Emotional Behavioural Difficulties Research Articles

Emotional - Behavioral Difficulties and Prosocial Behaviour among Vietnamese Adolescents: the Role of Social Support.

In recent decades, a high prevalence of mental health problems among adolescents has been reported worldwide. In Vietnam, mental health problems such as emotional and behavioural difficulties are relatively common in the adolescent age group. This study aimed to estimate the prevalence of emotional-behavioural problems and prosocial behaviours in Vietnamese adolescents and identify the role of social support in these adolescents' strengths and difficulties. A population sample of 582 adolescents from sixth to ninth grade from four secondary schools in Vietnam voluntarily participated by completing the Strengths and Difficulties Questionnaire (α = .64) and the Social Support Scale (α = .90). The research results revealed that Vietnamese adolescents suffered from considerable levels of emotional-behavioural difficulties and prosocial behaviour problems. Through multible regression analysis, support from their families significantly predicted to decrease students' emotional and behavioural symptoms (β\< 0; p\< .05) and increasing prosocial behaviours (β> 0; p \< .05). In contrast, friend support only contribute to protecting adolescents from behavioural problems (β = -.18; p \< .05) and encouraged prosocial behaviours (β = .22; p \< .05). Family support had a central role in its positive contribution to reducing emotional-behavioural and prosocial behaviour problems. Friend support only decreased behavioural problems and encouraged prosocial behaviours. These results are interpreted that educators could limit adolescents' emotional-behavioural difficulties and encourage prosocial behaviours through social support from their families and friends.

Patterns of intimate partner violence exposure across the first 10 years of life and children's emotional-behavioural outcomes at 10 years

BackgroundChildhood exposure to intimate partner violence (IPV) is associated with emotional-behavioural problems. However, little is known about children's emotional-behavioural outcomes following exposure to different long-term patterns of IPV. ObjectiveThe current study aimed to investigate the emotional-behavioural functioning of children at 10 years of age following exposure to different patterns of IPV across the first 10 years of life. Participants and settingData for this study was drawn from the Mothers' and Young People's Study- a longitudinal study of 1507 first time mothers and their first born child. MethodsWomen were recruited during pregnancy from six public hospitals in Victoria, Australia. Data was collected during pregnancy, and at one, four and ten years postpartum. Four patterns of IPV exposure were previously identified: (a) minimal IPV exposure; (b) early IPV; (c) Increasing IPV; and (d) persistent IPV. Logistic regression was used to assess associations between IPV exposure and emotional-behavioural outcomes. ResultsExposure to early, increasing, or persistent IPV was associated with increased odds of experiencing emotional-behavioural difficulties (OR 2.15–2.97). Children exposed to a persistent pattern of IPV experienced over 6 times the odds of conduct problems (OR = 6.15 CI = 2.3–16.44). ConclusionsChildren exposed to early, increasing, or persistent IPV experienced increased odds of emotional-behavioural problems at age 10, regardless of the duration or type of violence they were exposed to. However, children exposed to persistent IPV across childhood appeared to experience the highest odds of emotional-behavioural difficulties.

Smartphone dependency latent profile classification and association with emotional and behavioral difficulties among high school students in Korea

Purpose: The pervasive integration of smartphones into adolescents’ daily lives has resulted in a concerning upsurge in smartphone dependency among high school students. Due to the diverse types and severity levels of smartphone dependency, there is a critical need for research to explore its heterogeneity. This study aimed to identify latent profile of smartphone dependency in high school students based on the four subdomains of smartphone dependency: disturbance of adaptive functions, virtual life orientation, withdrawal, and tolerance. In addition, we explored how emotional and behavioral difficulties differ according to the profiles. Methods: We used data from 2,195 Korean high school students from the Korean Children and Youth Panel Survey 2018. Latent profile analysis (LPA) was performed to identify smartphone dependency latent profile. Statistical analysis including chi-square test, Analysis of Variance (ANOVA), and ranked Analysis of Covariance (ANCOVA) confirmed differences in smartphone use characteristics and emotional-behavioral difficulties according to the classified latent profile. Results: LPA identified four distinct latent profiles of smartphone dependency among high school students; 1) Underdependent type, 2) Moderate type, 3) Habitual user type, and 4) Virtual space dependent type. The results of ranked ANCOVA, controlling for gender, geographical location, economic status, parental smartphone dependency, and relational variables, revealed that habitual user type exhibited significantly higher rates of attention deficit hyperactivity disorder, social withdrawal, and depressive symptoms compared to other types. Conclusion: The identification of these profiles provides a foundation for developing tailored intervention programs for adolescents with different levels and patterns of smartphone dependency.

