Psychosocial and Developmental Predictors of Early Behavioral Problems in Preschool Children Referred for...

Behavioral problems in children may be associated with developmental characteristics and parental stress levels. This study aimed to identify potential early risk indicators and focal points for preventive intervention related to behavioral problems among preschool children suspected of developmental delay before diagnosis or formal intervention.

This cross-sectional study included 89 children aged 24-60 months referred for their first evaluation for suspected delays and 37 typically developing (TD) peers. Development was assessed with the Ages and Stages Questionnaire-Turkish version (ASQ-TR). Mothers completed the ASQ: Social-Emotional, Child Behavior Checklist (CBCL/1.5-5), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Parenting Stress Index-Short Form (PSI-SF). Groups were compared, and regression analyses identified child and parent factors associated with behavioral problems. Concurrently, the study examined the developmental, psychological, and familial factors associated with behavioral problems among children at developmental risk. In this subgroup, regression analyses assessed the associations between predefined child variables (age, sex, ASQ-TR domain scores) and maternal measures (BDI, STAI, PSI-SF, parental education, socioeconomic status) with CBCL outcomes.

Children with developmental risk had significantly higher CBCL total, internalizing, and externalizing scores than TD peers. Maternal depression symptom and anxiety scores did not differ between groups, but parenting stress was higher among mothers of children with risk. Within the developmental risk group, parenting stress was consistently associated with total, internalizing, and externalizing problems. Delays in personal-social and social-emotional domains were linked to total and externalizing difficulties, while gross motor delays were related to internalizing problems. The number of delayed developmental domains correlated with both behavioral problems and parenting stress.

Behavior problems are higher among children identified as being at developmental risk through screening, and parenting stress is closely associated across behavioral domains even before formal diagnosis or intervention. Multiple delays appear to exacerbate both child and parent outcomes. These findings highlight the need for early, family-centered interventions addressing children's developmental and behavioral needs alongside parental well-being.