OBJECTIVES: We aimed to compare preterm, neurodevelopmentally disordered and healthy full-term children. METHODS: We enrolled 47 children who were born preterm, 40 neurodevelopmentally disordered children, and 80 healthy children as control participants, in order to assess the cognitive functioning and the risk of behavioral problems at the age of 5. Children were assessed using the Korean Wechsler Preschool and Primary Scale of Intelligence-4th edition (K-WPPSI-IV), the Child Behavior Checklist (CBCL), and the Temperament and Character Inventory (TCI). RESULTS: The mean K-WPPSI-IV score of the preterm group was 87.19±17.36, which was significantly higher than that of the neurodevelopmental disorder group (69.98±28.63; p < 0.001) but lower than that of the control group (107.74±14.21; p < 0.001). The cumulative CBCL scores of the preterm children were not significantly different from those of the control group. Additionally, the TCI scores for reward dependence of the preterm children were higher than those of the control group. CONCLUSION: The cognitive performance of preterm infants was lower than that of healthy full-term infants at the age of 5, and there was an association between slower growth and decreased cognitive ability.
Checklist ; Child Behavior ; Child ; Cognition ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Neurodevelopmental Disorders ; Problem Behavior ; Reward ; Temperament

PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) is a common childhood illness, which frequently presents with various comorbid emotional, social, and behavioral problems. Yet, children with epilepsy also experience significant behavioral problems. In this study, we compared behavioral problems of 124 children and adolescents with newly diagnosed ADHD and 40 youths with epilepsy, aged 6~17 years. METHODS: Among 1,576 urban community children and adolescents, the ADHD rating scale, the Comprehensive Attention Test, and a psychiatric interview were used to diagnose ADHD. In addition, we used the mother's rating on the Korean Child Behavior Checklist (K-CBCL) to assess the presence of behavioral problems. RESULTS: Compared to the epilepsy group, the ADHD group had lower IQ scores (100.29±13.47 vs. 108.61±15.04, p=0.007). In addition, the ADHD group had higher total K-CBCL scores (66.44±10.32 vs. 50.68±8.97, p<0.001) as well as higher scores on all eight subscales of the K-CBCL than the epilepsy group. Sixty-five participants (52.4%) in the ADHD group showed significant behavioral problems (t score ≥64) compared to 7.5% of epilepsy group. After controlling for IQ, using an analysis of covariance, the ADHD group showed significantly higher total scores on the K-CBCL and all its subscales (p<0.001) than the epilepsy group, except on the somatic complaints subscale (p=0.275). CONCLUSION: Children with newly diagnosed ADHD suffer from various behavioral problems; therefore, the early assessment of and interventions for comorbid behavioral problems should be conducted for optimal management of childhood ADHD.
Adolescent* ; Checklist ; Child Behavior ; Child* ; Epilepsy* ; Humans ; Problem Behavior*

OBJECTIVE: To explore the clinical phenotype and genetic characteristics of a child with Intellectual developmental disorder with behavioral abnormalities and craniofacial malformations without epilepsy (IDDBCS). METHODS: A child who had visited the Lianyungang Maternal and Child Health Care Hospital in April 2021 was selected as the study subject. Clinical data of the child were collected. Genomic DNA was extracted from peripheral blood samples of the child and his parents and subjected to whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing of his family members. RESULTS: The child, a 3-year-and-4-month-old male, had presented with global developmental delay and cranial malformation. Genetic testing revealed that he has harbored a heterozygous c.1703delA (p.K568Sfs9) variant of the PHF21A gene, for which both of his parents were of the wild type. This low-frequency variant may alter the structure and function of the protein product. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was classified as a pathogenic variant (PVS1+PS2+PM2_Supporting). CONCLUSION The heterozygous c.1703delA (p.K568Sfs9) variant of the PHF21A gene probably underlay the IDDBCS in this patient.
Child ; Male ; Humans ; Infant ; Developmental Disabilities/genetics* ; Craniofacial Abnormalities/genetics* ; Seizures/genetics* ; Intellectual Disability/genetics* ; Problem Behavior ; Mutation

