Skip to main content
SpringerLink
Log in

Assessment and classification of psychopathology in epidemiological research of children 0–3 years of age

A review of the literature

  • REVIEW
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The research of psychopathology in children 0–3 years of age is dominated by clinical case studies and theoretical reflections, and epidemiological studies are few. This paper reviews methods to assess and classify psychopathology in children 0–3 years old in an epidemiological context. Diagnostic assessments of children 0–3 years of age are based on information from different sources and investigation of several domains of mental functioning, and the rapid developmental changes and the relationship context are taken into account. The reviewed literature shows a range of methods to assess and classify psychopathology in children 0–3 years of age: screening instruments with established psychometric properties, such as the Child Behaviour Checklist (CBCL) and the Checklist for Autism in Toddlers (CHAT), and methods of in-depth assessment known from both clinical practice and research: developmental tests, such as the Bayley Scales, and relationship assessments, such as the Early Relational Assessment (ERA). The classification of psychopathology in young children can be approved by the Diagnostic Classification 0–3. The reliability and validity of DC 0–3 have not yet been established, but preliminary results seem promising. The demands made on diagnostic assessment procedures in epidemiological research of children 0–3 years of age can be met by a combination of well-established research instruments, such as the CBCL, with in-depth clinical assessment procedures, such as the Bayley Scales and the ERA, and diagnostic classification by DC 0–3.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Achenbach T (1995) Epidemiological applications of multiaxial empirically based assessment and taxonomy. In: Verhulst F, Koot HM (eds) The epidemiology of child and adolescent psychopathology. Oxford University Press, New York, pp 22–41

  2. Achenbach TM, Edelbrock C, Howell CT (1987) Empirically based assessment of the behavioral/emotional problems of 2- and 3-year-old children. J Abn Child Psychol 4(15):629–650

    Google Scholar 

  3. Achenbach TM, Rescorla LA (2000) Manual for the ASEBA preschool forms and profiles. University of Vermont Department of Psychiatry, Burlington, VT

  4. Ainsworth MDS, Blehar MMC, Waters E, Wall S (1978) Patterns of attachment: a psychological study of the Strange Situation. Erlbaum, Hillsdale NJ

    Google Scholar 

  5. Alin-Åkerberg B, Nordberg L (1980) Griffith’s Utvicklingsskalor I och II. Manual. Psykologi Förlaget ab Stockholm

  6. American Academy of Child and Adolescent Psychiatry (1997) Practice parameters for the psychiatric assessment of infants and toddlers (0–36 months). J Am Acad Child Adolesc Psychiatry 36(Suppl):21S–34S

    Google Scholar 

  7. American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders 3rd edn. APA, Washington DC

  8. Aoki Y, Zeanah CH, Heller SS, Bakshi S (2002) Parent-infant relationship global assessment scale: a study of its predictive validity. Psychiatry Clin Neurosci 5(56):493–497

    Google Scholar 

  9. Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, Drew A (2000) A screening instrument for autism at 18 months of age: a 6-year follow-up study. J Am Acad Child Adolesc Psychiatry 6(39):694–702

    Google Scholar 

  10. Baron-Cohen S, Cox A, Baird G, Sweettenham J, Nightingale N, Morgan K, Drew A, Charman T (1996) Psychological markers in the detection of autism in infancy in a large population. Br J Psychiatry 168:158–163

    Google Scholar 

  11. Barton M, Robins D (2000) Regulatory disorders. In: Zeanah CH (ed) Handbook of infant mental health 2nd edn. The Guilford Press, New York, pp 310–325

  12. Bayley N (1993) Bayley Scales of Infant Development (2nd edn). Psychological Corporation San Antonio, NY

  13. Berument SK, Rutter M, Lord C, Pickles A, Bailey A (1999) Autism screening questionnaire: diagnostic validity. Br J Psychiatry 175:444–451

    PubMed  Google Scholar 

  14. Black MM, Matula K (2000) Essentials of the Bayley Scales of Infant Development—II. Assessment. Wiley & Sons, NY

  15. Boris NW, Fueyo M, Zeanah CH (1997) The clinical assessment of attachment in children under five. J Am Acad Child Adolesc Psychiatry 36:291–293

    Google Scholar 

  16. Briggs-Gowan MJ, Carter AS (1998) Preliminary acceptability and psychometrics of the Infant–Toddler Social and Emotional Assessment (ITSEA): a new adult-report questionnaire. Infant Ment Health J 19:422–445

    Google Scholar 

  17. Briggs-Gowan MJ, Carter AS, Skuban EM, Horwitz SM (2001) Prevalence of social-emotional and behavioral problems in a community sample of 1- and 2-year-old children. J Am Acad Child Adolesc Psychiatry 1(40):8–10

    Google Scholar 

  18. Cantwell DP (1996) Classification of child and adolescent psychopathology. J Child Psychol Psychiatry 1(37):3–12

    Google Scholar 

  19. Cicchetti DV, Sparrow SS (1990) Assessment of adaptive behavior in young children. In: Johnson JH, Goldman J (ed) Developmental assessment in clinical child psychology. Pergamon Press, New York

