Pre‐school children with and without developmental delay: behaviour problems and parenting stress over time
Abstract
Background Children with intellectual disability are at heightened risk for behaviour problems and diagnosed mental disorder. Methods The present authors studied the early manifestation and continuity of problem behaviours in 205 pre‐school children with and without developmental delays. Results Behaviour problems were quite stable over the year from age 36–48 months. Children with developmental delays were rated higher on behaviour problems than their non‐delayed peers, and were three times as likely to score in the clinical range. Mothers and fathers showed high agreement in their rating of child problems, especially in the delayed group. Parenting stress was also higher in the delayed group, but was related to the extent of behaviour problems rather than to the child's developmental delay. Conclusions Over time, a transactional model fit the relationship between parenting stress and behaviour problems: high parenting stress contributed to a worsening in child behaviour problems over time, and high child behaviour problems contributed to a worsening in parenting stress. Findings for mothers and fathers were quite similar.
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Several longitudinal studies have found reverse directional effects of parental distress on the behaviour problems of children with intellectual disabilities.
“Several longitudinal studies have found reverse directional effects of parental distress on the behaviour problems of children with intellectual disabilities (e.g.Baker et al. 2003;Orsmond et al. 2003;Hastings et al. 2006;Lecavalier et al. 2006).”
From Psychological acceptance mediates the impact of the behaviour problems of children with intellectual disability on fathers' psychological adjustment. (2010) · cites this paper as Baker et al. 2003
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Understanding aggressive behaviour across the lifespan
LIU, J., LEWIS, G., & EVANS, L. (2013) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2012.01902.x · Cited by 191 · see citing works
Tellegen, C. L., & Sanders, M. R. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.01.022 · Cited by 189 · see citing works
Seltzer, M. M., Floyd, F. J., Song, J., Greenberg, J. S., & Hong, J. (2011) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-116.6.479 · Cited by 187 · see citing works
“A great deal of research has been conducted about the impacts of parenting a child with intellectual and developmental disabilities on mothers and, to a lesser extent on fathers, with a focus on the impacts during early childhood (Baker et al., 2003; Crnic & Low, 2002), the school years (Floyd & Gallagher, 1997), and…”
Evidence-Base Update for Parenting Stress Measures in Clinical Samples
Holly, L. E., Fenley, A. R., Kritikos, T. K., Merson, R. A., Abidin, R. R., & Langer, D. A. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1639515 · Cited by 199 · see citing works
Transactional Relations Between Parenting Stress and Child Autism Symptoms and Behavior Problems
Rodriguez, G., Hartley, S. L., & Bolt, D. M. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3845-x · Cited by 182 · see citing works
Intellectual Disability and Language Disorder
Marrus, N. M., & Hall, L. (2017) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2017.03.001 · Cited by 174 · see citing works
“Challenging behaviors are common in ID and can be more strongly associated with parental stress than the level of cognitive impairment.(12) These challenging behaviors may include noncompliance, property destruction, tantrums, “meltdowns”, and phys-”
Olsson, M. B., & Hwang, C. P. (2008) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2008.01081.x · Cited by 173 · see citing works
“The impact of child characteristics, such as the diagnosis of autism or the presence of behaviour problems in the child, has been identified as a risk factor significantly related to decreased maternal well-being (Hastings & Brown 2002; Olsson & Hwang 2001; Baker et al. 2003; Emerson 2003; Eisenhower et al. 2005; Blac…”
BackgroundStratis, E. A., & Lecavalier, L. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2258-8 · Cited by 171 · see citing works
Lee, J. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.09.008 · Cited by 171 · see citing works
McConnell, D., & Savage, A. (2015) · Current Developmental Disorders Reports · doi:10.1007/s40474-015-0040-z · Cited by 170 · see citing works
Guralnick, M. J., Hammond, M. A., Neville, B., & Connor, R. T. (2008) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2008.01073.x · Cited by 165 · see citing works
Families of Children with Down Syndrome: Responding to “A Change in Plans” with Resilience
Riper, M. L. V. (2007) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2006.07.004 · Cited by 161 · see citing works
“…syndrome, families of children with Down syndrome generally experience higher levels of stress than families with typically developing children (Baker et al., 2003; Cheng & Tang, 116 From the Carolina Center for Genome Sciences, School of Nursing, University of North Carolina at Chapel Hill,…”
Emerson, E., Hatton, C., Llewellyn, G., Blacker, J., & Graham, H. (2006) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2006.00900.x · Cited by 198 · see citing works
Trute, B., Hiebert‐Murphy, D., & Levine, K. (2007) · Journal of Intellectual & Developmental Disability · doi:10.1080/13668250601146753 · Cited by 157 · see citing works
“These findings are consistent with Baker et al.’s (2003) research, which concluded that mothers and fathers show high agreement in their ratings of child problems, particularly in families with preschoolaged children with developmental disabilities.”
