In the second, we included gender and the five DSM-V subscales which are fewer in number and capture broader areas of difficulty than the eight syndrome subscales. To obtain comparable coefficients, we standardized all subscales before fitting the models. We used Wald tests to obtain post-estimation comparisons of coefficients. We used Stata 14 StataCorp in all analyses. Seven children 1. Of these, Finally, in an ordinal logistic regression model, rDCD status was associated with a higher probability for having a higher number of disorders.
Table 1. CBCL syndrome scale scores and subclinical thresholds by group and sex. Similar to the results observed with the syndrome scales, after adjusting for sex, children with rDCD scored significantly higher on all DSM-V scales.
Overall, the rDCD group had significantly higher mean scores on all syndrome scales and DSM-V subdomains as well as on syndrome scale totals for internalizing, externalizing, and total scores. Table 3. Linear and logistic regression analyses comparing rDCD and typically developing children to assess mean and subclinical threshold differences across CBCL syndrome scales and DSM-V scales adjusting for sex. For the subclinical threshold analyses using logistic regression, the rDCD group had a higher likelihood of meeting the threshold for all subdomains for the syndrome subscales with the exception of somatization and sleep.
They were also more likely to meet the subclinical threshold for internalizing, externalizing, and total summative scores. Finally, for both the syndrome scales and DSM-V categorizations, the rDCD group were more likely to score above the subclinical threshold on two or more syndromes identifying a higher likelihood of comorbidity. In the final analyses not reported in tables , we examined group by sex interactions for the individual syndrome subscales and the comorbidity across subscales.
In addition, regressing group membership on internalizing and externalizing syndrome subscales showed that the association was somewhat stronger with external than with internal symptoms, but this difference was not significant please see Supplementary Table 1. The results of the study indicate that preschool age children with motor difficulties have more parent-reported emotional and behavioral symptoms than their TD peers. This was true of all CBCL syndrome scales as well as all three summative scales.
These children were also more likely to be above the subclinical threshold on a wide range of psychological problems, and to meet CBCL subclinical thresholds for multiple conditions.
These results provide evidence that young children with motor coordination difficulties may be experiencing more emotional and behavioral problems than previously recognized and a higher severity level than expected based on higher levels of comorbidity.
These results confirm findings from previous studies that have identified an association between motor impairment and externalizing behaviors in young children regardless of whether these studies used observational approaches or parent reports using validated instruments 16 , 19 — For example, two previous studies have shown that children with higher levels of motor skill are less likely to have externalizing problems. Livesey et al. MacDonald et al. Thus, it appears clear that there is an increased risk of externalizing behavior problems in preschool age children with motor coordination problems as it has been consistently observed in young children despite the different measures of emotional and behavioral problems used across studies.
Studies of older children and adolescents have consistently observed an association between poor motor skill proficiency and higher internalizing behaviors 5 — 7 , 10 — 15 , but only four studies have examined this relationship in young children 20 , 21 , 30 , Three of these studies observed higher internalizing problems in young children with poorer motor skill scores 20 , 21 , Mancini et al.
King-Dowling et al. In contrast, Piek et al. We found that rDCD children had significantly higher scores for all internalizing conditions, as well as on the internalizing subscale. Our larger sample size, and hence increased power to detect differences, is the likeliest explanation for differences between our study and previous research.
Unique to the present study, we also observed that rDCD children more often met subclinical thresholds for externalizing and internalizing behaviors on both the syndrome scales and DSM-V oriented scales; few TD children met these criteria. For example, for the aggression and withdrawn syndrome subscales, only 1 child and 2 children, respectively, scored above the threshold, compared with 15 and 20 children in the rDCD group.
Children with motor difficulties had more parent-reported emotional and behavioral problems than their TD peers on both the CBCL syndrome scales as well as the DSM-V oriented scales; however, while the observed pattern was similar, it was somewhat inconsistent between the two scoring methods.
Children in the rDCD group scored higher on all CBCL syndrome scales, all DSM-V scales and all three syndrome scale summative scores; however, when examining scores meeting subclinical thresholds, rDCD children only scored at or above the clinical threshold for the DSM-V depression and autism scales compared with all syndrome scales save somatic and sleep.
