Early well-child check-ups can help identify children at risk of emotional, behavioral problems

A new study suggests clinicians might be able to identify children at risk of later emotional or behavioral problems by paying attention to a few key signs during early well-child check-ups. Researchers found that boys with early sleep problems and girls with language and speech delays tended to have more emotional problems in adolescence.

"Speaking little is an early sign of having problems, maybe because these early problems hamper social functioning, leading to emotional problems later on," explained author Sijmen Reijneveld, M.D., head of the Department of Health Sciences at University Medical Center Groningen in the Netherlands. He added that early sleep problems in boys might be due to fears or other emotional problems.

In addition, in both genders, having a mother who smoked during pregnancy, having parents with low education, and having divorced or single parents increased the odds of behavioral problems during adolescence.

Emotional problems were identified in teens who reported feeling worthless or crying frequently. Examples of behavioral problems included fighting and destroying belongings, explained Reijneveld.

The study, appearing in the Journal of Adolescent Health, used data from early child well-visits from birth to age 4, when parents are asked about the child's early developmental habits. A Youth Self-Report survey was also completed by 1,816 adolescents (ages 11-17) three separate times at ages 11, 14 and 17. Parents filled out Child Behavior Checklists.

The study also revealed that more girls were on the path toward clinical emotional problems than boys (8.6 percent vs. 2.3 percent, respectively) and more boys tended toward behavioral problems than girls (8.6 percent vs. 4.2 percent).

Reijneveld and his fellow researchers concluded that well-child visits offer a chance to both identify and help children at risk. They noted one limitation of their study was not controlling for parental psychopathology.

Mary O'Connor, Ph.D., professor in the department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA, agreed that early intervention may help change these children's course.

"Early diagnosis and treatment results in a much better long term prognosis," she said. "Nevertheless, unless the family issues are addressed in context, including early developmental problems in the child, marital and parental stress, alcohol and other drug use, and the need for psychosocial support, working with the child alone will have little long term impact."