Effect of Family Size and Type on Maternal Rejection of Children With ADHD

Objective: This study examined the impact of family size and type on maternal rejection and its relationship with emotional-behavioral difficulties in children with ADHD compared to those typically developing. Method: The participants were mothers of 7- to 12-year-old children with ADHD (n = 102) and mothers of typically developing children (n = 102) in Kazakhstan. In this cross-sectional study, multiple linear regression analysis was performed to explore the relationship between variables. Results: Family size affected maternal rejection after accounting for children’s emotional-behavioral difficulties only in mothers of children with ADHD. The effect of family type on maternal rejection was statistically significant in both groups. Family size exacerbated the relationship between children’s emotional-behavioral difficulties and maternal rejection only in children with ADHD. The moderating effect of family type was not found in either group. Conclusion: Our findings suggest that family size and type contribute to maternal rejection of children with ADHD.

Infant feeding method and special educational need in 191,745 Scottish schoolchildren: A national, population cohort study.

While special educational needs (SEN) are increasingly recorded among schoolchildren, infant breastfeeding has been associated with reduced incidence of childhood physical and mental health problems. This study investigated relationships between infant feeding method and risk of all-cause and cause-specific SEN. A population cohort of schoolchildren in Scotland was constructed by linking together health (maternity, birth, and health visitor records) and education (annual school pupil census) databases. Inclusion was restricted to singleton children, born in Scotland from 2004 onwards with available breastfeeding data and who attended local authority mainstream or special schools between 2009 and 2013. Generalised estimating equation models with a binomial distribution and logit link function investigated associations between infant feeding method at 6 to 8 weeks and all-cause and cause-specific SEN, adjusting for sociodemographic and maternity factors. Of 191,745 children meeting inclusion criteria, 126,907 (66.2%) were formula-fed, 48,473 (25.3%) exclusively breastfed, and 16,365 (8.5%) mixed-fed. Overall, 23,141 (12.1%) children required SEN. Compared with formula feeding, mixed feeding and exclusive breastfeeding, respectively, were associated with decreased all-cause SEN (OR 0.90, 95% CI [0.84,0.95], p < 0.001 and 0.78, [0.75,0.82], p < 0.001), and SEN attributed to learning disabilities (0.75, [0.65,0.87], p < 0.001 and 0.66, [0.59,0.74], p < 0.001), and learning difficulties (0.85, [0.77,0.94], p = 0.001 and 0.75, [0.70,0.81], p < 0.001). Compared with formula feeding, exclusively breastfed children had less communication problems (0.81, [0.74,0.88], p = 0.001), social-emotional-behavioural difficulties (0.77, [0.70,0.84], p = 0.001), sensory impairments (0.79, [0.65,0.95], p = 0.01), physical motor disabilities (0.78, [0.66,0.91], p = 0.002), and physical health conditions (0.74, [0.63,0.87], p = 0.01). There were no significant associations for mixed-fed children (communication problems (0.94, [0.83,1.06], p = 0.312), social-emotional-behavioural difficulties (0.96, [0.85,1.09], p = 0.541), sensory impairments (1.07, [0.84,1.37], p = 0.579), physical motor disabilities (0.97, [0.78,1.19], p = 0.754), and physical health conditions (0.93, [0.74,1.16], p = 0.504)). Feeding method was not significantly associated with mental health conditions (exclusive 0.58 [0.33,1.03], p = 0.061 and mixed 0.74 [0.36,1.53], p = 0.421) or autism (exclusive 0.88 [0.77,1.01], p = 0.074 and mixed 1.01 [0.84,1.22], p = 0.903). Our study was limited since only 6- to 8-week feeding method was available precluding differentiation between never-breastfed infants and those who stopped breastfeeding before 6 weeks. Additionally, we had no data on maternal and paternal factors such as education level, IQ, employment status, race/ethnicity, or mental and physical health. In this study, we observed that both breastfeeding and mixed feeding at 6 to 8 weeks were associated with lower risk of all-cause SEN, and SEN attributed to learning disabilities and learning difficulty. Many women struggle to exclusively breastfeed for the full 6 months recommended by WHO; however, this study provides evidence that a shorter duration of nonexclusive breastfeeding could nonetheless be beneficial with regard to the development of SEN. Our findings augment the existing evidence base concerning the advantages of breastfeeding and reinforce the importance of breastfeeding education and support.