  20. Clark R, Paulson A, Conlin S (1993) Assessment of developmental status and parent-infant relationships: the therapeutic process of evaluation. In: Zeanah CH (ed) Handbook of infant mental health. The Guilford Press, NewYork, pp 191–209

  21. Clark R (1999) The parent-child early relational assessment: a factorial validity study. Educ Psychol Measurement 5(59):821–846

    Google Scholar 

  22. Crittenden PM, Claussen AH (eds) (2000) The organisation of attachment relationships: maturation, culture and context. Cambridge University Press, New York

    Google Scholar 

  23. DeGangi GA, Breinbauer C, Roosevelt JD, Porges S, Greenspan S (2000) Prediction of childhood problems at three years in children experiencing disorders of regulation during infancy. Infant Ment Health J 3(21):156–175

    Google Scholar 

  24. DeGangi GA,DiPietro JA,Greenspan SI, Porges SW (1991) Psychophysiological characteristics of the regulatory disordered infant. Infant Behav Devel 14:37–50

    Google Scholar 

  25. DeGangi GA, Poisson S, Sickel RZ, Wiener AS (1995) The Infant-Toddler Symptom Checklist. Therapy Skill Builders, Tucson, Arizona

  26. Del Carmen-Wiggins R, Carter AS (2001) Assessment of infant and toddler mental health: advances and challenges. J Am Acad Child Adolesc Psychiatry 7(40):811–819

    Google Scholar 

  27. Di Lavore PC, Lord C, Rutter M (1995) Pre-linguistic autism diagnostic observation schedule. J Autism Devel Disord 4(25)355–379

    Google Scholar 

  28. Dunitz M, Scheer PJ, Kvas E, Macari S (1996) Psychiatric diagnoses in infancy: a comparison. Infant Ment Health J 17:12–23

    Google Scholar 

  29. Edwards S, Garman M, Hughes A, Letts C, Sinka I (1999) Assessing the comprehension and production of language in young children: an account of the Reynell Developmental Language Scales III. Int J Language Communication Disord 2(34):151–191

    Google Scholar 

  30. Emde RN, Bingham RD, Harmon RJ (1993) Classification and the diagnostic process in infancy. In: Zeanah CH (ed) Handbook of infant mental health. The Guilford Press, New York

  31. Emde RN, Wise BK (2003) Initial clinical trials of DC 0–3 and recommendation for revision. Infant Ment Health J 4(24):437–446

    Google Scholar 

  32. Esser G, Blanz B, Geisel B, Laucht M (1989) Mannheimer Elterninterview. Beltz, Weinheim

  33. Fenson LPS, Dale JS, Reznick D, Thal E, Bales JP,Hartung S, Pethick JS, Reilly JS (1993) The MacArthur Communication Development Inventory. San Diego

  34. Fombonne E (2002) Case identification in an epidemiological context. In: Rutter M, Taylor E (eds) Child and adolescent psychiatry. 4th edn. Blackwell Science, Oxford, pp 52–69

  35. Gilliam WS, Mayes LC (2000) Developmental assessment in infants and toddlers. In: Zeanah CH (ed) Handbook of infant mental health. 2nd edn. The Guildford Press, New York, pp 236–248

  36. Greenspan S, Wieder S (1993) Regulatory disorders. In: Zeanah CH (ed) Handbook of infant mental health. The Guilford Press, New York, pp 280–290

  37. Griffith R (1979) The abilities of young children. London: Child Development Research Center

  38. Johnson JH, oldman J (1990) Developmental assessment in clinical child psychology. A handbook. Pergamon General Psychology Series, Pergamon Press, NY

  39. Keren M, Feldman R, Tyano S (2001) Diagnoses and interactive patterns of infants referred to a community-based infant mental health clinic. J Am Acad Child Adolesc Psychiatry 1(40):27–35

    Google Scholar 

  40. Laucht M, Esser G, Schmidt MH (1997) Developmental outcome of infants born with biological and psychosocial risks. J Child Psychol Psychiat 7(38):843–853

    Google Scholar 

  41. Lord C, Rutter M, Le-Couteur A (1994) Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Devel Disord 5(24):659–685

    Google Scholar 

  42. Lyons-Ruth K, Zeanah CH (1993) Affective development in the primary caregiving relationship. In: Zeanah CH (ed) Handbook of infant mental health. The Guilford Press, New York, pp 14–37

  43. Nordberg L (1994) The first four years of children’s mental development. An empirical study with applications in psychology, child and adolescent psychiatry and pediatrics. Department of Woman and Child Health. Division for Child and Adolescent Psychiatry. Karolinska Institutet. Stockholm

  44. O’Connor TG (2002) Attachment disorders of infancy and childhood In: Rutter M, Taylor E (eds) Child and adolescent psychiatry. 4th edn. Blackwell Science, Oxford, pp 776–792

    Google Scholar 

  45. Richmann N, Stevenson J, Graham PJ (1975) Prevalence of behaviour problems in 3-year-old children: an epidemiological study in a London borough. J Child Psychol Psychiatry 16:277–287

