Difficulties In Young Children Research Articles

Informing creation of the FEEDS Toolkit to support parent-delivered interventions for eating, drinking and swallowing difficulties in young children with neurodisability: intervention use by neurodevelopmental diagnosis and healthcare professional role

BackgroundThe FEEDS (Focus on Early Eating, Drinking and Swallowing) study focused on interventions used to improve feeding for children with neurodisability and eating, drinking and swallowing difficulties (EDSD), and the...

Prevalence of Common Child Mental Health Disorders Using Administrative Health Data and Parent Report in a Prospective Community-Based Cohort from Alberta, Canada: Prévalence des troubles communs de santé mentale de l'enfant à l'aide des données de santé administratives et des rapports des parents dans une cohorte prospective communautaire d'Alberta, Canada.

Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age. Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional ("parent report"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition ["BASC-3"]), and cumulative inpatient, outpatient, or physician claims diagnoses ("administrative data"). Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources. The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood. Prevalence of child mental health disorders according to different data sources in Canada.

Pathways to epilepsy surgery in children with tuberous sclerosis complex-associated epilepsy

BackgroundPrevious studies showed the efficacy of epilepsy surgery in carefully selected children with epilepsy associated with tuberous sclerosis complex. However, how this selection is conducted, and the characteristics of the patients brought to surgery are still poorly described. By conducting a multicentric retrospective cohort study covering the practice of the last twenty years, we describe the paths leading to epilepsy surgery in children with epilepsy associated with tuberous sclerosis complex. MethodsWe identified 84 children diagnosed with tuberous sclerosis complex and epilepsy by matching two exhaustive registries of genetic diseases and subsequent medical records reviews within two French neuropediatric and epilepsy centers. Demographic, clinical, longitudinal, and diagnostic and surgical procedures data were collected. ResultsForty-six percent of the children were initially drug-resistant and 19% underwent resective surgery, most often before the age of four. Stereotactic electroencephalography was performed prior to surgery in 44% of cases. Fifty-seven and 43% of patients remained seizure-free one and ten years after surgery, respectively. In addition, 52% of initially drug-resistant patients who did not undergo surgery were seizure-free at the last follow-up. The number of anti-seizure medications required decreased in 50% of cases after surgery. Infantile spasms, intellectual disability, autism spectrum disorder or severe behavioral disorders were not contraindications to surgery but were associated with a higher rate of complications and a lower rate of seizure freedom after surgery. ConclusionDespite the assumption of complex multifocal epilepsy and practical difficulties in young children with tuberous sclerosis complex, successful surgery results are comparable with other populations of patients with drug-resistant epilepsy, and a spontaneous evolution to drug-sensitive epilepsy may occur in non-operated patients.

Inferential Comprehension Abilities in French-Speaking Preschoolers Exposed to Neglect in the Early Longitudinal Language and Neglect Study.

Using a longitudinal design, this study aimed to describe inferential comprehension abilities of neglected French-speaking preschool children from 42 to 66 months of age in comparison to non-neglected peers, to examine the association with receptive vocabulary, and to determine whether rates of change in inferential abilities over time was stable between the two group conditions. An inferential comprehension task and the French version of the Peabody Picture Vocabulary Test-Fourth Edition were administered to a group of neglected children (n = 37-40) and to a group of same-age non-neglected children (n = 71-91) at 42, 54, and 66 months old, as part of the Early Longitudinal Language and Neglect study. Results show that children exposed to neglect obtain significantly lower scores compared to their same-age peers on inferential comprehension and receptive vocabulary measures at all three time points (p < .001) with large to very large effect sizes and indicate moderate to strong correlations between the two variables. Children from the neglected group present difficulties in inferencing compared to same-age non-neglected peers, a disadvantage that remains stable over time. This study demonstrates the significant gap in inferential comprehension abilities between neglected and non-neglected preschool children. These results reiterate the importance of early detection of language comprehension difficulties in young children coming from vulnerable environments.

School Readiness in Preschool-Age Children with Critical Congenital Heart Disease.