ResultStaunton, E., Kehoe, C., & Sharkey, L. (2020) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2020.4 · Cited by 156 · see citing works
“Parental stress can negatively impact on the parent– child relationship and in turn can impact on the child’s behaviour (Baker et al. 2002, 2003; Emerson et al. 2010; Families Special Interest Research Group of IASSIDD 2014; Neece et al. 2012).”
BackgroundResultSAWYER, M. G., Bittman, M., Greca, A. M. L., Crettenden, A., Harchak, T. F., & Martin, J. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0912-3 · Cited by 155 · see citing works
“These include the level of children’s behaviour problems, the gender and age of parents, the level of parental social support, and parental psychological characteristics such as perceived self efficacy, locus of control and coping style ( Baker et al. 2003; Bromley et al. 2004; Dunn et al. 2001; Gill and Harris 1991;…”
BackgroundPsychological distress among parents of children with mental retardation in the United Arab Emirates
Khamis, V. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2006.10.022 · Cited by 154 · see citing works
“Additional child characteristics such as age, and parental characteristics such as employment predict parental stress over time (e.g., Baker et al., 2003; Floyd & Gallagher, 1997; Frey, Greenberg, & Fewell, 1989; Orsmond, Seltzer, Krauss, & Hong, 2003), as do aspects of the family environment…”
BackgroundMental Disorders in Five Year Old Children With or Without Developmental Delay: Focus on ADHD
Baker, B., Neece, C. L., Fenning, R., Crnic, K., & Blacher, J. (2010) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2010.486321 · Cited by 173 · see citing works
“Findings of elevated DBDs among children with ID are not surprising, given previous research showing that young children with DD exhibited elevated levels of behavior problems compared to TD children (B. L. Baker, Blacher, Crnic, & Edelbrock, 2002; B. L. Baker et al., 2003; Einfeld & Tonge, 1996).”
BackgroundResultInfluentialSelf-citationHastings, R. P. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0230-y · Cited by 153 · see citing works
Rzepecka, H., McKenzie, K., McClure, I., & Murphy, S. (2011) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2011.05.034 · Cited by 150 · see citing works
“CB is associated with particular syndromes such as Smith Magenis Syndrome, Down Syndrome and Prader-Willi Syndrome (Dykens, 2000; Dykens, 2007; Reddy & Pfeiffer, 2007) and is related to IQ levels (Emerson & Bromley, 1995); reinforcement (Emerson, 1998); parental stress (Baker et al., 2003); and communication difficult…”
BackgroundWoolfson, L. M., & Grant, E. (2006) · Child Care Health and Development · doi:10.1111/j.1365-2214.2006.00603.x · Cited by 147 · see citing works
Parental Stress in Families of Children With Disabilities
Hsiao, Y. (2017) · Intervention in School and Clinic · doi:10.1177/1053451217712956 · Cited by 147 · see citing works
Pro‐social behaviour and behaviour problems independently predict maternal stress
Beck, A., Hastings, R. P., Daley, D., & Stevenson, J. (2004) · Journal of Intellectual & Developmental Disability · doi:10.1080/13668250400014509 · Cited by 143 · see citing works
“In a pre-school sample, Baker et al. (2003) showed that behaviour problems and not the child’s cognitive level explained additional variance in maternal stress after controlling for stress scores from one year previously.”
