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Published on: September 19, 2019
Behavioural and emotional concerns reported by parents of children attending a neurodevelopmental diagnostic centre
Anton R Miller1, Emily Gardiner1, Louise Harding2
1BC Children's Hospital Research Institute, Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Insights
Parents of children with neurodisability frequently worry about behavioral and emotional problems. Key concerns include tantrums, inflexibility, and social difficulties, which often span across different diagnostic categories.
Area of Science:
- Child Psychology
- Neurodevelopmental Disorders
- Clinical Pediatrics
Background:
- Behavioral and emotional problems are a significant concern for parents of children with neurodisability.
- Limited understanding exists regarding the specific nature and distribution of these concerns across different neurodevelopmental subpopulations.
Purpose of the Study:
- To identify and categorize the behavioral and emotional concerns experienced by parents of children with neurodisability.
- To explore the commonalities and variations in these concerns across different clinical groups.
Main Methods:
- Extracted behavioral and emotional concern data from clinical reports of 129 children (aged 3-8 years) assessed by 12 developmental pediatricians.
- Utilized a two-stage, interdisciplinary concept-sorting technique to group concerns thematically.
Main Results:
- Identified 669 discrete concerns, aggregated into 58 First Stage Groupings and 28 Second Stage Clusters.
- Prominent concerns included attention/concentration issues, anxiety, social isolation, tantrums/meltdowns, self-regulation difficulties, and sensory issues.
- Tantrums/meltdowns, inflexibility, and social behaviors were consistently among the top concerns across different clinics.
Conclusions:
- The study provides a detailed insight into the phenomenology of behavioral and emotional concerns in children with neurodisability.
- Findings can inform clinicians and highlight the importance of addressing subthreshold concerns.
- Commonality of certain concerns across subpopulations supports a non-categorical view of behavioral and emotional problems in neurodisability.
Background:
Behavioural and emotional problems are a salient concern for parents of children with neurodisability, but little is known about the nature of such concerns in this population, nor about the distribution of concern types across ostensibly different subpopulations.
Methods:
Information about behavioural and emotional concerns was extracted from clinical reports of developmental paediatricians (N = 12) who had assessed children aged 3 to 8 years (N = 129) through three clinics at a major developmental and rehabilitation service centre. All concerns were captured at a granular level. A two-stage, consensus-based interdisciplinary concept-sorting technique was used to identify and group thematically related behavioural and emotional concerns into First Stage Groupings, intended to preserve detail and specificity, and a reduced number of Second Stage Clusters.
Results:
A total of 669 discrete concerns were encountered, aggregated to 58 First Stage Concern Groupings and 28 Second Stage Concern Clusters. Findings of the salience of Groupings related to Attention, Concentration and Distractibility, and Anxiousness, Shyness, and Emotional Sensitivity reflect existing literature for children with neurodevelopmental concerns. "Social Isolation/Peer Engagement," "Tantrums/Outbursts/Meltdowns" and "Volatility/Self-regulation Difficulties," and "Sensory Issues" emerged as areas of significant concern and salience as well. Across clinics, three Clusters recurred among the top five observed for each clinic: "Tantrums/Outbursts/Meltdowns," "Inflexibility/Gets Stuck or Fixated," and "Social Behaviours."
Conclusions:
This rich descriptive dataset affords insight into the phenomenology of behaviour and emotional concerns in the daily lives of parents whose children have known or suspected neurodisability. Study findings can inform and sensitize clinicians working with this population. Usefulness is enhanced by inclusion of behavioural material that is subthreshold for a formal psychopathologic diagnosis. Certain concern types are encountered commonly across different clinical subpopulations, supporting a noncategorical view of behavioural and emotional problems as functional attributes that cross neurodisability diagnostic categories.
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