Specific Learning Disabilities and Emotional-Behavioral Difficulties: Phenotypes and Role of the Cognitive Profile

Specific Learning Disabilities (SLD) are often associated with emotional-behavioral problems. Many studies highlighted a greater psychopathological risk in SLD, describing both internalizing and externalizing problems. The aims of this study were to investigate the emotional-behavioral phenotype through the Child Behavior Checklist (CBCL), and evaluate the mediating role of background and cognitive characteristics on the relationship between CBCL profile and learning impairment in children and adolescents with SLD. One hundred and twenty-one SLD subjects (7-18 years) were recruited. Cognitive and academic skills were assessed, and parents completed the questionnaire CBCL 6-18. The results showed that about half of the subjects manifested emotional-behavioral problems with a prevalence of internalizing symptoms, such as anxiety and depression, over externalizing ones. Older children showed greater internalizing problems than younger ones. Males have greater externalizing problems compared to females. A mediation model analysis revealed that learning impairment is directly predicted by age and familiarity for neurodevelopmental disorders and indirectly via the mediation of the WISC-IV/WAIS-IV Working Memory Index (WMI) by the CBCL Rule-Breaking Behavior scale. This study stresses the need to combine the learning and neuropsychological assessment with a psychopathological evaluation of children and adolescents with SLD and provides new interpretative insights on the complex interaction between cognitive, learning, and emotional-behavioral phenotypes.

Case Study: Factors Affecting the Behavior of School Students in the Age of Pre-Adolescence

Using multilevel modeling, this study sought to understand the factors affecting the behaviour of school students at the age of pre-adolescence. The study included 1977 pre-adolescents (1031 boys, 946 girls) from middle schools (Grades 4–7) in suburban areas of the United States from the Department of Children and Family (DCF) 2014 National Child and Youth Panel Survey database. The individual and environmental effects of significant factors affecting pre-adolescent behavior were studied using multilevel models. Among the characteristics linked to emotional-behavioral difficulties were BMI, study tendency, and socioeconomic status. Emotional-behavioral disorders were linked to connections with teachers, according to more studies. The school, family, friends, community, and media all negatively affect students' conduct. As a result, similar educational institutions should teach students social and emotional skills. This may help reduce student disruption. Individual and environmental factors influence pre-adolescents' emotional-behavioral issues. Preventing emotional-behavioral issues require addressing both the environment in which preadolescents live and their unique traits.

Neurodevelopmental correlates of caudate volume in children born at risk of neonatal hypoglycaemia.

Neonatal hypoglycaemia can lead to brain damage and neurocognitive impairment. Neonatal hypoglycaemia is associated with smaller caudate volume in the mid-childhood. We investigated the relationship between neurodevelopmental outcomes and caudate volume and whether this relationship was influenced by neonatal hypoglycaemia. Children born at risk of neonatal hypoglycaemia ≥36 weeks' gestation who participated in a prospective cohort study underwent neurodevelopmental assessment (executive function, academic achievement, and emotional-behavioural regulation) and MRI at age 9-10 years. Neonatal hypoglycaemia was defined as at least one hypoglycaemic episode (blood glucose concentration <2.6 mmol/L or at least 10 min of interstitial glucose concentrations <2.6 mmol/L). Caudate volume was computed using FreeSurfer. There were 101 children with MRI and neurodevelopmental data available, of whom 70 had experienced neonatal hypoglycaemia. Smaller caudate volume was associated with greater parent-reported emotional and behavioural difficulties, and poorer prosocial behaviour. Caudate volume was significantly associated with visual memory only in children who had not experienced neonatal hypoglycaemia (interaction p = 0.03), but there were no other significant interactions between caudate volume and neonatal hypoglycaemia. Smaller caudate volume is associated with emotional behaviour difficulties in the mid-childhood. Although neonatal hypoglycaemia is associated with smaller caudate volume, this appears not to contribute to clinically relevant neurodevelopmental deficits. At 9-10 years of age, caudate volume was inversely associated with emotional-behavioural difficulties and positively associated with prosocial behaviour but was not related to executive function or educational achievement. Previous studies have suggested that neonatal hypoglycaemia may contribute to smaller caudate volume but exposure to neonatal hypoglycaemia did not appear to influence the relationship between caudate volume and behaviour. Among children not exposed to neonatal hypoglycaemia, caudate volume was also positively associated with visual memory, but no such association was detected among those exposed to neonatal hypoglycaemia. Understanding early-life factors that affect caudate development may provide targets for improving behavioural function.

