Assessment & Research

The effects of diagnostic group and gender on challenging behaviors in infants and toddlers with cerebral palsy, Down syndrome or seizures.

Hattier et al. (2012) · Research in developmental disabilities 2012
★ The Verdict

Expect more tantrums in toddlers with seizures than in those with CP or Down syndrome, and pair behavior plans with communication training.

✓ Read this if BCBAs assessing infants and toddlers with seizures, CP, or Down syndrome in early-intervention clinics.
✗ Skip if Practitioners who only serve verbal school-age children or adults.

01Research in Context

01

What this study did

The team used the BISCUIT tool to score tantrum and conduct behaviors. They looked at toddlers with cerebral palsy, Down syndrome, or a history of seizures.

All kids were under three years old. The study asked two questions: Which group shows more tantrums? Does gender matter?

02

What they found

Toddlers with seizure histories had the highest tantrum scores. Kids with CP and Down syndrome looked the same.

Boys and girls did not differ. The seizure gap was the only clear signal.

03

How this fits with other research

Hattier et al. (2011) used the same BISCUIT cohort one year earlier. They found kids with seizures also had the weakest communication skills. Together the papers show seizures link to both language and behavior red flags.

Busch et al. (2010) moved the question to adults. They saw the same pattern: people with ID plus epilepsy had the most behavior problems. The seizure signal lasts across the lifespan.

Yip et al. (2009) add a twist. They showed challenging and communicative acts often share the same social function. So the tantrums we see in seizure toddlers may be their way of saying "I need help."

04

Why it matters

When you assess a toddler with seizures, plan for more tantrums than you see in CP or Down peers. Screen communication at the same time; the two issues travel together. Use this info to justify extra teaching of replacement requests and to prep caregivers for likely spikes during illness or med changes.

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→ Action — try this Monday

Add a brief communication screen to every intake for a toddler with seizures; note tantrum triggers that may double as requests.

02At a glance

Intervention
not applicable
Design
other
Sample size
76
Population
down syndrome, developmental delay, other
Finding
not reported

03Original abstract

Challenging behaviors are frequently studied in individuals with various developmental disabilities, although specific conditions are rarely compared to one another. Such data would be informative to clinicians who assess and develop treatment plans for children with these disabilities. For that reason, the current study's aim was to analyze problem behavior deficits in infants and toddlers diagnosed with cerebral palsy (CP), Down syndrome (DS), and a history of seizures/seizure disorder. Seventy six children participated in this study and were administered the Baby and Infant Screen for Children with aUtIsm Traits-Part 2 (BISCUIT-Part 2). Inspection of the Tantrum/Conduct Behavior subscale of this measure revealed that children with a history of seizures/seizure disorder exhibited significantly higher scores, indicating greater impairment, than those with CP or DS. Children with DS and those diagnosed with CP did not significantly differ from one another. Additionally, there was no significant main effect by gender. The CP and DS groups also had fewer endorsements on all 18 items of the subscale as compared to the seizures group. Implications of these results are discussed.

Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.09.014