD) symptoms.
Area of Science:
- Developmental Psychology
- Child Psychiatry
- Behavioral Science
Background:
- Approximately 20% of infants experience excessive crying, sleeping, or feeding problems.
- These early regulatory issues may predict later behavioral problems in childhood.
Purpose of the Study:
- To conduct a quantitative meta-analysis on the association between infant regulatory problems and childhood behavioral issues.
- To investigate the link between infant regulatory problems and internalizing, externalizing, and attention-deficit/hyperactivity disorder (ADHD) problems.
Main Methods:
- A meta-analysis of 22 longitudinal studies (1987-2006) involving 1935 children.
- Statistical analysis using Cohen's d to quantify the association.
- Assessment of heterogeneity and publication bias using I(2) statistic, meta-analysis of variance, and Rosenthal's fail-safe N.
Main Results:
- A significant association (effect size 0.41) between infant regulatory problems and increased childhood behavioral problems was found.
- Externalizing and ADHD problems were the strongest behavioral outcomes linked to regulatory issues.
- Cumulative problems and clinical referral exacerbated the risk of behavioral problems, though comorbidity, type, or duration of regulatory problems did not significantly moderate the outcomes.
Conclusions:
- Infants with regulatory problems are at higher risk for developing behavioral problems in childhood.
- The risk is particularly elevated in multi-problem families.
- Further research is needed to understand the long-term behavioral outcomes for infants with sleep, feeding, or multiple regulatory disturbances.
Background:
Excessive crying, sleeping or feeding problems are found in approximately 20% of infants and may predict behavioural problems in childhood.
Methods:
A quantitative meta-analysis of 22 longitudinal studies from 1987 to 2006 that statistically tested the association between infant regulatory problems and childhood internalising, externalising and attention-deficit/hyperactivity disorder (ADHD) problems was carried out; 1935 children with regulatory problems were tested. Cohen's d was used to express the association between regulatory problems and behavioural problems. Heterogeneity of the effect sizes was assessed using the I(2) statistic and meta-analysis of variance and meta-regressions were conducted to assess the influence of moderators. Rosenthal's classic fail-safe N and correlation of sample sizes to effect sizes were used to assess publication bias.
Results:
The weighted mean effect size for the main regulatory problems-behavioural problems association was 0.41 (95% CI 0.28 to 0.54), indicating that children with previous regulatory problems have more behavioural problems than controls. Externalising and ADHD problems were the strongest outcome of any regulatory problem, indicated by the highest fail-safe N and lowest correlation of sample size to effect size. Meta-analyses of variance revealed no significant moderating influences of regulatory problem comorbidity (I(2)=44.0, p>0.05), type (I(2)=41.8, p>0.05) or duration (I(2)=44.0, p>0.05). However, cumulative problems and clinical referral increased the risk of behavioural problems.
Conclusions:
The meta-analyses suggest that children with previous regulatory problems have more behavioural problems than controls, particularly in multi-problem families. Further studies are required to assess the behavioural outcomes of previously sleep, feeding or multiply disturbed children.
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