Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: associations with parental mental health and family functioning.
Tackle behaviour problems in toddlers with PDD or DD first; the diagnosis label can wait.
01Research in Context
What this study did
Reyer et al. (2006) watched toddlers with PDD or developmental delay for one year. They asked: what hurts families more—the diagnosis or the child’s day-to-day behaviour?
Parents filled out checklists about stress, mood, and family life. Kids got no new treatment. The team just tracked what changed.
What they found
The toddlers’ behaviour problems, not the PDD label, best predicted later mum stress and family strain. A calm child meant a calmer home, even if the diagnosis stayed the same.
When behaviour worsened, mums felt worse and family routines broke down. Diagnosis alone did not drive that slide.
How this fits with other research
Giovagnoli et al. (2015) saw the same pattern in preschoolers with ASD: behaviour, not autism severity, set parent stress levels. The 2006 toddler data now looks like the first clear snapshot of this link.
Katz et al. (2003) had already shown that behaviour and stress feed each other over time in developmental delay. Reyer et al. (2006) narrowed the lens to toddlers and pinned the start of the cycle on behaviour.
Gallagher et al. (2014) later found that child behaviour fully explains why parents of kids with DD have double the depression risk. The toddler finding sits at the front of that longer story.
Why it matters
If you serve toddlers with ASD or DD, screen for behaviour problems early and treat them fast. Target sleep, tantrums, or non-compliance before they snowball into parent burnout and family chaos.
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02At a glance
03Original abstract
BACKGROUND: Behavioural and emotional problems occur at a high rate in children and adolescents with intellectual disability, often from a young age. Some studies have indicated that children and adolescents with autism present with even higher rates. Less is known about the presentation, development and family impact of these difficulties in young children with autism. This study aimed to explore these issues in toddlers with pervasive developmental disorders (PDDs), those with delay without a PDD, and their families. METHODS: Participants were 123 children aged 20-51 months, referred to a developmental assessment clinic. Parents completed a checklist on child behavioural and emotional problems, and individual questionnaires on family functioning, their own mental health, and stress in relation to parenting their child. The child's language and cognitive skills, adaptive functioning and behaviour were assessed by standardized measures. Measures were repeated 1 year postdiagnosis. Behavioural and emotional problems in young children with a PDD were compared with those in children with developmental delay without a PDD, and their impact on parental outcomes explored over time. RESULTS: Initial and follow-up measures of child behaviour and emotional problems, parent mental health problems, parent stress and family functioning were significantly correlated, providing some evidence of stability over time. Child emotional and behavioural problems contributed significantly more to mother stress, parent mental health problems, and perceived family dysfunction than child diagnosis (PDD/non-PDD), delay or gender. Compared with mothers, all fathers reported significantly less stress in relation to parenting their child. CONCLUSION: Results highlighted the importance of addressing emotional and behavioural problems in very young children with autism and/or developmental delay. The need for early support and intervention for mothers, fathers and families in this context was also evidenced. As research has shown that behavioural and emotional problems persist into adolescence and young adulthood, understanding of these issues in very young children and their parents has important implications for intervention and long-term outcomes.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00904.x