BackgroundGao, Y., Sheng, C., Xie, R., Sun, W., Asztalos, E. V., Moddemann, D. M., Zwaigenbaum, L., WALKER, M. C., & Wen, S. W. (2016) · PLoS ONE · doi:10.1371/journal.pone.0165626 · Cited by 143 · see citing works
Eisenhower, A., Baker, B. L., & Blacher, J. (2006) · Journal of School Psychology · doi:10.1016/j.jsp.2006.10.002 · Cited by 142 · see citing works
“Relative to their typically developing peers, these children enter school with more behavior problems (e.g. Baker et al., 2003), more negative parent-child interactions (e.g. Floyd & Phillippe, 1993), and difficulties with emotional and behavioral regulation (Wilson, 1999), each of which may put…”
BackgroundSelf-citationKeenan, M., Dillenburger, K., Doherty, A., Byrne, T., & Gallagher, S. M. (2010) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/j.1468-3148.2010.00555.x · Cited by 142 · see citing works
Eisenhower, A., Baker, B. L., & Blacher, J. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.09.033 · Cited by 140 · see citing works
“Moreover, the relation between child behavior problems and family adjustment is often transactional (Baker et al., 2003; Sameroff & Chandler, 1975).”
BackgroundResultInfluentialSelf-citationThe predictors of distress in parents of children with autism spectrum disorder
Firth, I., & Dryer, R. (2013) · Journal of Intellectual & Developmental Disability · doi:10.3109/13668250.2013.773964 · Cited by 140 · see citing works
Lloyd, T., & Hastings, R. P. (2008) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2007.00974.x · Cited by 132 · see citing works
Neece, C. L., & Baker, B. L. (2008) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2008.01071.x · Cited by 131 · see citing works
“This is inconsistent with previous research, showing that the relationship between child intellectual status and parenting stress is accounted for by child behaviour problems (i.e. Baker et al. 2003; Beck et al. 2004).”
BackgroundResultInfluentialSelf-citationCramm, J. M., & Nieboer, A. P. (2011) · Journal of Intellectual Disabilities · doi:10.1177/1744629511410922 · Cited by 131 · see citing works
“…include the child’s functional level (behavioral problems, speaking skills), level of dependence (mobility, ability to wash and dress) and the level of physical pain (Baker et al., 2003; Blacher and McIntyre, 2006; Pearlin et al., 1990; Raina et al., 2004; Wallander et al., 1989a; 1989b).”
BackgroundBenson, P. R., & Kersh, J. E. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1198-9 · Cited by 131 · see citing works
Stress in parents of children with cerebral palsy: what sources of stress are we talking about?
Ketelaar, M., Volman, M. J. M., Gorter, J. W., & Vermeer, A. (2008) · Child Care Health and Development · doi:10.1111/j.1365-2214.2008.00876.x · Cited by 131 · see citing works
Gallagher, S. M., Phillips, A. C., & Carroll, D. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsp093 · Cited by 130 · see citing works
“…is now reasonable consensus that problematic and challenging behaviors are a main source of stress for parents of children with developmental disabilities (Baker et al., 2003; Blacher & McIntyre, 2006; Floyd & Gallagher, 1997; Hastings, Daley, Burns, & Beck, 2006).”
BackgroundBrief Report: Stress and Perceived Social Support in Parents of Children with ASD
Drogomyretska, K., Fox, R., & Colbert, D. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04455-x · Cited by 114 · see citing works
Wang, M., Turnbull, A. P., Summers, J. A., Little, T. D., Poston, D. J., Mannan, H., & Turnbull, R. (2004) · Research and Practice for Persons with Severe Disabilities · doi:10.2511/rpsd.29.2.82 · Cited by 126 · see citing works
Wang, Y., Huang, Z., & Kong, F. (2017) · Journal of Health Psychology · doi:10.1177/1359105317739100 · Cited by 125 · see citing works
“, 2005), while parents of children with developmental disorders, such as cerebral palsy (CP), autism, and intellectual disabilities, tend to suffer from higher parenting stress (Baker et al., 2003; Davis and Carter, 2008; Estes et al., 2009; Glenn et al., 2009; Hassall et al., 2005).”
