Externalizing behavior problems in preschool children How engagement and interaction are correlated to different externalizing problems in preschool children over a three-year period

Introduction: Externalizing behavior problems, which are often operationalized to include hyperactivity and conduct problems, are among the most common detectable mental health problems in preschool children. Children experiencing these problems are at a high risk of developing disorders in the same or overlapping fields years later. Early intervention is therefore important, but which intervention is appropriate is debatable. Recent focus has been on detecting possible risk factors in the preschool setting, in the hope of studying successful interventions. Studies have shown that positive interactions with peers and preschool teachers can have a rewarding influence on a child’s mental health. Another important factor is these children’s engagement in preschool activities. Engagement is important for the child’s development and learning. Research shows children displaying externalizing behaviors tend to spend less time engaged and have more problems when it comes to interaction. More knowledge is needed regarding how different externalizing problems correlate to these factors. The aim of our study was to research how patterns of different externalizing problems, i.e. hyperactivity and conduct problems, correlated to engagement and interaction in preschool settings over a three-year period. Methods: Data had been collected during a previous longitudinal study from 2012-2014, where preschool teachers answered questionnaires about the children. This study used data from the first and last years of that data collection. Children were divided into groups based on their behavioral patterns, evaluated by the preschool teacher’s version of the SDQ. The groups were N = Normal, H = Hyperactivity with no conduct problems, C = Conduct problems with no hyperactivity, B = Both hyperactivity and conduct problems. Chi square tests were used to compare groups with respect to demographic data. One-way ANOVAs were conducted to determine whether there were any significant differences between the means of the groups. Tukey‘s and Games Howell post hoc tests were then performed to localize the differences between groups. Results: H group stayed relatively stable in size while C group decreased over time. In general, the H group received the lowest ratings (and N group the highest) in both the first and last year for interaction and engagement. The H group was also the only group to show more functional impairment than the N group in the first year, and when it came to the last year, they also showed more functional impairment compared to the C group. The C group’s rating was lower than N group’s in the last year for the child’s interaction with other children, but no difference was found regarding engagement between those two groups. The C group had significantly higher ratings for interactions to other children and teachers compared to the H group in both the first and last year. In the last year, they also had better engagement than the H group. The B group showed better engagement than the H group in the first year. In the last year, the B group received lower ratings than the N group for their interactions with other children and teachers, and developmental delay. Conclusion: Children with hyperactivity seemed to have more difficulties than children with conduct problems when it came to interactions and engagement in preschool settings. Engaged, interacting children are more likely to function better over time. Studies on interventions focusing on positive interactions and enhanced engagement are needed.