Impact of COVID-19 on emotional and behavioral problems among preschool children: a meta-analysis.
Behavioral problems
COVID-19
Emotional disturbances
Meta-analysis
Preschool children
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
16 Jul 2024
16 Jul 2024
Historique:
received:
26
07
2023
accepted:
03
07
2024
medline:
17
7
2024
pubmed:
17
7
2024
entrez:
16
7
2024
Statut:
epublish
Résumé
The impact of the Coronavirus Disease 2019 (COVID-19) on society is continuous, resulting in negative psychological consequences. Given the vulnerability and sensitivity to the environment among preschool children, their emotional and behavioral problems deserve more attention. The current study aimed to explore the impact of the epidemic on preschool children's mental health by determining the pooled prevalence of emotional and behavioral problems amidst the Coronavirus Disease 2019 pandemic and to reveal potential reasons for variations between studies. Published studies were searched in Embase, PubMed, ProQuest, PsycINFO, Web of Science, CNKI, and Wanfang. Based on the inclusion criteria outlined in this study, a total of 10 studies encompassing 38,059 participants were incorporated. Employing a random-effect model for estimating the prevalence of emotional and behavioral problems, the results revealed a pooled prevalence rate of 24.3% (95% CI, 0.15-0.38; I²=99.9%) among preschool children. This rate surpasses the pre-outbreak prevalence observed in different countries, signifying a detrimental influence of the epidemic on the mental well-being of preschoolers. Therefore, mental health care and recovery are essential for the vulnerable group during and after the public health crisis. Specific emotional and behavioral problems among preschool children are expected to be researched in the future to provide more targeted guidance for intervention.
Identifiants
pubmed: 39014321
doi: 10.1186/s12887-024-04931-8
pii: 10.1186/s12887-024-04931-8
doi:
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
455Subventions
Organisme : National Key Research and Development Program of China
ID : 2021YFC2501405
Organisme : Qingpu District Health Bureau Project
ID : MY2023-4
Informations de copyright
© 2024. The Author(s).
Références
Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, Iosifidis C, Agha R. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71–6.
pubmed: 32112977
pmcid: 7105032
doi: 10.1016/j.ijsu.2020.02.034
SeyedAlinaghi S, Karimi A, Shobeiri P, Nowroozi A, Mehraeen E, Afsahi AM, Barzegary A. Psychological symptoms of COVID-19 epidemic: a systematic review of current evidence. Psihologija. 2021;54(2):173–92.
doi: 10.2298/PSI200703035S
Mehraeen E, Oliaei S, SeyedAlinaghi S, Karimi A, Mirzapour P, Afsahi AM, Barzegary A, Vahedi F, Soleymanzadeh M, Behnezhad F, et al. COVID-19 in pediatrics: a systematic review of current knowledge and practice. Infect Disord Drug Targets. 2022;22(5):e290921196908.
pubmed: 34587889
doi: 10.2174/1871526521666210929121705
Pashaei Z, SeyedAlinaghi S, Qaderi K, Barzegary A, Karimi A, Mirghaderi SP, Mirzapour P, Tantuoyir MM, Dadras O, Ali Z, et al. Prenatal and neonatal complications of COVID-19: a systematic review. Health Sci Rep. 2022;5(2):e510.
pubmed: 35224216
pmcid: 8844871
doi: 10.1002/hsr2.510
Kolcakoglu K, Yucel G. Anxiety and harmful oral habits in preschool children during the 2020 first-wave COVID–19 lockdown in Turkey. Dent Med Probl. 2021;58(4):433–9.
pubmed: 34931763
doi: 10.17219/dmp/142284
Briggs-Gowan MJ, Carter AS, Bosson-Heenan J, Guyer AE, Horwitz SM. Are infant-toddler social-emotional and behavioral problems transient? J Am Acad Child Adolesc Psychiatry. 2006;45(7):849–58.
pubmed: 16832322
doi: 10.1097/01.chi.0000220849.48650.59
Nuckols CC. The diagnostic and statistical manual of mental disorders,(DSM-5). Philadelphia: American Psychiatric Association 2013.
