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Developmental and Behavioral Problems of Preschool-Age Children with Chronic Rheumatic Diseases
Tuba Çelen Yoldaş1, Semanur Özdel2, Jale Karakaya3
1Department of Pediatrics, Division of Developmental Pediatrics, University of Health Sciences, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
Insights
Preschoolers with chronic rheumatic diseases like juvenile idiopathic arthritis (JIA) and familial Mediterranean fever (FMF) show more developmental and behavioral issues. Early screening for these problems is crucial for effective management.
Area of Science:
- Pediatric Rheumatology
- Developmental Pediatrics
- Child Psychology
Background:
- Juvenile idiopathic arthritis (JIA) and familial Mediterranean fever (FMF) are common chronic rheumatic diseases in childhood.
- These conditions can impact a child's overall development and well-being.
Purpose of the Study:
- To identify developmental and behavioral problems in preschool-age children with JIA and FMF.
- To compare these problems across different diagnostic categories.
- To determine factors associated with these difficulties.
Main Methods:
- A study included 91 children (46 with rheumatic diseases: 27 JIA, 19 FMF) and 45 healthy controls.
- Developmental and behavioral issues were assessed using the Ages and Stages Questionnaire and Child Behavior Checklist-1½-5.
- Maternal well-being was evaluated using the State-Trait Anxiety Inventory and Beck Depression Inventory.
Main Results:
- Children with chronic rheumatic diseases exhibited increased internalizing problem scores and higher rates of developmental delays, particularly in fine motor and problem-solving domains.
- Lower maternal education and increased screen time were independent risk factors for developmental delay.
- Maternal anxiety correlated with internalizing and total problems specifically in children with FMF.
Conclusions:
- Preschoolers with chronic rheumatic diseases are at increased risk for developmental and behavioral problems compared to healthy peers.
- Routine screening for developmental and behavioral issues should be integrated into the early management of these chronic conditions.
Objective:
Juvenile idiopathic arthritis (JIA) is the most common autoimmune and familial Mediterranean fever (FMF) the most common autoinflammatory chronic rheumatic disease in childhood. We aimed first to identify developmental and behavioral problems of preschool-age children with common chronic rheumatic diseases, second to compare the diagnostic categories, and third to elucidate the associated factors with these difficulties.
Method:
Of the 91 participants included in this study, 46 were children with rheumatic diseases (27 with JIA and 19 with FMF) and 45 were healthy children. The general developmental and emotional/behavioral problems of each child were evaluated by the Ages and Stages Questionnaire and Child Behavior Checklist-1½-5, respectively. The State-Trait Anxiety Inventory and Beck Depression Inventory were used for maternal well-being.
Results:
Internalizing problem scores were increased, and the percentage of children who failed at least 1 developmental domain and experienced delays in fine motor and problem-solving domains were higher in children with chronic rheumatic diseases when compared with healthy children. Being in the group of rheumatic diseases, fewer maternal education years and higher screen time were found to be independent risk factors significantly associated with any developmental delay in the multivariable model. Maternal trait anxiety scores were positively associated with internalizing and total problems only in FMF.
Conclusion:
Preschool-age children with a diagnosis of chronic rheumatic diseases were more vulnerable for developmental and behavioral problems compared with healthy children. The management of chronic rheumatic diseases in the early years should include the screening of developmental and behavioral problems.
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