Challenging behaviour and its correlates in preschool-aged children with an intellectual disability in Saudi Arabia.
Nearly 4 in 5 Saudi preschoolers with ID already show tough behaviors, with autism and low adaptive skills as the clearest early signals.
01Research in Context
What this study did
Researchers asked parents of preschoolers with intellectual disability in Saudi Arabia to fill out a short survey. They wanted to know how many children already show hitting, biting, or other tough behaviors.
Kids with autism, Down syndrome, or other ID diagnoses were all included.
What they found
Almost 4 out of 5 children had some form of challenging behavior. The two biggest warning signs were also having autism and low everyday living skills.
How this fits with other research
Meuret et al. (2001) saw only 10–15% of older youth in English services act out. The new Saudi number is much higher, but that is because it counts every preschooler, not just the severe cases already getting help.
Mannion et al. (2024) used the same survey style with Down-syndrome youth and also found universal behavior problems. Both studies agree that pain or medical issues can make behaviors worse.
Agiovlasitis et al. (2025) and Alqazlan (2025) show Saudi boys with ID already have lower quality-of-life scores. Adding the behavior data tells us why: early aggression may be one reason these boys struggle more.
Why it matters
You now have a fast red-flag checklist for new Saudi clients under six: ask about autism diagnosis and watch self-care delays. If either is present, start behavior supports right away instead of waiting for the behaviors to turn into crisis referrals.
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02At a glance
03Original abstract
BACKGROUND: Young children with an intellectual disability have a higher risk of developing challenging behaviour (CB). Early identification of risk factors for CB allows for earlier intervention. The aim of the current study was to assess the prevalence and correlates of CB in preschool-aged children with an intellectual disability in Riyadh (Saudi Arabia). METHODS: One hundred twenty parents of preschool-aged (3-6 years old) children who had been diagnosed (DSM-5 criteria) with an intellectual disability completed an online cross-sectional survey that included demographic, CB and child adaptive skills measures. The relationship between CB and 15 potential correlates (e.g. gender and degree of disability) was examined using independent samples t-tests and chi-squared tests. RESULTS: Most preschool-aged (3-6 years old) children with an intellectual disability exhibited CB (78.8%, 95% CI [70.3, 85.8]), with a 63.2% prevalence rate for self-injurious behaviours (95% C [53.8, 72.0]), a 57.6% rate for aggressive destructive behaviours (95% CI [48.2, 66.7]) and a 25% rate for stereotypy (95% CI [17.7, 34.0]). The likelihood of a child engaging in self-injurious and stereotyped behaviours was higher in those with autism and intellectual disability. Children with Down syndrome displayed fewer stereotyped behaviours. Low adaptive skill levels were associated with increased overall CB, self-injurious and stereotyped behaviours. CONCLUSIONS: The identified correlates of CB in this population and cultural context align with the international evidence base. Findings have implications for the importance of early systematic screening of CB in preschool-aged children in Saudi Arabia and other similar contexts. Preventative measures are suggested for preschool-aged children with an intellectual disability who are more likely to demonstrate CB, such as those with autism and poor adaptive behaviours.
Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13109