Abstract
Children with below average cognitive ability represent a substantial yet under-researched population for whom cognitive and social demands, which increase in complexity year by year, may pose significant challenges. This observational study examines the longitudinal relationship between early cognitive ability and emotional-behavioral difficulties (EBDs) between the age of three and nine. Participants include 7134 children from the population-based cohort study growing up in Ireland. Cognitive ability was measured at age three using the Picture Similarities Scale. A t-score one to two standard deviations below the mean was defined as below average cognitive ability (n = 767). EBDs were measured using the Strengths and Difficulties Questionnaire (SDQ) at three, five, and nine years of age. Generalized linear mixed models and logistic regression were used to examine the relationship. Below average cognitive ability was an independent predictor of higher longitudinal SDQ scores. After adjustment, children with below average cognitive ability were 1.39 times more likely (AOR 1.39, 95% CI 1.17–1.66, p < 0.001) to experience a clinically significant EBD between the ages of three to nine years. This study demonstrates the increased risk of EBDs for children with below average cognitive ability. A scalable method of early identification of at-risk children should be a research priority for public health, enabling early intervention for cognitive and adaptive outcomes.
Highlights
There are many confounding variables in the relationship between cognitive ability and emotional-behavioral development, as risk factors such as childhood adversity and markers of lower socioeconomic status predispose to both outcomes. Acknowledging these challenges in establishing a causal relationship between cognitive ability and emotional-behavioral development, the results of this study suggest a worsening in emotional-behavioral function for those with below average cognitive ability between the age of five and nine, a period coinciding with increasingly complex cognitive tasks as one progresses through formal education
While there are a number of systematic reviews and meta-analyses reporting a disproportionately high prevalence of mental health problems among children with intellectual developmental disabilities, no such reviews exist for the larger proportion of children with below average cognitive ability
In this study we examined the relationship between early cognitive ability and emotional-behavioral development using a variety of statistical models
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Children with below average cognitive ability represent a substantial proportion of children, and often have unrecognized difficulties [1,2]. Intellectual function and adaptive behavior that are approximately two or more standard deviations (SD) below the mean on a standardized test are diagnostic of an intellectual developmental disability (IDD) [3]. Those who perform one to two SD below the mean fall into a “grey area”, which is substantially below that of the average population but not meeting the diagnostic criteria for IDD
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