This study examined the nature, variability, and predictors of school readiness difficulties in young children with critical congenital heart disease (CCHD). We hypothesized that, compared to a community control (CC) group, children with CCHD would score less well on measures of readiness and that readiness would be associated with CCHD-related risk factors. Children (60 CCHD and 60 CC) were 4 to 5 years of age and not yet attending kindergarten. Readiness measures included tests of cognition, executive function, motor ability, and pre-academic skills. Caregivers provided child behavior ratings. Analyses examined group differences in readiness, readiness profiles, and associations of readiness with CCHD-related medical risk factors. The CCHD group had lower scores than the CC group on testing and higher caregiver ratings of problems in social communication, as well as higher rates of deficits on several of the measures. Latent class analysis provided evidence for different readiness profiles, with more children with CCHD displaying profiles characterized by weaknesses in readiness. CCHD-related medical risk factors associated with readiness problems in the CCHD group included a co-morbid genetic disorder, postnatal diagnosis of CCHD, major perioperative complication, and longer periods of hospitalizations, cardiopulmonary bypass, and aortic cross-clamp placements. Findings document multiple problems in school readiness in young children with CCHD. Deficits vary across individuals and are associated with higher medical risk. Results confirm the importance of screening for school readiness in these children and suggest areas to target in designing screening measures and providing early childhood interventions.

On Realizing External Arguments: A Syntactic and Implicature Theory of the Disjointness Effect for Passives in Adult and Child Grammar

We present an account of why disjoint reference effects obtain in verbal but not in adjectival passives. Passives in child language are independently argued to always be adjectival, which allows us to use a natural experiment in child grammar that is not available in the adult grammar: predicting the lack of a disjoint reference effect in even those passives that prima facie seem verbal. We conduct our discussion against the background of the difference between adjectival and verbal passives in general. Our account is based on (grammatical) Implicature Theory. Since the initiator in the semantic representation of adjectival passives stays at a kind level, it cannot introduce a discourse referent, hence cannot trigger a disjointness implicature, unlike the initiator in verbal passives (Gehrke 2013, 2015). We show in two experiments that children’s passives do not exhibit disjoint reference, unlike adults’ verbal passives, even though children have no trouble computing disjointness implicatures elsewhere. Our contribution thus confirms with a novel kind of evidence the syntactic nature of young children’s difficulty with verbal passives. It offers a new perspective on the external argument difference between verbal and adjectival passives based on Reinhart’s (2016) Theta System, while also offering additional evidence for a grammatical, rather than general pragmatic, theory of implicatures.

Internet‐delivered Parent–Child Interaction Therapy increases positive parenting behaviors that maintain over time

AbstractYoung children's display of emotional and behavioral difficulties is relatively commonplace. However, if left unaddressed, these challenging behaviors have potential to develop into more serious problems. Furthermore, parents often report feeling unprepared to prevent and address their young children's emotional and behavioral difficulties. Fortunately, behavioral parent training strategies, such as Parent–Child Interaction Therapy, have been found to be effective for helping parents learn to effectively improve young children's behavior. Although effective, there are barriers to accessing behavioral parent training, such as cost, lack of transportation, and living in rural areas with limited mental and behavioral health care. Therefore, the purpose of this pilot study was to evaluate the effects of internet‐delivered PCIT (iPCIT) on parents' use of praise, reflections, imitations, descriptions, and enjoyment/enthusiasm (PRIDE skills) with children referred for disruptive behavior. Participants in this study included three parents and their 2‐year‐old children. We used a concurrent multiple probe across participants' design to test the effects of iPCIT on parents' use of PRIDE skills and maintenance of treatment effects. Results indicated that all three parents increased their use of PRIDE skills and maintained them following termination of treatment. Results, implications, and future directions are discussed.

Sickle Cell Disease and Hydroxyurea Knowledge, Views and Perceptions Among 400 Sickle Cell Patients and Caregivers at Mulago Hospital Sickle Cell Clinic: A Global Health Study in Kampala, Uganda

