Prevalence and Co-Occurrence of Developmental and Emotional-Behavioral Problems in Young Children

OBJECTIVE: A limited number of studies have estimated the prevalence of emotional-behavioral disorders among young children. None have assessed their co-occurrence with devel-opmental delays using standardized assessment tools. Our objective was to estimate the prevalence of emotional -behav-ioral disorders and their co-occurrence with developmental delays among young children (2-5.5 years). METHODS: Parents of young children (N = 987) enrolled from pediatric waiting rooms completed developmental-behavioral screening questionnaires. Based on results, 585 families were invited to and 439 completed evaluations that included struc-tured diagnostic interviews with parents to assess child psycho-pathology (Preschool Age Psychiatric Assessment (PAPA)), developmental testing with children (including the Bayley Scales of Infant and Toddler Development, third Edition for children <= 42 months; Differential Ability Scales, second Edi-tion for older children), and videotaped observation to establish whether autism risk was sufficient to warrant further evaluation. RESULTS: According to PAPA algorithms, 23.0% of children met criteria for a DSM-IV disorder, while 9% qualified for a developmental delay. Presence of delay doubled the odds of having a DSM-IV disorder (OR = 2.1; CI: 1.02-4.3), and pres-ence of disorder doubled the odds of having a moderate-to -severe developmental delay (OR=2.0; CI: 1.10-3.50). Preva-lence of DSM-IV disorders (48.8% (95% CI: 33.5-64.5%)) and developmental delays (57.5% (95% CI: 41.7-71.9%)) were both higher among children at risk for autism. While developmental delay did not vary by race/ethnicity, prevalence of DSM-IV disorders was lower among African-American/ Black (10.6%; CI: 2.9-18.3) and Hispanic/Latino children (11.1%; CI: 4.3-17.9). CONCLUSIONS: Developmental delays and emotional -behav-ioral disorders among young children seen in pediatric settings are characterized by high prevalence and substantial co -occurrence.