Emotional and behavioural difficulties: is this a useful category? The implications of clustering and co-morbidity – the relevance of a taxonomic approach

Abstract

Previous research has demonstrated that there is significant co-morbidity in different disorders of behaviour and emotion. It is also a common perception that the category of Special Educational Needs (SEN) collectively called Emotional and Behavioural Difficulties (EBD) refers to those children who exhibit externalizing problems. The present study has explored these assumptions by analysing the range and type of behaviours found in the EBD population, proposing that the identification of different groups within the EBD category has a necessary impact on issues of assessment and intervention. The hypotheses propose that the category of EBD contains distinct sub-groups of children with similar characteristics; that although the category of EBD often suggests Conduct Disorder (CD), other factors are involved and finally, that many children with EBD have Attention Deficit Hyperactivity Disorder (ADHD) with co-morbid Conduct Disorder (CD).The Teacher Report Form (TRF) of the Child Behaviour Checklist (CBCL) (Achenbach, 1991) was completed by teachers of 254 boys attending schools for children with emotional and behavioural difficulties in one local education authority.Cluster analysis yielded five distinct groupings of children within the EBD population in this sample. These were conduct problems; emotional problems; attentional problems; co-morbid conduct, emotional and attentional difficulties and a group with no apparent problems. The usefulness of the EBD label is questioned as it is clear that this is not a homogeneous population. The implication is that greater identification of typology is required if appropriate intervention is to be recommended and applied in order to meet the diverse needs of this group of children. The stated hypotheses were all supported.