Background: In 2017, hydroxyurea was approved for the treatment of all sickle cell patients with genotype HbSS in Uganda following overwhelming support from the NOHARM trial conducted in a malaria endemic region at Mulago National Referral Hospital's Sickle Cell Clinic. Between January 2019 and June 2022, immediately following nationwide approval and distribution of hydroxyurea, hydroxyurea was prescribed a total of 4017 (51.2%) times out of the 7851 HbSS patient visits to the clinic according to data available from the clinic. Aims:The purpose of this study is to investigate the knowledge, perceptions, and beliefs of patients with sickle cell disease and their caregivers attending this clinic in Kampala regarding their disease, complications, genetic impact, general anticipated course of treatment or natural history of disease, and hydroxyurea. Methods: A total of 400 (56%) out of 713 patients were surveyed over a 3-week period using standardized, pretested questionnaires administered orally by trained research personnel in both English (253, 63%) and Luganda (147, 36.8%), which are the most common local languages and dialects spoken by patients in Kampala. Three-hundred and twenty-one (80.3%) participants were caregivers and 79 (19.8%) were children with sickle cell disease between 12- and 17-years-old. Results: Most participants reported receiving counseling about sickle cell disease (333; 83.3%) largely by hematologists (286; 85.9%), however, several knowledge gaps were identified. Two-hundred and ninety-seven (74.3%) participants reported not knowing the type of sickle cell or genotype of the patient. Moreover, presentation of various options did not significantly improve recognition of the correct genotype, with only 121 (30.3%) participants correctly identifying HbSS. Three-hundred and twenty-eight (82%) participants correctly identified the heritable transmission of the disease from both parents; however, caregivers exhibited limited understanding of genetic risk with only 31 (9.7%) correctly identifying the one in four chances of having a subsequent child with sickle cell disease when both parents are carriers. Hydroxyurea counseling was reported by 326 (81.5%) of participants, and 307 (76.7%) participants reported that the patient received hydroxyurea, with most patients taking the medication for at least 1 year. Of the 93 (23.5%) participants who identified the patient had never received hydroxyurea, 32 (34.4%) were uncertain if the patient would be eligible and 56 (57%) believed the patient was eligible to take the medication. Participants identified hydroxyurea benefits as decreases in pain (332; 83%), hospitalization (162; 40.8%), need for blood transfusion (148; 37%), need for pain medication (87; 21.8%), infections (42; 61%), weight loss (22; 31.9%), length of hospital stay (18; 4.5%), and incidence of stroke (10; 2.5%). Slightly more than half of patients had no concerns about hydroxyurea (218; 54.5%). Most patients with concerns (182; 45.5%) identified hydroxyurea's high cost as their main concern (141; 77.5%). Other rumors and fears about hydroxyurea included: negative affects on internal organs such as the liver or kidneys (54; 29.7%), other negative side effects (27; 14.8%), inaccessibility in pharmacies and remote areas (18; 10%), harm due to stopping or missing doses (16; 8.8%), ineffectiveness (16; 8.8%), additional indications as a cancer medication (9; 4.9%), and younger children's difficulty swallowing pills (6; 3.3%). Conclusion:Given the significantly improved morbidity and mortality of sickle cell patients who are adherent to hydroxyurea, it is necessary to address the rumors, misconceptions, and gaps in understanding of the genetic impact of the disease as well as the risks and benefits of hydroxyurea therapy. At the population level, learning is impacted by education levels, literacy rates, health literacy rates, and other cultural and societal factors, thus teaching should be culturally competent and inclusive with verbal and visual methods. The high cost of the medication and lack of consistent supply seem to be the most prohibitive factors in patient acceptance and adherence to take hydroxyurea. With only 1% of Uganda's population covered by health insurance, it is imperative for system-wide changes to address the affordability and accessibility of hydroxyurea and/or to extend the coverage of health insurance to those in need.

Executive functions in preschool children with moderate hyperphenylalaninemia and phenylketonuria: a prospective study

BackgroundThe risk of neuropsychological disorders appears to be high in hyperphenylalaninemia (HPA). The hypothesis of executive function impairment is prominent in accounting for the neuropsychological phenotype in phenylketonuria (PKU) and is suspected in moderate hyperphenylalaninemia (MHP). However, the issue of early onset of executive disorders remains. The aim of this study was to explore the hypothesis of early executive dysfunction in HPA patients and the possible links with certain metabolic variables according to the new international classifications for patients with PKU and MHP. A group of 23 HPA children (12 PKU, 11 MHP) aged 3 to 5 years was included and compared to 50 control children. The two groups were comparable in terms of socio-demographics (age, sex, parental education level). Executive functions were assessed using performance-based tests and daily life questionnaires (parents and teachers).ResultsPreschool HPA patients have comparable executive scores to control subjects. In contrast, PKU patients score significantly worse than MHP patients on 3 executive tests (verbal working memory, visual working memory and cognitive inhibition. There is no executive complaints in daily life (parents and teachers) for the 2 groups of patients. In addition, 3 correlations were identified between executive scores and Phe levels at inclusion, mean Phe level and variability of Phe levels throughout life.ConclusionsThus, there appears to be evidence of early executive dysfunction in PKU preschool-children, but not in MHP children. Occasionally, certain metabolic indicators can predict executive difficulties in young children with PKU.

