SPECIAL SECTION: ASSESSMENT OF INFANT AND TODDLER MENTAL HEALTH: ADVANCES AND CHALLENGES
Infant and Toddler Pathways Leading to Early Externalizing Disorders

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ABSTRACT

Objective

To examine pathways leading to specific types of early externalizing disorders.

Method

Longitudinal data were collected on 310 low-income, male subjects followed from infancy until age 6 years.

Results

Support across informants was found for the importance of the caregiving environment during infancy in relation to the development of externalizing disorders at school entry. Support was also found for the significance of early child factors, but this was limited to child behavior at home.

Conclusions

The results are consistent with social learning and attachment models, which suggest that severe conduct problems in early childhood are the result of deficits in the caregiving environment. Support was also found for Moffitt's hypothesis that children with the comorbid attention-deficit/hyperactivity disorder–oppositional defiant disorder/ conduct disorder pattern experience multiple child and psychosocial risk factors that begin during infancy.

Section snippets

PARTICIPANTS

The source for subject recruitment was low-income families who use the Allegheny County's Women, Infants, and Children (WIC) Program in the Pittsburgh metropolitan area (Shaw et al., 1998). Over the course of 2 years, 310 participants were recruited from WIC sites throughout the Pittsburgh metropolitan area. Because the intent of the original investigation was to examine the developmental precursors of antisocial behavior, the sample was restricted to boys because of their greater relative risk

RESULTS

Using maternal and teacher reports, we examined between-group differences among the five externalizing disorder groups in relation to child characteristics and psychosocial risk factors. Because sample sizes were small across disorder groups and informants, it was decided to control for type I error post hoc by comparing the ratio of significant to nonsignificant results. Using this approach, we could minimize the risk of type II error while maintaining the ability to assess the probability

DISCUSSION

Based on maternal reports of children's psychiatric diagnosis, children in the comorbid ADHD-ODD/CD group demonstrated the most chronic and pervasive set of child, family, and neighborhood risk factors, especially in comparison with normal and ADHD children. Also according to maternal report, children with CD had a great frequency of child, family, and neighborhood risk factors in comparison with nonproblem children. Children in the ODD group were characterized primarily by family risk factors

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  • Cited by (238)

    • Psychosocial development of toddler ages in Kendal city

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      The results showed that the majority of toddlers raised by his parents. The results of this study reinforce the statements of Shaw, Owens, Giovannelli, and Winslow (2001) that the problem of social learning behaviors and role models for severe toddler age stem from the results of deficits in the caregiving environment.15 The results of this study are also supported by Moffitt's hypothesis that toddlers with attention deficits and behavioral disorders experience psychosocial risk factors that begin during infancy.

    View all citing articles on Scopus

    This study was supported by NIMH grant 50907 to Dr. Shaw.

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