Geddes JR, Andreasen NC. New Oxford textbook of psychiatry. Oxford University Press, USA; 2020.
Stülb K, Messerli-Bürgy N, Kakebeeke TH, Arhab A, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Meyer AH, Kriemler S, Jenni OG, et al. Prevalence and predictors of behavioral problems in healthy Swiss Preschool Children over a one year period. Child Psychiatry Hum Dev. 2019;50(3):439–48.
pubmed: 30368619
doi: 10.1007/s10578-018-0849-x
Kwon S, O’neill ME, Foster CC. The associations of Child’s clinical conditions and behavioral problems with parenting stress among families of preschool-aged children: 2018–2019 National Survey of Child Health. Children. 2022;9(2):241.
pubmed: 35204961
pmcid: 8869988
doi: 10.3390/children9020241
Oliva S, Russo G, Gili R, Russo L, Di Mauro A, Spagnoli A, Alunni Fegatelli D, Romani M, Costa A, Veraldi S. Risks and protective factors associated with mental health symptoms during COVID-19 home confinement in Italian children and adolescents: The# understandingkids study. Front Pead 2021:537.
Wipfli B, Landers D, Nagoshi C, Ringenbach S. An examination of serotonin and psychological variables in the relationship between exercise and mental health. Scand J Med Sci Sports. 2011;21(3):474–81.
pubmed: 20030777
doi: 10.1111/j.1600-0838.2009.01049.x
Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017;106:48–56.
pubmed: 29150166
doi: 10.1016/j.maturitas.2017.09.003
Lloyd BA, Hake HS, Ishiwata T, Farmer CE, Loetz EC, Fleshner M, Bland ST, Greenwood BN. Exercise increases mTOR signaling in brain regions involved in cognition and emotional behavior. Behav Brain Res. 2017;323:56–67.
pubmed: 28130174
pmcid: 5359005
doi: 10.1016/j.bbr.2017.01.033
McArthur BA, Tough S, Madigan S. Screen time and developmental and behavioral outcomes for preschool children. Pediatr Res. 2022;91(6):1616–21.
pubmed: 34012028
doi: 10.1038/s41390-021-01572-w
Pfefferbaum B, Van Horn RL. Physical activity and sedentary behavior in children during the COVID-19 pandemic: implications for Mental Health. Curr Psychiatry Rep 2022:1–9.
van den Heuvel MI, Vacaru SV, Boekhorst MG, Cloin M, van Bakel H, Riem MM, de Weerth C, Beijers R. Parents of young infants report poor mental health and more insensitive parenting during the first Covid-19 lockdown. BMC Pregnancy Childbirth. 2022;22(1):1–14.
Russell BS, Hutchison M, Tambling R, Tomkunas AJ, Horton AL. Initial challenges of caregiving during COVID-19: caregiver burden, mental health, and the parent–child relationship. Child Psychiatry Hum Dev. 2020;51(5):671–82.
pubmed: 32749568
pmcid: 7398861
doi: 10.1007/s10578-020-01037-x
Carlson SM, Wang TS. Inhibitory control and emotion regulation in preschool children. Cogn Dev. 2007;22(4):489–510.
doi: 10.1016/j.cogdev.2007.08.002
Zhu J, Xiao B, Hipson W, Yan C, Coplan RJ, Li Y. Social avoidance and social adjustment: the moderating role of emotion regulation and emotion lability/negativity among Chinese preschool children. Front Psychol. 2021;12:618670.
pubmed: 33790837
pmcid: 8005725
doi: 10.3389/fpsyg.2021.618670
Pruss-Ustun A, Corvalán CF, Organization WH. Preventing disease through healthy environments: towards an estimate of the environmental burden of disease. World Health Organization; 2006.
Stevens JS, van Rooij SJ, Jovanovic T. Developmental contributors to trauma response: the importance of sensitive periods, early environment, and sex differences. Behav Neurobiol PTSD 2016:1–22.
