August 11, 2014
News Review From Harvard Medical School -- Study Links Mental Delays, Behavior Problems
Babies with delays in mental development may be more likely to have behavior problems later. That's the conclusion of a new study. The study included 8,000 children. Researchers looked at measurements of development at age 9 months. They divided the children into 2 groups: cognitive delay and typical development. Children with cognitive delays may learn or understand something later than most children. By age 24 months, cognitive delays had gone away for 80% of the children who had delays at 9 months. Researchers also looked at assessments of the same children's behavior at age 24 months. Among children who always had typical cognitive development, 13% had behavior problems. These problems were more common for those with cognitive delays. About 19% of the children with early delays that went away had behavior problems. So did 36% of those with lasting cognitive delays. Some children developed cognitive delays after 9 months. About 22% of them had behavior problems at 24 months. Behavior problems tended to get worse by age 5. This was especially true if cognitive delays did not improve. The journal Pediatrics published the study. Daily RxNews wrote about it August 11.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Sometimes there is more to a fussy baby or a toddler having a tantrum than meets the eye.
Difficult behavior -- such as fussiness, tantrums, aggression or clinginess -- is very common in babies and young children. It's so common, in fact, that we don't think anything of it. If we see it in someone else's child at the park or store, we often chalk it up to poor parenting. But sometimes behavior problems can be a sign of something else: a cognitive delay.
"Cognitive delay" means that a child learns or understands something later than others the same age. Cognitive delays are different from motor delays. With a motor delay, a child does something physical (such as sitting or crawling) later than other children. A child with a cognitive delay might take longer to talk, or understand words, or figure out how to play with another child.
It's easy to understand why a child with cognitive delays might have behavior problems. If a child doesn't understand that when his mother leaves she will come back, he might get extremely upset every time she leaves. If a child can't explain what she wants, she may throw tantrums out of frustration. And if a child doesn't understand the concept of sharing a toy, she may hit or otherwise be aggressive toward a child who is playing with a toy she wants.
Researchers were interested in knowing if there were links between cognitive delays and behavior problems. In particular, they wanted to find out how this played out over time. Because for many children, delays are just that: delays. With a little time, the children catch up completely with their peers. Other children don't catch up. In that case, the delays become a sign of a bigger problem.
The researchers studied 8,000 children from the Early Childhood Longitudinal Study. They looked at the children's development as well as signs of behavior problems. Examples of behavior problems included:
- Being fussy
- Showing aggression
- Getting easily upset
- Demanding attention
- Breaking things
- Having tantrums
- Being overly active
- Having sleep problems
- Having difficulty engaging in tasks
- Being distractible
The good news from this study is that researchers found cognitive delays got better in 80% of the children who were found to have them at age 9 months. As for behavior problems, they were indeed more common in children with cognitive delays. Problems were noted as early as 9 months. About 1 in 5 children with cognitive delays that got better had a behavior problem. In children whose delays didn't get better, that rose to 1 in 3.
What Changes Can I Make Now?
As I said before, most of the time behavior problems in children are entirely normal. They may be related to the situation or the child's temperament. Sometimes they are related to parenting. (Setting consistent, loving limits can make all the difference.) But sometimes they are a sign of a bigger problem.
If your child is having persistent problems with behavior, talk to your doctor. Even when it's not a sign of a bigger problem, your doctor can help you sort out what's triggering the behavior and help you come up with strategies to manage it.
But if your child is showing any signs of delays in development, it might be a good idea to have a developmental evaluation done. This will help determine if there are any problems that should be addressed. If there are, the sooner you find them, the sooner you can get your child help -- and that can make a big difference with cognitive delays.
What Can I Expect Looking to the Future?
What I want most as a pediatrician is for my patients to have the best future possible. Finding problems early -- and getting help for them quickly -- makes that more likely. I hope that this study, and others like it, will help children live happier, healthier lives.