A novel exploration of irritability in adolescent males: A preliminary study.

Irritability is a key symptom of mood disorders and is common in adolescence; nevertheless, it is poorly understood and assessed. Research examining irritability and its relationship to mood and anxiety disorders risk factors in adolescent males is lacking. Therefore, the current study aimed to address this gap. An online survey designed to interrogate the relationship between irritability and other risk factor variables was administered to 627 adolescent males (ages 12-17). Findings were analysed statistically using MANOVAs. When divided into high and low irritability groups, higher irritability scores were significantly correlated with higher scores on all risk factor variables. Further, higher irritability scores were associated with higher scores on all variables that indicate an increased risk for development of psychological disorders, such as depression and anxiety. This study is the first to focus on subjective irritability. In adolescent males, it identifies a potentially novel model of irritability's involvement in maladaptive processes relating to emotional dysregulation, behavioural difficulties and anxiety.

Do Parents' Internal Processes and Feelings Contribute to the way they Report Their Children's Mental Difficulties on the Strength and Difficulties Questionnaire (SDQ)?

The way parents report their child's emotional and behavioral difficulties is important both for identifying the child's needs, diagnosis, and prevention. This study examined to what extent parents' internal processes predict the way in which parents report their child's emotional and behavioral difficulties on the SDQ, as mediated by parental feelings. Parents of children who were referred to a community mental health clinic completed a self-report questionnaire including the following scales: adulthood attachment style, self-regulation difficulty, personal well-being, self-compassion parental feelings, and their child's emotional-behavioral difficulties. Study findings indicated that parents' internal processes do not directly predict parents' report of their children's mental difficulties on the SDQ, only when mediated by parental feelings. These findings highlight the significance of parental feelings in reporting children's behavioral and emotional difficulties. It also contributes to the body of knowledge concerning the importance of caring for parents' needs and feelings and overall parenthood.

Maternal Parenting and Preschoolers' Psychosocial Adjustment: A Longitudinal Study.

Previous research reported that positive parenting and parenting stress might impact children's psychosocial adjustment. The current longitudinal study aimed at evaluating the associations over time between mothers' positive parenting, their parenting stress, and their preschoolers' social-emotional competence and emotional-behavioral difficulties. Participants were 53 Italian mothers, aged between 24 and 47 years (M = 35.30, SD = 5.28) at T0, and their children (females = 51%), aged between 3 and 6 years (M = 4.48, SD = 0.84) at T0. Mothers completed self-report scales at 2 time points (with a 2-year lag). An autoregressive cross-lagged model was tested that had a good fit to the data, χ2(6) = 3.37 ns, CFI = 1.00, RMSEA = 0.00. The results showed that maternal positive parenting at T0 negatively predicted maternal parenting stress at T1; maternal parenting stress at T0 negatively predicted children's social-emotional competence at T1. Moreover, at each time point, children's social-emotional competence was associated positively with maternal positive parenting and negatively with maternal parenting stress; children's emotional-behavioral difficulties were positively associated with maternal parenting stress. The results confirm that interactions with mothers are fundamental for children's psychosocial adjustment. Implications for research and practice aimed at reducing parenting stress and fostering positive parenting are discussed.

Good enough residential care setting: Child-parent contact and youth adjustment in the context of staff attitudes towards parent involvement

The importance of parent-child contact to the well-being of children in residential care is emphasized in child welfare literature. However, despite the central role of youth care workers in the lives of children in residential care settings (RCSs), there is a lack of research on the role of RCS staff in child-parent contact. This study, based on the reports of 240 youth, aged 14 to 18, in therapeutic RCSs for children at risk in Israel, examined the link between frequency of contact and quality of attachment between mothers and adolescents and adolescents’ emotional-behavioral difficulties, and the moderating role of RCS youth care workers’ attitudes towards mother involvement in that link. The findings show a negative relationship between adolescents’ emotional-behavioral difficulties and their perceived quality of attachment to their mother. Frequency of contact was found to be non-significantly linked with adolescent difficulties. The attitudes of RCS staff towards mother involvement moderated the relationship between quality of mother-child contact and adolescents’ adjustment difficulties, so that among youth who reported a more positive attitude of the staff towards mothers’ involvement, the relationship between the quality of child-mother attachment and fewer adjustment difficulties among adolescents was stronger. The study has implications for designing interventions and training RCS staff to enhance child-parent contact while in care.