Herringa RJ. Trauma, PTSD, and the developing brain. Curr Psychiatry Rep. 2017;19(10):1–9.
doi: 10.1007/s11920-017-0825-3
Hollo A, Wehby JH, Oliver RM. Unidentified language deficits in children with emotional and behavioral disorders: a meta-analysis. Except Child. 2014;80(2):169–86.
doi: 10.1177/001440291408000203
King-Dowling S, Missiuna C, Rodriguez MC, Greenway M, Cairney J. Reprint of co-occurring motor, language and emotional–behavioral problems in children 3–6years of age. Hum Mov Sci. 2015;42:344–51.
pubmed: 26094140
doi: 10.1016/j.humov.2015.06.005
Sun J, Singletary B, Jiang H, Justice LM, Lin T-J, Purtell KM. Child behavior problems during COVID-19: associations with parent distress and child social-emotional skills. J Appl Dev Psychol. 2022;78:101375.
pubmed: 34924662
doi: 10.1016/j.appdev.2021.101375
van den Bedem NP, Dockrell JE, van Alphen PM, Rieffe C. Emotional competence mediates the relationship between communication problems and reactive externalizing problems in children with and without developmental language disorder: a longitudinal study. Int J Environ Res Public Health. 2020;17(16):6008.
pubmed: 32824870
pmcid: 7459595
doi: 10.3390/ijerph17166008
Sadowsky J. Madness in civilization: a Cultural history of insanity, from the Bible to Freud, from the madhouse to Modern Medicine by Andrew Scull. Bull Hist Med. 2017;91(1):126–7.
doi: 10.1353/bhm.2017.0006
Nourbakhsh SMK, Atamanesh M, Effatpanah M, Salehi M, Heidari M. The Association between behavioral problems with Self-Esteem and Self-Concept in Pediatric patients with thalassemia. Iran J Psychiatry. 2021;16(1):36.
pubmed: 34054981
pmcid: 8140307
Berchiatti M, Ferrer A, Badenes-Ribera L, Longobardi C. School adjustments in children with attention deficit hyperactivity disorder (ADHD): peer relationships, the quality of the student-teacher relationship, and children’s academic and behavioral competencies. J Appl School Psychol 2021:1–21.
Kwon K, Kim E, Sheridan S. Behavioral competence and academic functioning among early elementary children with externalizing problems. School Psychol Rev. 2012;41(2):123–40.
doi: 10.1080/02796015.2012.12087516
Mundy LK, Canterford L, Tucker D, Bayer J, Romaniuk H, Sawyer S, Lietz P, Redmond G, Proimos J, Allen N. Academic performance in primary school children with common emotional and behavioral problems. J Sch Health. 2017;87(8):593–601.
pubmed: 28691169
doi: 10.1111/josh.12531
Organization WH. World mental health report: transforming mental health for all: executive summary. In: World mental health report: transforming mental health for all: executive summary edn.; 2022.
Zhu Z, Zhang X, Xue H, Li H, Liu M, Li X. The associations between screen exposure and problems in emotion and behavior among Preschool Children——The moderating effect of Sleep Duration. J Shaanxi Xueqian Normal Univ 2021.
Barkmann C, Schulte-Markwort M. Prevalence of emotional and behavioural disorders in German children and adolescents: a meta-analysis. J Epidemiol Community Health. 2012;66(3):194–203.
pubmed: 20889591
doi: 10.1136/jech.2009.102467
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.
pubmed: 19622511
doi: 10.7326/0003-4819-151-4-200908180-00135
Lung NH, Institute B, Health NIo H, UDo, Services H. Study quality assessment tools: quality assessment tool for observational cohort and cross-sectional studies. In.; 2018.
Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA. Cochrane handbook for systematic reviews of interventions. Wiley; 2019.
Wang P, Li W, Hu Y, Wang G, Jiang F, Chen J. Investigation on sleep problems and related factors in preschool children during home quarantine. Chin J Child Health Care. 2021;29(5):479.
Wang X, Du W, Zhang M. Investigation on screen time and psychosocial problems of preschoolers during the prevalence of COVID-19. China J Health Psychol 2021.
Zhang X, Chen R. Psychological and behavioral problems of children aged 3–6 years during COVID-19. Health Med Res Pract 2022.
Wang X, Yin G, Guo F. Variation in screen time before and after COVID-19 epidemic and its correlation with behavior problems among preschool children. Chin J Public Health. 2021;37(5):769–73.