BackgroundThe effects of early autism intervention on parents and family adaptive functioning
Estes, A. M., Swain, D. M., & MacDuffie, K. E. (2019) · Pediatric Medicine · doi:10.21037/pm.2019.05.05 · Cited by 127 · see citing works
Gourley, L., Wind, C., Henninger, E. M., & Chinitz, S. (2012) · Journal of Child and Family Studies · doi:10.1007/s10826-012-9650-9 · Cited by 121 · see citing works
“Previous research has illustrated the reciprocal and mutually amplifying nature of children’s behavior problems and parental stress (Donenberg and Baker 1993; Baker et al. 2003).”
McIntyre, L. L. (2008) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2008.01108.x · Cited by 121 · see citing works
“Baker et al. (2003) suggested a bi-directional relationship between parenting stress and child behaviour problems over time in families with young children with developmental problems.”
InfluentialSelf-citationPredictors of Stress in Parents of Children with Fetal Alcohol Spectrum Disorders
Paley, B., O’Connor, M. J., FRANKEL, F., & Marquardt, R. K. (2006) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200610000-00005 · Cited by 121 · see citing works
“There is also a mounting body of research documenting higher levels of stress among parents of children with developmental problems than parents with typically developing children.(29,30) These higher levels of stress do not appear to be transient perturbations in parental well-being, but rather are fairly chronic and…”
BackgroundHastings, R. P. (2016) · International review of research in developmental disabilities · doi:10.1016/bs.irrdd.2016.05.002 · Cited by 120 · see citing works
Beighton, C., & Wills, J. (2019) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12617 · Cited by 122 · see citing works
Empowerment in parents of school‐aged children with and without developmental disabilities
Nachshen, J. S., & Minnes, P. (2005) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2005.00721.x · Cited by 118 · see citing works
Friendship Quality in Adolescents with and without an Intellectual Disability
Tipton, L. A., Christensen, L. L., & Blacher, J. (2013) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12051 · Cited by 116 · see citing works
Self-citationCrnic, K., Neece, C. L., McIntyre, L. L., Blacher, J., & Baker, B. (2017) · Child Development · doi:10.1111/cdev.12740 · Cited by 101 · see citing works
“The increased level of behavior problems is especially salient for families and children with ID given the evidence that behavior problems in children with ID may be more predictive of later child and family functioning than are cognitive abilities (Baker et al., 2003).”
BackgroundInfluentialSelf-citationValla, L., Wentzel‐Larsen, T., Hofoss, D., & Slinning, K. (2015) · BMC Pediatrics · doi:10.1186/s12887-015-0528-z · Cited by 115 · see citing works
“…studies have described the negative impacts of developmental delays in children, including emotional, behavioural and health problems later in life [1, 2], difficulties in parental child care and the parent-child relationship [3, 4], educational achievement [4, 5] and economic impacts on the…”
Families and intellectual disability
Blacher, J., Neece, C. L., & Paczkowski, E. A. (2005) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000179488.92885.e8 · Cited by 114 · see citing works
Self-citationMinnes, P., Perry, A., & Weiss, J. A. (2014) · Journal of Intellectual Disability Research · doi:10.1111/jir.12160 · Cited by 114 · see citing works
Guralnick, M. J., Hammond, M. A., Connor, R. T., & Neville, B. (2006) · Child Development · doi:10.1111/j.1467-8624.2006.00872.x · Cited by 114 · see citing works
“Recent research indicates that about 25% of children with developmental delays within the cognitive range of those in our sample are likely to exhibit clinically significant behavior problems and that there is considerable continuity over time (Baker, Blacher, Crnic, & Edelbrock, 2002; Baker et al., 2003).”