OBJECTIVES: The purpose of this study was to investigate the clinical utility of the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV) and General Ability Index (GAI) in children with attention-deficit hyperactivity disorder (ADHD). METHODS: The GAI and Full Scale IQ (FSIQ) in K-WISC-IV were compared for a group of 79 children with ADHD and 234 normal children. The mean differences within each group were testified by the t-test and Cohen's d. The Wechsler's descriptive classifications for each GAI and FSIQ score were analyzed in the children with ADHD. Additionally, the critical value for the difference between the means of the FSIQ and GAI was calculated in the normal children. RESULTS: The score on the GAI was higher than that on the FSIQ in the children with ADHD, with a mean difference of 2.19 points. The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. According to Wechsler's descriptive classification, the application of the GAI showed a lower (7.59%), equal (61.65%) or higher (60.76%) prevalence of ADHD compared to the application of FSIQ. CONCLUSION: The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. The GAI reflecting the attention and behavioral problems in children with ADHD could be utilized as an alternative global intelligence estimate that considers their potential for development.
Child ; Classification ; Humans ; Intelligence* ; Prevalence ; Problem Behavior

Objective: To investigate the influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problems at the age of 6 years. Methods: Using a prospective cohort design, 262 children were extracted from mother-child birth cohort recruited from May 2012 to July 2013 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Children's sleep and physical activities were assessed using actigraphy at 6, 12, 18, 24, and 36 months of age, from which the sleep fragmentation index (FI) at each follow-up point was calculated. Children's emotional and behavioral problems at 6 years of age were assessed using the strengths and difficulties questionnaire. Group-based trajectory model was applied to determine sleep FI in infancy and toddler period trajectory groups with Bayesian information criteria being used to determine the best fitting model. Children's emotional and behavioral problems between groups were examined with independent t test and linear regression models, etc. Results: A total of 177 children, with 91 boys and 86 girls, were included in the final analysis and were divided into 2 groups: high FI group (n=30) and low FI group (n=147). Compared with children in the low FI group, those in the high FI group presents with higher total difficulties score and higher hyperactivity or inattention score ((11.0±4.9) vs. (8.9±4.1), (4.9±2.7) vs. (3.7±2.3) scores, t=2.17, 2.23, both P<0.05, respectively), with the differences remaining significant after adjusting for covariates (t=2.08, 2.09, both P<0.05 respectively). Conclusion: High sleep fragmentation in infancy and toddler period is associated with more emotional and behavioral problems, especially hyperactivity or inattention problems, at 6 years of age.
Male ; Female ; Humans ; Infant ; Child, Preschool ; Child ; Cohort Studies ; Problem Behavior/psychology* ; Sleep Deprivation ; Prospective Studies ; Bayes Theorem ; China ; Surveys and Questionnaires

PURPOSE: This study was conducted to examine the longitudinal effects of parenting stress and parental control attitudes on problem behaviors in preschool children, using a latent growth model. METHODS: Participants were 1,724 pairs of parents and 1,724 preschool children who had completed the panel survey on Korean children (5th~7th survey panels). RESULTS: An analysis of the multivariate latent growth model of parenting stress, parental control attitudes, and children's problem behaviors suggested that the parents' intercepts for parenting stress influenced their intercepts for parental control attitudes (father: β=.21, p < .001; mother: β=.55, p < .001). In addition, the slopes for fathers' parenting stress was the only aspect that affected the slopes for mothers' parental control attitudes (β=.77, p < .001). Moreover, both the intercepts and slopes of parenting stress and parental control attitudes significantly affected the children's problem behaviors. CONCLUSION: This study is significant as it provides longitudinal evidence of the impact of parenting stress and parental control attitudes on children's problem behaviors. The findings suggest that accurately assessing changes in parenting stress and parental control attitudes and developing intervention programs to reduce them will be effective in reducing problem behaviors in children.
Child ; Child, Preschool ; Humans ; Mothers ; Parenting ; Parents ; Problem Behavior

OBJECTIVETo investigate the influencing factors for psychological and behavioral problems in school-age twins and to provide a basis for reducing the incidence of these problems.

METHODSThe psychological and behavioral problems were assessed in 147 pairs of twins aged 6-12 years in Huhhot, China, using the Achenbach Child Behavior Checklist (CBCL). The Family Adaptability and Cohesion Evaluation Scales and Family General Condition Questionnaire were used to collect data.

RESULTSThe overall detection rate of psychological and behavioral problems in these children was 24.1%; the detection rate of thought problems (15.3%) was the highest, and the detection rate of physical discomforts (3.4%) was the lowest. According to the multiple logistic regression analysis, full-term birth or not was significantly associated with withdrawn behavior and total score on the CBCL (P<0.05); temperament type was significantly associated with thought problems and overall detection rate of psychological and behavioral problems (P<0.05); father's child-bearing age was significantly associated with thought problems (P<0.05); family cohesion was significantly associated with discipline violation (P<0.05); family adaptability was significantly associated with thought problems (P<0.05); family rearing patterns were significantly associated with socialization problems (P<0.05).