The inconsistency is not surprising as the two scoring methods were created using different methods in order for the data to be used by both researchers and clinicians The syndrome scale scores were empirically derived using large samples of children and using exploratory factor analysis and principal component analysis 32 , while the DSM-IV, and later DSM-V, oriented scales were created through expert consensus 32 , The authors compared the syndrome scale scores and DSM-V scale scores to the results of a diagnostic interview conducted with parents to examine their clinical utility They demonstrated that, in general, the DSM-V scales did not perform better than the original syndrome scales when compared to the results of the diagnostic interview; however, specifically, only the DSM-V ADHD scale performed better than did the Attention problems syndrome scales.
We observed a similar finding in the present study: rDCD children were significantly more likely to score at or above the syndrome scale clinical threshold for attention but not on the DSM-V ADHD scale.
Despite these inconsistencies, together the results provide strong evidence that preschool age rDCD children have more emotional and behavioral symptoms than their TD peers on a wide range of psychological problems. We examined the interactions between sex and motor functioning in this context. Previous studies have either not considered sex differences 16 , 18 , 19 , 21 or included sex only as a main effect 17 , 30 , We found a significant interaction for the anxiety subscale in both syndrome scales and DSM-V versions, with symptoms most common among rDCD girls.
In our data, the overall rDCD-TD difference in anxiety is, in fact, attributable entirely to the difference among girls; these scores did not differ among boys. Given the large number of comparisons carried out, however, it is not clear whether a genuine sex-specific association between motor functioning and anxiety exists. No group by sex interaction was observed for externalizing behaviors.
Overall, findings indicate that both boys and girls with rDCD have higher levels of internalizing and externalizing symptoms than their TD peers, while the possibility of a specific sex difference for anxiety deserves further consideration.
This is the largest study to date of the association between motor and social-behavioral problems among preschool age children. At the same time, there are limitations. First, these data are cross-sectional, so precedence is not clear. In addition, emotional-behavioral symptoms were only assessed by the parents few others are well-placed to report on preschool-aged children.
Despite these limitations, these results indicate that both the prevalence and severity of emotional and behavioral problems may be greater than previously thought for preschool age children, indicating that opportunities for interventions may exist at early ages. In the school year, more than , children and youth with emotional disturbance received these services to address their individual needs related to emotional disturbance.
Under IDEA, this evaluation is provided free of charge in public schools. There is a lot to know about the special education process, much of which you can learn here on the CPIR site. We invite you to read the wide range of publications we offer on the topic, especially:. As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders.
We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder. These include such different disorders as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder OCD , post-traumatic stress disorder PTSD , social anxiety disorder also called social phobia , and specific phobias.
According to the Anxiety Disorders Association of America , anxiety disorders are the most common psychiatric illnesses affecting children and adults. Unfortunately, only about Severe changes in energy and behavior go along with these changes in mood. For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment. Conduct disorder refers to a group of behavioral and emotional problems in youngsters.
Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. It will also depend on how severe the condition is. Treatment may include:. Eating disorders are characterized by extremes in eating behavior—either too much or too little—or feelings of extreme distress or concern about body weight or shape.
Females are much more likely than males to develop an eating disorder. Anorexia nervos a and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging.
Both of these disorders are potentially life-threatening. Binge eating is also considered an eating disorder. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives.
According to the National Eating Disorders Association :. Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder… Many people utilize a treatment team to treat the multi-faceted aspects of an eating disorder.
Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder which was discussed earlier in this fact sheet.
Repetitive behaviors handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain.
Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder.
Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy a type of counseling. As mentioned, emotional disturbance is one of the categories of disability specified in IDEA. This means that a child with an emotional disturbance may be eligible for special education and related services in public school.
These services can be of tremendous help to students who have an emotional disturbance. Emotional and behavioral disorders are psychiatric illnesses , which means they affect the brain and how it functions. They need help and support so they experience life more positively and, by default, so others in their lives can experience life more positively, too.
Professional mental health help is essential for these children. To help with school success, many kids with emotional and behavioral disorders qualify for special education services. What Are Emotional and Behavioral Disorders? Medically reviewed by Harry Croft, MD. All Rights Reserved. Site last updated November 11,
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