    Google Scholar 

  46. Roid GH, Miller LJ (1995, 1997) Leiter International Performance Scale—Revised. Stoelting Co, Wood Dale IL

  47. Rothbart MK, Dalberry D (1981) Development of individual differences in temperament. In: Lamb ME, Brown AL (eds) Advances in developmental psychology (Vol 1). Erlbaum, Hillsdale NJ

  48. Rutter M (1989) Isle of Wight revisited: twenty-five years of child psychiatric epidemiology. J Child Psychol Psychiatry 28:633–653

    Google Scholar 

  49. Rutter M (1995) Clinical implications of attachment concepts: retrospect and prospect. J Child Psychol Psychiatry 1(36):549–571

    Google Scholar 

  50. Skovgaard AM, Houmann T, Landorph SK, Christiansen E (2003) Mental health disturbances in Danish infants. 12. ESCAP Congress, Paris

  51. Taylor E, Rutter M (2002) Classification: conceptual issues and substantive findings. In: Rutter M, Taylor E (eds) Child and adolescent psychiatry. 4th edn. Blackwell Science, Oxford, pp 3–17

  52. Thomas A, Chess S, Birch HG, Hertzig ME, Korn S (1963) Behavioural individuality in early childhood. New York University Press, New York

  53. Thomas JM, Clark R (1998) Disruptive behavior in the very young child: diagnostic classification: 0–3 guides identification of risk factors and relational interventions. Infant Ment Health J 2(19):229–244

    Google Scholar 

  54. Tronick EZ, Als H, Adamson L, Wise S, Brazelton TB (1978) The infant’s response to entrapment between contradictory messages in face-to-face interaction. J Am Acad Child Psychiatry 17:1–13

    Google Scholar 

  55. Van Ijzendoorn MH (1995) Adult attachment representations, parental responsiveness and infant attachment: a meta-analysis of attachment in clinical samples. Child Development 59:147–156

    Google Scholar 

  56. Verhulst FC (1995) The epidemiology of child and adolescent psychopathology: strengths and limitations. In: Verhulst F, Koot HM (eds) The epidemiology of child and adolescent psychopathology. Oxford Medical Publications, pp 1–21

  57. Verhulst FC, Koot H (1992) Prevalence studies: a review. In: Verhulst FC, Koot HM (eds) Child psychiatric epidemiology. Concepts, methods and findings. Developmental Clinical Psychology and Psychiatry. Vol 23. Sage Publications, Beverly Hills, pp 111–132

  58. Verhulst FC, Van der Ende (2002) Rating scales. In: Rutter M, Taylor E (eds) Child and Adolescent Psychiatry, 4th edn. Blackwell Science, Oxford, pp 70–86

  59. Weinberg KM, Tronick EZ (1994) Beyond the face: an empirical study of infant affective configurations of facial, vocal, gestural, and regulatory behaviors. Child Devel 65:1503–1515

    Google Scholar 

  60. World Health Organization (1992) ICD-10: The ICD-10 Classification of Mental and Behavioral Disorders: clinical description and diagnostic guidelines. World Health Organization, Geneva

  61. Zeanah CH, Benoit D, Hirshberg L, Barton ML, Regan C (1994) Mothers’ representations of their infants are concordant with infant attachment classifications. Devel Issues in Psychiatry Psychol 1:1–14

    Google Scholar 

  62. Zeanah CH, Boris NW, Heller SS, Hinshaw-Fuselier S, Larrieu J, Lewis M, Palomino R,Rovaris M,Valliere J (1997) Relationship assessment in infant mental health. Infant Ment Health J 18:182–197

    Google Scholar 

  63. Zeanah CH, Boris NW, Scheeringa MS (1997) Psychopathology in infancy. J Child Psychol Psychiatry 1(38):81–99

    Google Scholar 

  64. Zeanah CH (2000) Psychopathology. In: Zeanah CH (ed) Handbook of infant mental health. 2nd edn. The Guilford Press,New York, pp 267–436

  65. Zero to Three (1994) Diagnostic classification 0–3. National Center for Infants, Toddlers, and Families,Washington, DC 20005–1013

  66. Zimmermann IL, Steiner VG, Pond RE (1992) Preschool language scales-3. Psychological Corporation, San Antonio, TX

Download references

Author information

Authors and Affiliations

  1. Child and Adolescent Psychiatric Centre, Copenhagen University Hospital, Glostrup, 2600, Glostrup, Denmark

    A. M. Skovgaard, T. Houmann & S. L. Landorph

  2. Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Bispebjerg, 2400, Copenhagen, Denmark

    E. Christiansen

Authors
  1. A. M. Skovgaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Houmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. L. Landorph
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Christiansen
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Skovgaard, A.M., Houmann, T., Landorph, S.L. et al. Assessment and classification of psychopathology in epidemiological research of children 0–3 years of age. European Child & Adolescent Psychiatry 13, 337–346 (2004). https://doi.org/10.1007/s00787-004-0393-z

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-004-0393-z

Key words

Search

Navigation