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Member Research & Reports

Member Research & Reports

Northwestern Study Helps Distinguish between Normal and Worrisome Early Childhood Misbehavior

Temper tantrums and meltdowns aren’t unusual for preschool-age children, but frequent and intense irritable behaviors can leave parents questioning what’s normal behavior and what’s not.

In a study published in the Journal of the American Academy of Child and Adolescent Psychiatry, scientists at Northwestern University Feinberg School of Medicine Programs in Public Health developed a dimensional method for distinguishing misbehavior that is expected in early childhood versus behaviors that are cause for clinical concern.

“Basically, we are generating a science of when to worry in early childhood, a kind of behavioral precision medicine for preschoolers,” said Dr. Lauren Wakschlag, professor and vice chair of Medical Social Sciences, faculty at the Institute for Public Health and Medicine and lead author of the study.

To get a developmentally-tuned, accurate view of irritable behavior over time, Dr. Wakschlag and her team developed a survey called the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB), which asks mothers to report their preschoolers’ irritability at multiple time points. They then used these patterns of irritability to predict which preschoolers would exhibit problems that interfere with their ability to regulate behavior and learning or participate in daily life activities.

“By combining this dimensional approach with consideration of other key factors that influence the likelihood that high early irritability will result in mental health problems, our goal is to provide a clinical decision-making roadmap for pediatricians, teachers and mental health professionals caring for young kids,” said Dr. Wakschlag, who is also a fellow of the Institute for Policy Research.

Results from the MAP-DB showed that children whose irritability scores were at a level previously considered within the normal range had risk of clinical problems as high as 67 percent. By assessing a broad spectrum of young children’s behavior from typical tantrums to destructive tantrums and intense angry moods, researchers were able to calibrate how children’s risk increased across the dimensional spectrum.


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