BackgroundQuintero, N., & McIntyre, L. L. (2010) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/1088357609350367 · Cited by 113 · see citing works
“The presence of child maladaptive behavior has been demonstrated to greatly affect parenting stress and well being (Baker et al., 2003; Lecavalier, Leone, & Wiltz, 2006) and may affect sibling adjustment.”
BackgroundMethodSelf-citationParenting Children With Borderline Intellectual Functioning: A Unique Risk Population
Fenning, R. M., Baker, J. K., Baker, B. L., & Crnic, K. A. (2007) · American Journal on Mental Retardation · doi:10.1352/0895-8017(2007)112[107:pcwbif]2.0.co;2 · Cited by 111 · see citing works
“Method Overview The current study was part of an ongoing, longitudinal (age 3 to 9 years) investigation of child and family factors thought to relate to the development of psychopathology among children with a range of cognitive abilities (Baker et al., 2002; Baker et al., 2003).”
BackgroundInfluentialSelf-citationNorlin, D., & Broberg, M. (2012) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2012.01564.x · Cited by 109 · see citing works
Coping and care-related stress in parents of a child with autism spectrum disorder
Shepherd, D., Landon, J., Taylor, S., & Goedeke, S. (2018) · Anxiety Stress & Coping · doi:10.1080/10615806.2018.1442614 · Cited by 107 · see citing works
“, 2006), producing a “mutually escalating effect” whereby parental stress elicits further problem behaviors, which in turn induces further stress (Baker et al., 2003; Benson & Karlof, 2009). The autism spectrum is typically characterized by four core symptoms: restricted and or ritualized behaviors, language difficult…”
BackgroundInfluentialTrajectories of Stress among Parents of Children with Disabilities: A Dyadic Analysis
Woodman, A. C. (2014) · Family Relations · doi:10.1111/fare.12049 · Cited by 102 · see citing works
“fathers, lending further support to the salience of behavior problems to parental well-being (Baker et al., 2003).”
BackgroundMethodMacDonald, E. E., Hastings, R. P., & Fitzsimons, E. (2010) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/j.1468-3148.2009.00546.x · Cited by 101 · see citing works
Intervention and Support for Siblings of Youth with Developmental Disabilities: A Systematic Review
Tudor, M. E., & Lerner, M. D. (2014) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-014-0175-1 · Cited by 100 · see citing works
“…not reflect a proposed homogeneity across diagnostic groups or the associated sibling functioning thereof. stressed than mothers of TD children (Baker et al. 2003), which is associated with child problem behavior (e.g., Baker et al. 2002; Eisenhower et al. 2005; Lecavalier et al. 2006; Osborne…”
BackgroundHalstead, E. J., Griffith, G. M., & Hastings, R. P. (2017) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2017.1329192 · Cited by 99 · see citing works
- Authors
- Baker, B. L., McIntyre, L. L., Blacher, J., Crnic, K., Edelbrock, C., & Low, C.
- Affiliations
- University of California, Los Angeles (US)
- University of California, Riverside (US)
- Pennsylvania State University (US)
- Corresponding author
- Baker, B. L.
- Venue
- Journal of Intellectual Disability Research
- Publisher
- Wiley
- Published
- 2003-05
- Volume
- 47
- Issue
- 4-5
- Pages
- 217-230
- ISSN
- 0964-2633 (ISSN-L)
- 1365-2788
- OpenAlex
- W2154865829
- Cited by
- 930
- References
- 60
- Citations by year
- 2026: 11 · 2025: 47 · 2024: 33 · 2023: 44 · 2022: 46 · 2021: 42 · 2020: 49 · 2019: 60 · 2018: 58 · 2017: 61 · 2016: 47 · 2015: 60 · 2014: 64 · 2013: 53 · 2012: 41
- FWCI
- 19.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Intellectual Disability Research (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD34879-1459, R01HD034879)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- developmental delay, intellectual disability, preschool children, behavioral problems, parental stress, longitudinal stability, transactional model, early intervention
- MeSH terms
- Adult, Child Behavior Disorders, Developmental Disabilities, Child, Preschool, Family, Female, Humans, Male, Parents, Surveys and Questionnaires, Stress, Psychological, Parenting
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