Zhong H, Tang H, Meng H. Behavioral problems and its association with family factors of young children in home quarantine during the COVID-19 pandemic. Chin J Social Med 2021.
Buechel C, Nehring I, Seifert C, Eber S, Behrends U, Mall V, Friedmann A. A cross-sectional investigation of psychosocial stress factors in German families with children aged 0–3 years during the COVID-19 pandemic: initial results of the CoronabaBY study. Child Adolesc Psychiatry Ment Health. 2022;16(1):37.
pubmed: 35581664
pmcid: 9113073
doi: 10.1186/s13034-022-00464-z
Conti E, Sgandurra G, De Nicola G, Biagioni T, Boldrini S, Bonaventura E, Buchignani B, Della Vecchia S, Falcone F, Fedi C. Behavioural and emotional changes during covid-19 lockdown in an Italian paediatric population with neurologic and psychiatric disorders. Brain Sci. 2020;10(12):918.
pubmed: 33260987
pmcid: 7760933
doi: 10.3390/brainsci10120918
Hails KA, Petts RA, Hostutler CA, Simoni M, Greene R, Snider TC, Riley AR. COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences. Child Abuse Negl. 2022;130(Pt 1):105450.
pubmed: 34969517
doi: 10.1016/j.chiabu.2021.105450
Wichstrøm L, Berg-Nielsen TS, Angold A, Egger HL, Solheim E, Sveen TH. Prevalence of psychiatric disorders in preschoolers. J Child Psychol Psychiatry. 2012;53(6):695–705.
pubmed: 22211517
doi: 10.1111/j.1469-7610.2011.02514.x
Wlodarczyk O, Pawils S, Metzner F, Kriston L, Wendt C, Klasen F, Ravens-Sieberer U. Mental Health problems among preschoolers in Germany: results of the BELLA Preschool Study. Child Psychiatry Hum Dev. 2016;47(4):529–38.
pubmed: 26353908
doi: 10.1007/s10578-015-0586-3
Han B, Huang H, Yao X, Li X, Li S, Yan H. Association of screen time with emotional and behavioral problems in preschool children. Chin J School Health 2019:1669–71.
Dollberg DG, Hanetz-Gamliel K, Levy S. COVID-19, child’s behavior problems, and mother’s anxiety and mentalization: a mediated moderation model. Curr Psychol 2021:1–12.
Rakickienė L, Jusienė R, Baukienė E, Breidokienė R. Pre-schoolers’ behavioural and emotional problems during the first quarantine due to COVID-19 pandemic: the role of parental distress and screen time. Psichologija. 2021;64:61–8.
doi: 10.15388/Psichol.2021.41
Clarke J, Kipping R, Chambers S, Willis K, Taylor H, Brophy R, Hannam K, Simpson SA, Langford R. Impact of COVID-19 restrictions on preschool children’s eating, activity and sleep behaviours: a qualitative study. BMJ open. 2021;11(10):e051497.
pubmed: 34663663
doi: 10.1136/bmjopen-2021-051497
Reyes AN, Molina ML, Jansen K, De Lima Bach S, Do Amaral PL, Spessato BC. Silva RAd: biological rhythm and emotional and behavioral problems among schoolchildren in Southern Brazil. Chronobiol Int. 2019;36(3):353–9.
pubmed: 30501445
doi: 10.1080/07420528.2018.1545781
Kharel M, Sakamoto JL, Carandang RR, Ulambayar S, Shibanuma A, Yarotskaya E, Basargina M, Jimba M. Impact of COVID-19 pandemic lockdown on movement behaviours of children and adolescents: a systematic review. BMJ Global Health. 2022;7(1):e007190.
pubmed: 35078809
doi: 10.1136/bmjgh-2021-007190
Sum KK, Cai S, Law E, Cheon B, Tan G, Loo E, Lee YS, Yap F, Chan JKY, Daniel M. COVID-19–Related life experiences, Outdoor Play, and long-term adiposity changes among preschool-and school-aged children in Singapore 1 Year after Lockdown. JAMA Pediatr. 2022;176(3):280–9.
pubmed: 35072692
doi: 10.1001/jamapediatrics.2021.5585
Andersen SL. Sensitive periods of Brain Development and Preventive interventions. Volume 53. Springer International Publishing; 2022.
