Social and Emotional Development in Children with Challenging Behaviors

Despite the relative lack of data on their application to preschool children, a number of classification systems exist and are used to diagnose and describe specific emotional and behavioral problems in children. It is important for professionals working with young children with special needs to be familiar with these systems, particularly because some of these systems have measurement devices that may need to be completed by teachers as part of the diagnostic evaluation process.

One of the most commonly recognized systems for classifying child psychopathology is the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (2000). Now in its fourth edition, this system provides a multidimensional framework for conceptualizing problem behaviors. The current version of the DSM has more specific diagnoses for children than any previous version and requires greater specification for a professional to assign a specific diagnosis. This is the diagnostic system that typically is used by most mental health professionals in the United States.

Regardless of the classification system used, there is a very high prevalence of young children in whom parents and teachers report challenging behaviors. According to Rockhill, Collett, McClellan, and Speltz (2006), 2 to 3% of children fit the criteria for a clinical diagnosis of oppositional defiant disorder (ODD). Among other behaviors, these children exhibit anger, defiance, and noncompliance. About 25 to 50% of the children who are diagnosed with ODD also have attention deficit– hyperactivity disorder (ADHD) (Rockhill et al., 2006). Moreover, children with ODD may also have depressive or anxiety disorders. It is important to note, however, that because of problems with how symptoms are defined for these disorders, we cannot be sure how often they actually co-occur (Rockhill et al., 2006).

One way of classifying challenging behaviors is by considering those children who have problems with externalizing versus internalizing behaviors. Children who exhibit externalizing behaviors show high rates of hyperactivity, impulsivity, aggression, defiance, and noncompliance. These children show undercontrol; their behaviors are often annoying and can cause hurt to others (Campbell, 1990, p. 66). Externalizing behaviors are directed outwardly toward people or objects.

In contrast, children who have internalizing behaviors are fearful, depressed, and withdrawn (Rockhill et al., 2006). Internalizing behaviors are directed inward by the child. Both parents and teachers have more difficulty with children with externalizing behaviors, and those behaviors are remarkably stable over time. Campbell (2002) found that over half of the children who had moderate to severe externalizing behaviors in preschool still showed those behaviors in elementary school, with 67% of these children diagnosed with attention deficit–hyperactivity disorder, oppositional defiant disorder, or a conduct disorder at age 9.

It is not clear what causes children to have behavior problems at such an early age, but researchers have suggested that both organic and environmental factors may put them at risk. For example, children with delays in social, communication, or cognitive development and children who experience poor home or school environments are more likely to exhibit challenging behaviors (Conroy & Davis, 2000).