Effectiveness of ENGAGE in reducing difficulties in everyday executive functions among Finnish preschoolers: a randomized controlled trial

ABSTRACT Effective interventions applicable for young preschool-age children are needed to reduce the risk of widespread and sustained adversities that are linked to early executive function (EF) difficulties. This randomized controlled trial (RCT) examined the effectiveness of the play-based ENGAGE intervention in improving behavioral outcomes related to EFs among Finnish preschool-age children with hyperactivity and/or inattention problems. 95 children between 4 and 5 years of age and their parents were randomly assigned to the ENGAGE intervention or a waitlist control group. Parents and early childhood education (ECE) teachers rated the children’s EF difficulties and problem behaviors at pre-intervention, post-intervention, and 5-month follow-up. Repeated measures linear mixed modeling was used to examine the effect of ENGAGE on child outcomes. Those receiving ENGAGE exhibited significantly greater decreases in parent-rated attentional problems, hyperactivity/impulsivity, and acting out behaviors than the control group did, with mostly moderate effect sizes. No consistent improvements in the teacher ratings of children’s EF related difficulties were found in either group. Low dropout (8%) from the intervention and high acceptability ratings indicated that ENGAGE is a palatable intervention for parents. The present study showed that findings from an earlier RCT on ENGAGE conducted in New Zealand could be generalized to a different cultural setting, as the intervention effectively reduced young Finnish children's EF difficulties in the home context. Extending ENGAGE and other play-based interventions into different everyday contexts of children, such as ECE, could further enhance the beneficial effects on children's EFs and behavior.

Preschoolers' information search strategies: Inefficient but adaptive.

Although children's sensitivity to others' informativeness emerges early in life, their active information search becomes robustly efficient only around age 10. Young children's difficulty in asking efficient questions has often been hypothesized to be linked to their developing verbal competence and growing vocabulary. In this paper, we offer for the first time a quantitative analysis of 4- to 6-year-old children's information search competence by using a non-verbal version of the 20-questions game, to gain a more comprehensive and fair picture of their active learning abilities. Our results show that, even in this version, preschoolers performed worse than simulated random agents, requiring more queries to reach the solution. However, crucially, preschoolers performed better than the simulated random agents when isolating the extra, unnecessary queries, which are made after only one hypothesis is left. When additionally isolating all the unnecessary queries, children's performance looked on par with that of the simulated optimal agents. Our study replicates and enriches previous research, showing an increase in efficiency across the preschool-aged years, but also a general lack of optimality that seems to be fundamentally driven by children's strong tendency to make unnecessary queries, rather than by their verbal immaturity. We discuss how children's non-optimal, conservative information-search strategies may be adaptive, after all.

The Need for Performance Standards in Preschools: Stealing Shamelessly from Comprehensive School Mental Health Literature

Young children are at-risk for developing significant mental health difficulties just as their older, school-aged peers. Preschool settings have increasingly attempted to proactively address early childhood socioemotional needs by expanding their prevention and intervention activities. A number of emerging best practices in promoting early childhood mental health have been proposed. However, there are no comprehensive performance standards for preschool mental health and limited guidance on how preschools can align themselves with best practices. This expansion in service scope parallels the development of Comprehensive School Mental Health Systems in K-12 schools. Resources and tools developed for K-12 educational settings may serve as a useful example for preschool mental health systems interested in quality comprehensive mental health care. This conceptual article will describe the prevalence of mental health difficulties in young children, review the current guidance on supporting mental health in young children, and provide support for adapting widely used K-12 school mental health performance standards to establish comprehensive standards for organizing and implementing high quality care systems in preschool settings.

