Three-Year Outcomes for Preschool Children with Disruptive Behavior and Adaptive Disability

A 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” (p. 64).

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.