Benca R, Duncan MJ, Frank E, McClung C, Nelson RJ, Vicentic A. Biological rhythms, higher brain function, and behavior: gaps, opportunities, and challenges. Brain Res Rev. 2009;62(1):57–70.
pubmed: 19766673
pmcid: 2801350
doi: 10.1016/j.brainresrev.2009.09.005
Tandon PS, Zhou C, Johnson AM, Gonzalez ES, Kroshus E. Association of children’s physical activity and screen time with mental health during the COVID-19 pandemic. JAMA Netw Open. 2021;4(10):e2127892–2127892.
pubmed: 34596669
pmcid: 8486978
doi: 10.1001/jamanetworkopen.2021.27892
Ueno C, Yamamoto S. The relationship between behavioral problems and screen time in children during COVID-19 school closures in Japan. Scandinavian J Child Adolesc Psychiatry Psychol. 2022;10(1):1–8.
Hoehe MR, Thibaut F. Going digital: how technology use may influence human brains and behavior. In.: Taylor & Francis; 2022.
Sanders T, Parker PD, del Pozo-Cruz B, Noetel M, Lonsdale C. Type of screen time moderates effects on outcomes in 4013 children: evidence from the longitudinal study of Australian children. Int J Behav Nutr Phys Activity. 2019;16(1):1–10.
doi: 10.1186/s12966-019-0881-7
Idoiaga Mondragon N, Berasategi Sancho N, Dosil Santamaria M, Eiguren Munitis A. Struggling to breathe: a qualitative study of children’s wellbeing during lockdown in Spain. Psychol Health. 2021;36(2):179–94.
pubmed: 32762551
doi: 10.1080/08870446.2020.1804570
Vasileva M, Alisic E, De Young A. COVID-19 unmasked: Preschool children’s negative thoughts and worries during the COVID-19 pandemic in Australia. Eur J Psychotraumatology. 2021;12(1):1924442.
doi: 10.1080/20008198.2021.1924442
Schäfer SK, Sopp MR, Koch M, Göritz AS, Michael T. The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: a prospective observational study. J Psychiatr Res. 2022;153:236–44.
pubmed: 35841820
pmcid: 9257329
doi: 10.1016/j.jpsychires.2022.07.004
Hu T, Zhang D, Yang Z. The relationship between attributional style for negative outcomes and depression: a meta-analysis. J Soc Clin Psychol. 2015;34(4):304.
doi: 10.1521/jscp.2015.34.4.304
Stuijfzand S, Creswell C, Field AP, Pearcey S, Dodd H. Research Review: is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta-analysis. J Child Psychol Psychiatry. 2018;59(11):1127–42.
pubmed: 29052865
doi: 10.1111/jcpp.12822
Ranieri J, Guerra F, Cilli E, Caiazza I, Gentili N, Ripani B, Canzio M, Coletti E, Quassoni A, Niutta S. Buffering effect of e-learning on Generation Z undergraduate students: a cross-sectional study during the second COVID-19 lockdown in Italy. Mediterranean J Clin Psychol 2021, 9(2).
Daskalakis NP, Oitzl MS, Schächinger H, Champagne DL, de Kloet ER. Testing the cumulative stress and mismatch hypotheses of psychopathology in a rat model of early-life adversity. Physiol Behav. 2012;106(5):707–21.
pubmed: 22306534
doi: 10.1016/j.physbeh.2012.01.015
Nederhof E, Schmidt MV. Mismatch or cumulative stress: toward an integrated hypothesis of programming effects. Physiol Behav. 2012;106(5):691–700.
pubmed: 22210393
doi: 10.1016/j.physbeh.2011.12.008
Courtney D, Watson P, Battaglia M, Mulsant BH, Szatmari P. COVID-19 impacts on child and youth anxiety and depression: challenges and opportunities. Can J Psychiatry. 2020;65(10):688–91.
