Parent-referred problem three-year-olds: follow-up at school entry

Area of Science:

• Child Psychology
• Developmental Psychology
• Behavioral Science

Background:

• Early hyperactivity and externalizing behaviors in preschoolers are significant predictors of later childhood adjustment.
• A substantial proportion of children referred for these issues may develop Attention Deficit Disorder (ADD).

Purpose of the Study:

• To examine the long-term adjustment outcomes for children initially identified with early signs of hyperactivity and externalizing problems.
• To determine predictors of persistent difficulties and the development of Attention Deficit Disorder (ADD) by age six.

Main Methods:

• Longitudinal study tracking parent-referred three-year-olds with early behavioral problems compared to a control group.
• Utilized maternal reports, teacher questionnaires, observational measures, and laboratory assessments at age three and follow-up at age six.
• Diagnostic criteria from the DSM-III were used to identify Attention Deficit Disorder (ADD).

Main Results:

• Half of the children with initial problems continued to experience adjustment difficulties at home, school, and with peers at age six.
• One-third of the problem group met DSM-III criteria for Attention Deficit Disorder (ADD).
• Persistent behavioral problems, rather than initial laboratory measures, were key differentiators between improved and persistently affected children; initial maternal symptom severity was also a significant predictor.

Conclusions:

• Early hyperactivity and externalizing problems have a significant risk for persistent adjustment difficulties and Attention Deficit Disorder (ADD) into middle childhood.
• Maternal ratings of initial symptom severity are valuable in predicting long-term outcomes.
• While laboratory measures at age three were not predictive, persistent symptoms and initial maternal reports are crucial for identifying children at risk.