Feeding and Swallowing Issues in Autism Spectrum Disorders.

Children with autism spectrum disorder (ASD) often experience difficulties related to communication and behaviour. However, their feeding issues are most distressing to their families and healthcare professionals as they impact on the children’s adaptive function and health. In comparison to typically developing children, those with ASD experience significantly more feeding difficulties. Children with ASD may display distinctive feeding difficulties and atypical feeding behaviours that include picky eating, limited independent feeding, need for increased feeding times, and a highly restrictive food repertoire. Many of these feeding difficulties continue into childhood, persist in adolescence, and even spill over into adulthood. This proves to be a formidable challenge, as feeding is an essential component for healthy nutrition, growth, and development. This article will highlight how particular food items that are eaten and preferred by affected children may be contributing to their exhibited feeding difficulties. Next, it will be shown how the children’s restrictive diets supplant more healthy food options. When this is combined with the children’s noted reduced physical activity, the consequences are especially serious, as they include not only malnutrition but also give rise to childhood obesity. In sum, it will be demonstrated that feeding difficulties in young children with ASD are not well understood nor managed. The dearth of knowledge about feeding issues in this population affects both assessment choices and, specifically, management practices – aspects that will be elaborated on in this article. Conclusions will include suggested future directions for enhancing and complementing knowledge of these issues for stakeholders.

Finding the (most efficient) way out of a maze is easier than asking (good) questions.

We investigate whether a spatial representation of a search task supports 4- to 7-year-old children's information-search strategies, relative to their performance in a question-asking game. Children played two computationally and structurally analogous search games: a spatial search task, the maze-exploration game, in which they had to discover the path through a maze by removing masks covering its passages; and a verbal search task, the 20-questions game, where they had to identify a target monster from a set of eight monsters by asking yes-no questions. Across four experiments, we found that children searched more efficiently when they could make queries nonverbally (Experiments 1 and 2a). We also found that merely providing children with a visual conceptual aid that supports their representation of the hypothesis space (Experiment 2b), or familiarizing them with the hypothesis-space structure (Experiment 3) was not sufficient to improve their search strategies. Together, our results suggest that young children's difficulties in the 20-questions game are mainly driven by the verbal requirements of the task. However, they also demonstrate that efficient search strategies emerge much earlier than previously assumed in tasks that do not rely on verbal question generation. These findings highlight the importance of developing age-appropriate paradigms that capture children's early competence, in order to gain a more comprehensive picture of their emerging information-search abilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A systematic review and meta-analysis of early childhood intervention programs for developmental difficulties in low-and-middle-income countries.

Early acknowledgment of developmental difficulties in young children strengthens both preventive and therapeutic approaches. Despite their feasibility, early intervention services are limited in Low-and-Middle-Income (LAMI) countries compared to highincome countries. The aim of this study was to examine the evidence for early childhood intervention programs for developmental difficulties in children below five years in LAMI countries through a systematic review and meta-analysis. In this background, original studies published in peer-reviewed journals from 2010 to 2019with a focus on developmental difficulties including delays and deviances; randomized research design with a clear description of the intervention and measurable outcomes, and conducted in LAMI countries were considered for the systematic review. Electronic databases, including ProQuest, PubMed, Ovid, EBSCOhost, and Google Scholar, were searched using a combination of specific keywords. PRISMA guidelines were followed to include the studies. Each of the selected study was assessed for quality before applying appropriate statistics to synthesize the data. Fourteen publications were identified from 2697 publications for the systematic review, out of which four were found compatible for a meta-analysis. The studies reviewed were conducted in Bangladesh, India, Pakistan, Uganda, Vietnam, and Zambia. A meta-analysis of four studies provided considerable evidence for the effects of early developmental intervention. This systematic review provides an evidence for early childhood intervention programs in LAMI countries. Implications of these findings for the early childhood programs are discussed in this article.

Developing the FEEDS toolkit of parent-delivered interventions for eating, drinking and swallowing difficulties in young children with neurodisability: findings from a Delphi survey and stakeholder consultation workshops

BackgroundYoung children with neurodisability commonly experience eating, drinking and swallowing difficulties (EDSD). Little is documented about which interventions and outcomes are most appropriate for such children. We aimed to seek...

