Prevalence of social-emotional and behavioral problems in a community sample of 1-and 2-year-old children

Objective: To examine the prevalence of infant-toddler social-emotional and behavioral problems and associations with social-emotional competence, interference in family life, and parental worry. Method: The sample consisted of 1- and 2-year-old children (mean [MN] age = 24.8 months) from the baseline survey of a representative sample of healthy births (N = 1,280). Parent questionnaires included the Child Behavior Checklist (CBCL/2-3), Parenting Stress Index Short Form (PSI/SF), and Infant-Toddler Social and Emotional Assessment social-emotional competence scales, as well as questions about parental worry and family activities. Results: Approximately 80% of eligible subjects participated. The weighted prevalence of parent-reported subclinical/clinical CBCL/2-3 scores was 11.8% for 2-year-olds. Approximately 6% of parents of 1- and 2-year-olds reported clinical-level scores on the PSI Difficult Child (PSI/DC) scale, which was included as a proxy for behavior problems among 1-year-olds, for whom measures were limited. Sex differences were not observed. CBCL/2-3 and PSI/DC scores were uniquely associated with economic disadvantage (relative risk = 1.89 and 2.24, respectively). Approximately 32% of 2-year-olds with subclinical/clinical CBCL/2-3 scores had delayed social-emotional competence. Problems were also associated with parental worry about child behavior and interference in family activities. Conclusions: A significant need for early identification of emotional/behavioral problems in very young children is highlighted by associations with delayed competence and disruptions in family life that may further contribute to risk for persistent problems.