pubmed: 32567353
pmcid: 7502880
doi: 10.1177/0706743720935646
Oliveira T, Costa D, Alvim-Soares A, de Paula J, Kestelman I, Silva A, Malloy-Diniz L, Miranda D. Children’s behavioral problems, screen time, and sleep problems’ association with negative and positive parenting strategies during the COVID-19 outbreak in Brazil. Child Abuse Negl. 2022;130:105345.
pubmed: 34625278
doi: 10.1016/j.chiabu.2021.105345
Frigerio A, Nettuno F, Nazzari S. Maternal mood moderates the trajectory of emotional and behavioural problems from pre-to during the COVID-19 lockdown in preschool children. Eur Child Adolesc Psychiatry 2022:1–11.
Wang P, Sun X, Li W, Wang Z, He S, Zhai F, Xin Y, Pan L, Wang G, Jiang F. Mental Health of parents and preschool-aged children during the COVID-19 pandemic: the mediating role of harsh parenting and child sleep disturbances. Front Psychiatry 2021, 12.
Yang F, Wen J, Huang N, Riem MM, Lodder P, Guo J. Prevalence and related factors of child posttraumatic stress disorder during COVID-19 pandemic: a systematic review and meta-analysis. Eur Psychiatry. 2022;65(1):e37.
pubmed: 35726735
pmcid: 9280924
doi: 10.1192/j.eurpsy.2022.31
Salzberger B, Glück T, Ehrenstein B. Successful containment of COVID-19: the WHO-Report on the COVID-19 outbreak in China. In., vol. 48: Springer; 2020: 151–153.
Zhang S, Wang Z, Chang R, Wang H, Xu C, Yu X, Tsamlag L, Dong Y, Wang H, Cai Y. COVID-19 containment: China provides important lessons for global response. Front Med. 2020;14(2):215–9.
pubmed: 32212059
pmcid: 7095399
doi: 10.1007/s11684-020-0766-9
Rescorla LA, Althoff RR, Ivanova MY, Achenbach TM. Effects of society and culture on parents’ ratings of children’s mental health problems in 45 societies. Eur Child Adolesc Psychiatry. 2019;28(8):1107–15.
pubmed: 30659384
doi: 10.1007/s00787-018-01268-3
Achenbach TM, Becker A, Döpfner M, Heiervang E, Roessner V, Steinhausen H-C, Rothenberger A. Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: research findings, applications, and future directions. J Child Psychol Psychiatry. 2008;49(3):251–75.
pubmed: 18333930
doi: 10.1111/j.1469-7610.2007.01867.x
Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45.
pubmed: 11699809
doi: 10.1097/00004583-200111000-00015
Warnick EM, Bracken MB, Kasl S. Screening efficiency of the child Behavior Checklist and strengths and difficulties Questionnaire: a systematic review. Child Adolesc Mental Health. 2008;13(3):140–7.
doi: 10.1111/j.1475-3588.2007.00461.x
Mansolf M, Blackwell CK, Cummings P, Choi S, Cella D. Linking the child behavior checklist to the strengths and difficulties Questionnaire. Psychol Assess. 2022;34(3):233.
pubmed: 34843282
doi: 10.1037/pas0001083
Abdekhodaie Z, Tabatabaei SM, Gholizadeh M. The investigation of ADHD prevalence in kindergarten children in northeast Iran and a determination of the criterion validity of Conners’ questionnaire via clinical interview. Res Dev Disabil. 2012;33(2):357–61.
pubmed: 22119681
doi: 10.1016/j.ridd.2011.10.006
Sheldrick RC, Henson BS, Neger EN, Merchant S, Murphy JM, Perrin EC. The baby pediatric symptom checklist: development and initial validation of a new social/emotional screening instrument for very young children. Acad Pediatr. 2013;13(1):72–80.
pubmed: 23092547
doi: 10.1016/j.acap.2012.08.003
Baker BL, McIntyre LL, Blacher J, Crnic K, Edelbrock C, Low C. Pre-school children with and without developmental delay: behaviour problems and parenting stress over time. J Intellect Disabil Res. 2003;47(4–5):217–30.
pubmed: 12787154
doi: 10.1046/j.1365-2788.2003.00484.x