Mothers and fathers of pre-school children: a study on parenting stress and child’s emotional-behavioral difficulties

The present study aimed to analyze the differences between maternal and paternal parenting stress and children’s behavioral functioning, as determined by teacher and parent reports. In addition, it sought to evaluate the presence of clusters based on parenting stress and to determine whether perceptions of children’s behavioral functioning varied across these clusters. The sample was composed of the parents and teachers of N = 201 children. Parents completed a self-report questionnaire on parenting stress and parents and teachers filled out report-form questionnaires assessing children’s emotional and behavioral functioning. The results showed that mothers had higher levels of parenting stress than fathers, and both parents reported more prosocial behavior in children than did teachers. Furthermore, middle stressed parents had children who expressed more prosocial behavior than did parents in other clusters. The findings also showed that parenting stress influenced partners’ perceptions of children’s behavioral functioning. The multiplicity of child observers facilitated a better understanding of how parenting stress, linked to parent–child interactions, may play an important role in shaping parents’ perceptions of their children.

Prospective assessment of anxiety among pediatric oncology patients and their caregivers during the COVID-19 pandemic a cohort study

Objective: To assess COVID-19-pandemic related anxiety and emotional-behavioral difficulties among oncologic children and their caregivers. Design: Prospective cohort study conducted from March to November 2020. Participants: 76 pediatric oncological and 28 nonmalignant hematological patients aged 1.6–23.4 years and their caregivers. Methods: A total of 104 families completed an age-specific self-report psychological assessment; of these, 20 oncologic families completed the assessment at two time points. Findings: Ten percent of the caregivers and 13.9% of the patients reported anxiety disorder. Additionally, 3.1% of the caregivers reported behavioral difficulties. No significant differences emerged between patients’ self-reports and caregivers’ reports. No differences emerged between oncological and nonmalignant hematological participants. Conclusions: The prevalence of anxiety associated with the COVID-19 pandemic was similar to the reported prevalence of anxiety following a diagnosis of pediatric malignancy. Implications: Real-time assessment of psychological effects revealed no COVID-19-associated anxiety. Nonetheless, late effects will need to be monitored.

Parental Mentalizing during Middle Childhood: How Is the Adoption of a Reflective Stance Associated with Child's Psychological Outcomes?

This exploratory cross-sectional study attempts to understand the mechanisms underlying the role of parental mentalizing in a child’s psychological functioning during middle childhood by using Parental Reflective Functioning (PRF) and Parental Insightfulness (PI) constructs. The main aims are to examine the role of PI and PRF as processes capable of influencing a child’s psychological functioning in terms of emotional–behavioral difficulties and social–emotional competencies. Eighty-six community parents (48 mothers, 38 fathers) and their 50 children in middle childhood (Mage = 10.10, SD = 1.13) participated in this study, recruited through a non-probabilistic sampling. The following measures were used to assess the aims of this study: Insightfulness Assessment, Parental Reflective Functioning Questionnaire, Child Behavior Checklist (CBCL) and Devereux Student Strengths Assessment (DESSA) questionnaires. Results showed that parental mentalizing was found to be significantly associated with both child’s internalizing and externalizing symptoms and social–emotional competencies as reported by parents through the CBCL and DESSA questionnaires. This study may offer a contribution to the study of parental mentalizing during middle childhood, supporting the hypothesis that both parents’ ability to understand their child’s mental states could affect the child’s psychological functioning. Clinical and theoretical implications are geared toward a family-based view with a specific focus on the importance of fostering in both parents a positive attitude toward mentalizing processes.

Social and emotional characteristics of girls and young women with DDX3X-associated intellectual disability: a descriptive and comparative study

DDX3X variants are a common cause of intellectual disability (ID) in females, and have been associated with autism spectrum disorder and emotional-behavioural difficulties. In this study, we compared phenotypic data for 23 females with DDX3X variants, to 23 females with ID and other genetic diagnoses. We found a wide range of adaptive, social and emotional function within the DDX3X group. Autism characteristics did not differ between DDX3X and comparison groups, while levels of anxiety and self-injurious behaviour (SIB) were significantly higher in the DDX3X group. Within the DDX3X group, adaptive function, autism characteristics, anxiety and SIB scores were positively correlated, with evidence for group-specific associations with SIB. Future work is warranted to explore the multilevel mechanisms contributing to social and emotional development in individuals with DDX3X variants.

