Outcomes for Preschool Children with
Disruptive Behavior and Adaptive Disability
research team led by ADHD expert Russell Barkley (2002) evaluated
3-year outcomes for 169 children identified as having high vs.
low levels of disruptive behavior (DB) when they were screened
for entrance into Worcester, Massachusetts kindergartens. The
children were then reassessed 3 years later to determine whether
"Adaptive Disability" (AD) assessed at the initial screening
would add to DB as a predictor of poor outcomes. AD was defined
as low scores on the Normative Adaptive Behavior Checklist (NABC).
At the 3-year reassessment, most CBCL and TRF scales, plus other
measures, showed that the DB+AD children were more impaired than
children who had DB without AD who, in turn, were more impaired
than control children with neither DB nor AD. In testing the predictors
of outcomes, Barkley et al. found that preschool CBCL scores for
Attention Problems and Aggressive Behavior significantly predicted
all 16 measures of impairment, including DSM Conduct Disorder
symptoms reported by parents on the Diagnostic Interview Schedule
for Children (DISC-P), the Home Situations Questionnaire (HSQ),
and the Parenting Stress Index (PSI). The preschool NABC scores
added significant predictive variance only to the number of Conduct
Disorder symptoms reported on the DISC-P. Comparison of AD scores
at the preschool screening vs. follow-up reassessment led the
authors to conclude that AD ". . . is not a highly stable
dimension or category over the first few grades of formal schooling."
Furthermore, ". . . attendance at kindergarten may help to
attenuate children's initial levels of adaptive disability in
the preschool years, perhaps by offering another powerful set
of contributing forces to the children's development of self-sufficiency,
that being teachers, the educational curriculum, and classmates"
Reference: Barkley, R.A., Shelton, T.L., Crosswait, C.,
Moorehouse, M., Fletcher, K., Barrett, S., Jenkins, L., &
Metvia, L. (2002). Preschool children with disruptive behavior:
Three-year outcome as a function of adaptive disability. Development
and Psychopathology, 14, 45-67.