CONCLUSIONSChildren's temperament type, full-term birth or not, father's child-bearing age, family cohesion, family adaptability, and family rearing patterns are the main influencing factors for the psychological and behavioral problems in school-age twins.

Child ; Child Behavior Disorders ; etiology ; Female ; Humans ; Logistic Models ; Male ; Problem Behavior ; psychology ; Twins ; psychology

BACKGROUND: This study aimed to examine the environmental tobacco smoke (ETS) exposure at home and associated problem behaviors in Korean children and adolescents. METHODS: Approximately 2,167 children aged 3–18 years were included in the study after excluding 163 active smokers from the Korean Environmental Health Survey in Children and Adolescents (2012–2014). ETS data were obtained using a questionnaire; problem behaviors were measured using the Child Behavior Checklist administered to parents. The relationship between ETS exposure and problem behavior was evaluated using a survey regression model adjusted for region, age, sex, income, and father's education. The population-attributable fraction (PAF%) was calculated based on problem behaviors related to ETS exposure at home. RESULTS: The rates of ETS exposure at home were 20%, 28%, and 39% in children aged 3–5, 6–11, and 12–18 years, respectively; ETS exposure at home was associated with behavioral problems: the exposed group having higher total behavioral problem score (95% confidence interval [CI]) than the non-exposed by 2.46 (0.60–4.32) and 2.74 (0.74–4.74) in children aged 6–11 and 12–18 years, respectively, with no significant association in those aged 3–5 years. The PAF% (95% CI) of total problem behaviors for ETS exposure at home were 2.68 (−10.11–17.78), 10.66 (3.25–17.55), and 11.62 (3.03–18.96) in children aged 3–5, 6–11, and 12–18 years, respectively. Children with externalizing problems had higher PAF% than those with internalizing problems. CONCLUSION: In Korea, ETS exposure at home is associated with problem behaviors in children and adolescents with about more than 10% population attributable fraction.
Adolescent* ; Checklist ; Child Behavior ; Child* ; Education ; Environmental Health ; Humans ; Korea ; Parents ; Problem Behavior* ; Smoke* ; Tobacco*

OBJECTIVES: The purpose of this study was to verify discriminant validity and the clinical cutoff score of Child Behavior Checklist 1.5-5 in the diagnosis of developmental delayed infants. METHODS: The participants were screened by Denver II which includes 156 developmental delayed infants and 288 normal infants. Chi-squared test, t-test, ROC curve analysis, odds ratio analysis were performed on the data. RESULTS: Only 47 items out of 99 items among the CBCL 1.5-5 of total groups, 36 items of boys and 48 items of girls, discriminated developmental delayed infants well. Discriminant validity was confirmed by mean differences on the subscales of Withdrawn, Sleep Problems, Attention Problems, Internalizing Problems, Externalizing Problems, Total Problems, DSM Pervasive Developmental Problems and DSM Attention Deficit/Hyperactivity Problems between the two groups. Additionally, ROC analyses demonstrated that Withdrawn, Attention Problems, Internalizing Problems, Total Behavior Problems and DSM Pervasive Developmental Problems significantly predicted developmental delayed infants compared to normal infants. Also, the clinical cutoff score criteria adopted in the Korean CBCL 1.5-5 for subscales of Withdrawn, Attention Problems, Internalizing Problems, Total Behavior Problems and DSM Pervasive Developmental Problems were shown to be valid. CONCLUSION: The subscales of Withdrawn, Attention Problems, Internalising Problems, Total Behavior Problems and DSM Pervasive Developmental Problems significantly discriminated in the diagnosis of developmental delayed infants well.
Checklist ; Child ; Child Behavior ; Humans ; Infant ; Odds Ratio ; ROC Curve

PURPOSE: This study aims to investigate the individual and environmental factors related to emotional/behavioral problems to early adolescence in Korea by applying multilevel modeling. METHODS: From the database of the 2014 Korean Child and Youth Panel Survey (KCYPS), the researchers selected 1,977 adolescents who are in the second year of middle school. Multilevel model analysis was performed to estimate the impact of relevant factors at the individual and environmental levels. RESULTS: At the individual level, the significant factors associated with emotional/behavioral problems included BMI and study tendency in boys, and drinking, study tendency and economic levels in girls. At the environmental level, the significant factor associated with emotional/behavioral problems included relationship with the teacher. CONCLUSION: The emotional/behavioral problems of early adolescence are influenced not only by the individual factors but also by the environment factor. Therefore, the environment surrounding the adolescents should also be considered to prevent emotional/behavioral problems.
Adolescent* ; Child ; Drinking ; Female ; Humans ; Korea ; Multilevel Analysis ; Problem Behavior*