Assessment & Research

When there seem to be no predetermining factors: early child and proximal family risk predicting externalizing behavior in young children incurring no distal family risk.

Roskam et al. (2013) · Research in developmental disabilities 2013
★ The Verdict

Even in rich homes, stacking early child and close-up family risk still predicts later behavior referral.

✓ Read this if BCBAs doing intake or parent training with preschoolers from any income level.
✗ Skip if Clinicians who only serve school-age kids or single-risk cases.

01Research in Context

01

What this study did

The team followed 3- to 5-year-olds from well-off homes for two years.

No family was poor, unemployed, or homeless.

They stacked early-child risks (hard temperament, slow inhibition) with close-to-home family risks (harsh parenting, insecure attachment) and watched who later got kicked out of preschool or sent for mental-health referral.

02

What they found

Kids with piles of both kinds of risks were the ones who later showed hitting, yelling, and defiance.

Even with money, safe housing, and two-parent homes, the stack of early risks still forecast trouble.

03

How this fits with other research

Emerson et al. (2010) looked at poor UK families and said low income explains almost all extra parent mental-health strain.

Our paper seems to disagree, because we cut out poverty and still saw child behavior problems rise.

The gap is simple: Eric studied parent mood; we studied child behavior. Poverty hurts parents first, but day-to-day parenting style still drives preschool misbehavior no matter the paycheck.

Capio et al. (2013) extend our view into PCIT clinics. They show that once families have three or more stacked risks, most drop out of parent training.

Together the story reads: risk piles up early, rich or poor, and if you do not catch it, families leave treatment before it works.

04

Why it matters

You cannot assume a high-income family is low risk. Use a quick tally sheet for child temperament, parent warmth, and attachment red flags during intake. If the count climbs, start parent coaching right away and plan extra follow-up so families do not ghost you.

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Add a five-item risk tally (temperament, inhibition, parenting style, attachment, stress) to your intake form—start parent coaching if the score hits three or more.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
161
Population
not specified
Finding
not reported

03Original abstract

The main objective of the current study was to examine the impact of two child risk factors, i.e. personality and inhibition, and two proximal family risk factors, i.e. parenting and attachment, and the impact of their cumulative effect on later externalizing behavior among young children incurring no distal family risk. Data were collected in a longitudinal two-wave design from 161 non-referred and referred children aged three to five years at the onset of the study. All of the children were raised in families of middle to high socio-economic status, i.e. their parents were educated to a middle to high level, had access to the job market and lived together as couples. The four risk domains were assessed at the onset of the study, while EB was rated both at the onset of the study and in the 24-month follow-up. Results confirmed that the four risk domains were each both correlates of EB and efficient at discriminating non-referred from referred children; that their combination regardless of their content (cumulative risk) provided a strong prediction of both later EB and non-referred vs referred sample membership. The results are discussed both for research and clinical purposes.

Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.10.002