Attachment disorganisation and poor maternal discipline in early childhood: independent contributions to symptoms of conduct problems

ABSTRACT Conduct problems (CP) are common behaviour difficulties in young children. Poor parenting and caregiver-child attachment relationships are important risk factors of CP, but more research is required to understand their concurrent contribution to CP in the early childhood years. We examined the association of maternal-reported conduct problems (CP) (Strengths and Difficulties Questionnaire) with maternal-reported harsh and inconsistent discipline (Preschool-Alabama Parenting Questionnaire) and children’s representations of attachment (Manchester Attachment Story Task) in a sample of children between 4 and 6 years old (n = 66). Correlation analysis showed that CP were associated with attachment insecurity, high levels of attachment disorganisation, and maternal harsh and inconsistent discipline. Regression analysis showed that disorganisation and inconsistent discipline explained unique variance in CP ratings even after controlling for the effects of confounding variables. The findings suggest that attachment disorganisation and aspects of poor maternal discipline in early childhood reflect parallel processes with unique contributions to CP.

Young children's sleep difficulties: Are mainstream research findings supported by more recent evidence?

A substantial body of evidence about how to support parents with their child's sleep difficulties has been published and this can inform the practice of health visitors and others who work with the families concerned. However, does more recently published research in this field support or question the findings of mainstream studies? This article will examine how some recent studies do support and develop earlier evidence, while others open new fields of research, or challenge official guidance in new ways.

Preschoolers are capable of fine-grained implicit cognitive control: Evidence from development of the context-specific proportion congruency effect

Whereas much of the developmental literature has focused on the difficulties of young children in regulating their behavior, an increasing base of evidence suggests that children may be capable of surprisingly flexible engagement of cognitive control when based on implicit experience with the situation. One of the most fine-grained examples of implicit cognitive control in adults is the context-specific proportion congruency (CSPC) effect—the finding that interference in a conflict task is reduced for stimuli that are presented in a context (e.g., a spatial location) where stimuli are generally incongruent. Can such a subtle modulation of control be observed in children? In Experiment 1 (N = 180), we showed that this effect exists in preschoolers for two different types of context manipulation and that its magnitude is at least as large as in older children. In Experiment 2 (N = 40), we confirmed that the effect transfers to unbiased stimuli, indicating that it is not attributable to contingency learning of stimulus–response associations and can be taken to actually reflect cognitive control. These results support the possibility that implicit cognitive control (implemented without explicit intentions and without requiring subject awareness) can be functionally distinct from explicit control and that even very young children can implement fine-grained cognitive control when it is based on implicit cues.

Building a Predictive Model of Social-Emotional Adjustment: Exploring the Relationship between Parenting Self-Efficacy, Parenting Behaviour and Psychological Distress in Mothers of Young Children in Ireland.

The purpose of this study was to generate greater understanding of social-emotional difficulties in infants and toddlers in an Irish context. This study compared rates of reported social-emotional difficulties in young children in clinical and non-clinical samples and probed a predictive model of social-emotional adjustment. Data were collected from a cross-sectional sample of 72 mothers of young children aged between 12 and 48 months. Mothers were recruited from waiting lists for child Early Intervention services (clinical sample) and community mother-toddler groups (non-clinical sample). Mothers completed a questionnaire battery which assessed parenting self-efficacy, parenting behaviour, psychological distress and child social-emotional adjustment. The results indicated that 55.5% of young children in the clinical sample and 15% in the non-clinical sample had significant social-emotional problems. Similarly, 55.5% of young children in the clinical sample and 30% in the non-clinical sample had significant delays in the acquisition of social-emotional competencies. Two hierarchical multiple regressions were carried out with social-emotional problems and social-emotional competencies as the respective criterion variables. Clinical or non-clinical group membership, parenting satisfaction and maternal psychological distress were found to be significant predictors of child social-emotional problems in a model which explained 59% of the variance. Task-specific self-efficacy was the only significant predictor of child social-emotional competencies in a model which explained 21% of the variance. The significant rates of social-emotional problems in young children in the current study and the potential negative impact on child health and wellbeing, suggest that the early assessment of social-emotional adjustment should be incorporated into routine clinical assessment for young children. For services to effectively meet the needs of children with social-emotional difficulties and their families, consideration of maternal factors is also necessary.