Cognitive and behavioral profiles in children with autism spectrum disorder with and without Attention-Deficit/hyperactivity disorder.

Understanding the developmental trajectories of children with autism spectrum disorder (ASD) with and without comorbid ADHD is relevant to tailor care plans. This prospective study assessed, for the first time, cognitive, emotional, behavioral, and learning outcomes in adolescence of children with ASD-ADHD and in those with ASD+ADHD in childhood. Possible predictors of severity of ASD core symptoms in adolescence were also evaluated. Forty-five adolescents without intellectual disability, 26 diagnosed in childhood with ASD-ADHD and 19 with ASD+ADHD, were evaluated at baseline (mean age: 8.6 ± 1.3) and at 5-year follow-up (mean age: 12.9 ± 0.9). Parents and teachers completed questionnaires on executive functions, theory of mind (ToM), emotional/behavioral difficulties (EBD), and learning style at both time points.. Overall different developmental trajectories for the two groups were found. In general, deficits in metacognition processes, ToM skills, EBD, and learning abilities were more pronounced in the ASD+ group. Over time, the ASD+ADHD group, but not the ASD-ADHD, tended to improve in EBD and metacognition but their level of development continued to be lower compared with ASD+ADHD. EBD in childhood were significant predictors of autism core symptoms of adolescents. Our findings highlight the importance of an early identification of comorbid ADHD symptoms in ASD to offer treatment strategies based on specific developmental trajectories.

Intergenerational Impact of Violence Exposure: Emotional-Behavioural and School Difficulties in Children Aged 5-17.

Background and Objectives: The intergenerational impacts of parental exposure to violence during childhood and adulthood have largely been investigated separately. This limits our understanding of how cumulative violence exposure over a lifespan elevates the risk of subsequent generation's maladjustment. To address this, we examined if parental exposure to violence during childhood and during adulthood was associated with increased emotional-behavioural and school difficulties among the children of these parents. Further, we examined if parental exposure to cumulative violence increased the odds of their children experiencing difficulties.Participants and Setting: 705 participants (354 mothers and 351 fathers) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017 and March 2019.Methods: Multivariable logistic regressions were conducted to ascertain the impact of parental exposure to violence on children's outcomes after adjustment for sociodemographic characteristics. The impact of parental cumulative violence exposure on children's outcomes was also explored.Results: Findings indicated that children of parents who had histories of exposure to violence during childhood were at increased risk for experiencing emotional-behavioural or school difficulties. However, where parents reported a history of childhood abuse but not adult experience of violence, their children had similar odds of experiencing difficulties as the children of parents who had not been exposed to any violence in their lifetime. Children of parents who had been exposed to violence only during adulthood were at higher risk of experiencing emotional-behavioural difficulties compared with children of parents with no violence exposure. Children of parents with histories of exposure to violence during both childhood and adulthood had the highest prevalence of experiencing emotional/behavioural and school difficulties.Conclusion: These findings highlight the intergenerational impacts of violence exposure and the complex intersections between parents' and children's life experiences. Our findings suggest the need for violence prevention initiatives to foster the development of safe, stable and nurturing relationships and to expand services for parents already exposed to violence to build resilience and to break the inter-generational cycle of disadvantage.

Below Average Cognitive Ability-An under Researched Risk Factor for Emotional-Behavioural Difficulties in Childhood.

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.

Overview of the findings and advances in the neurocognitive and psychosocial functioning of mild to moderate pediatric CKD: perspectives from the Chronic Kidney Disease in Children (CKiD) cohort study.

The Chronic Kidney Disease in Children (CKiD) prospective cohort study was designed to address the neurocognitive, growth, cardiovascular, and disease progression of children and adolescents with mild to moderate CKD. The study has had continuous funding from NIDDK for 17 years and has contributed significant advances in pediatric CKD. The goals of this educational review are threefold: (1) to provide an overview of the neurocognitive and psychosocial studies from CKiD to date; (2) to provide best practice recommendations for those working with the neurocognitive and psychosocial aspects of pediatric CKD based on CKiD findings; and (3) to help chart future goals and directives for both research and clinical practice. This collection of 22 empirical studies has produced a number of key findings for children and adolescents with mild to moderate CKD. While various studies suggest a relatively positive presentation for this population as a whole, without evidence of significant impairment or deterioration, findings do indicate the presence of neurocognitive dysfunction, emotional-behavioral difficulties, and lower quality of life for many children with CKD. These findings support the promotion of best practices that are accompanied by additional future clinical and research initiatives with this patient population.