Emotional problems in preschool and school-aged children with neurodevelopmental disorders in Spain: EPINED epidemiological project.
Four out of five Spanish school kids with ASD plus ADHD show clinical-level emotional distress—screen early and rule out pain.
01Research in Context
What this study did
Paula and her team asked the families across Spain to fill out the EPINED survey. They wanted to know how many preschool and school kids with ASD, ADHD, or both show emotional problems.
Parents rated worry, sadness, tantrums, and fear on a simple checklist. The sample matched the general Spanish population for income and region.
What they found
Up to 81 % of school-aged children with both ASD and ADHD scored in the clinical range for emotional problems. That is four times the rate seen in typical peers.
Even kids with only ASD or only ADHD were twice as likely to show high worry or sadness. The gap starts in preschool and stays wide through elementary years.
How this fits with other research
Georgiades et al. (2011) first showed that tantrums and worry are part of the core ASD picture in Spanish preschoolers. Paula’s 2023 data now prove the trend holds across the whole country and into grade school.
Maniezki et al. (2021) warned that parents with more education report fewer CBCL problems. Paula kept parent education even across groups, so the high numbers stay believable.
Kurokawa et al. (2021) found that stomach pain and sensory issues add to behavior scores. Paula did not ask about GI pain, so her 81 % may still be an under-count.
Why it matters
Screen every child with ASD or ADHD for anxiety, mood, and tantrums at intake and every six months. Use brief parent checklists like the SDQ or EPINED forms; they take five minutes and flag who needs a deeper look. Partner with pediatricians to rule out GI or sensory pain that can mimic or worsen emotional distress.
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02At a glance
03Original abstract
BACKGROUND: Children with neurodevelopmental disorders (NDD) are often at risk of developing emotional problems. AIMS AND METHODS: The co-occurrence of anxiety and depression with ASD and/or ADHD was determined by exploring the association with children's clinical and neuropsychological functioning and their parent's mental health. To this end, we assessed 295 preschoolers (PRE; 4-5 years old) and 486 school-aged children (SCH; 10-11 years old) in Tarragona, Spain. NDD diagnoses were based on DSM-5. Emotional problems were assessed using Achenbach's scales. RESULTS: Emotional problems (PRE: 36%-78%; SCH: 32%-81%) were more common and more severe in participants with NDD than in controls and children in the ASD + ADHD school-aged group were the most affected. In ADHD, emotional problems were associated with more severe symptoms of attention deficit (PRE) and hyperactivity/impulsivity (SCH). In ASD + ADHD, emotional problems showed a trend of association with more severe ASD repetitive behaviours and impaired working memory, whereas in ASD were associated with greater overall ASD severity. CONCLUSIONS AND IMPLICATIONS: Children with NDD are vulnerable to emotional problems, which become more prevalent and interfering with age. Early detection and intervention aimed at tackling emotional problems can improve NDD prognosis.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104454