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DOI: https://dx.doi.org/10.18535/jmscr/v4i12.56

Study of Behavioral Problems in Preschool Children

Authors
Bheemreddy Raghu Nandan Reddy , J.M. Pawar2, C D Aundhakar3, Lekha Mishra4,
1*

Pankaj Goyal5
1,4,5
Postgraduate resident, 2 Associate Professor, 3Professor & HOD,
Department of Pediatrics, Krishna Institute of Medical Sciences, Karad, Maharashtra.
*Corresponding Author
Bheemreddy Raghu Nandan Reddy
Department of Pediatrics, Krishna Institute of Medical Sciences, Karad, Maharashtra
Email: srimathireddy705@gmail.com. Contact No: 9763219639

Abstract
Background: Behavior problems among children are a deviation from the accepted pattern of behavior on
the part of the children when they are exposed to an inconsistent social and cultural environment. But these
are not to be equated with the presence of psychiatric illness in the child as these are only the symptoms or
reactions to emotional and environmental stress. The study is carried out to evaluate behavioral problems in
preschool children.
Methodology: This descriptive cross sectional study was carried out on 350 preschool children aged 3 to 6
years. In the field area 6 anganwadi schools, 6 english medium nursery schools and 5 marathi medium
nursery schools were used and by simple random sampling 20 preschool children from each centre were
selected.
Results: 24% of children in our study had behavior problems. The prevalence is more among children in 3.1-
4 yrs of age group (47.14%). The prevalence of behavior problems was higher among boys (63.1%).The
prevalence of behavioral problems was higher in children belonging to Class II & Class III socio economic
status (54.7%). The prevalence of behavior problem was higher in children belonging to a nuclear family
(69.04%).
Conclusion: Symptoms like temper tantrums, fights & bites, destructive nature, management problems
hyperkinesis and distractibility were more common in boys. On the other hand being over-sensitive, having
fearful reactions and attention seeking was more common in girls in our study.
Keywords: Behavioral problems, Preschool children, Socioeconomic class.

INTRODUCTION malleable and it is then that many barriers to

A nation's most important and precious resource is normal development are erected.1
its children who constitute its hope for continued All educators have stressed the importance of the
achievement and productivity. There is no more home in the early education of the child. The
crucial period of life than the age up to six years. quality and nature of the parental nurturance that a
It is during this period that the child is most child receives will profoundly influence his future

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development. But only few homes provide the although certain behavioral outcomes maybe due
right type of environment to the growing child. 2 to biological and genetic reasons.8
Many children are denied the opportunities for A developmental, socio-economic and cultural
healthy all round development. In learning to perspective is vital for identification or definition
adjust to the world in which the child is growing of behavioral abnormalities in children. Bed-
up, he develops certain kinds of behaviors which wetting, avoidance of strangers or fear of
are annoying or embarrassing to the adults with darkness, for example, in a particular age is
whom he comes in contact.3 typical and beyond a developmental stage, they
Adults frequently label such behaviors as problem are viewed as problem behavior. More than being
and try to correct them. This usually makes the a passing age related phenomenon, persisting
situation worse. What adults call problem behavior problems are shown to have long term
behavior may be perfectly normal for the child at negative outcome for affected children, their
his age and level of development. Through family and society.9
ignorance of what is socially acceptable behavior, Early childhood behavior problems appear to
the child tries to express his natural impulses in induce impulsive behaviors, predispose them in
ways that gives him satisfaction but which are not securing low IQ test scores, school failure,
socially acceptable. So these behaviors make life academic problems, substance abuse, delinquency
difficult and unsatisfactory for parents as well as and/abnormal behaviors even in their adulthood.10
the child.4 Moderate to severe degrees of subclinical or
Behavior problems among children are a deviation clinical levels of problem behaviors ranging
from the accepted pattern of behavior on the part between 2-40 percent have been reported across
of the children when they are exposed to an ages, gender, locations, family, socio-economic
inconsistent social and cultural environment. But classes and/or nations in preschool to high school
these are not to be equated with the presence of children.11
psychiatric illness in the child as these are only the Studies have used field surveys, referrals from
symptoms or reactions to emotional and psychiatric department, standardized screening
environmental stress.5 instruments and/or parent interview techniques to
But if these behaviors are allowed to continue, report wide range of types of behavior problems
they are likely to pose problems of adjustment to like sleep disturbances, unsocial or socialized
the child in his school age and adolescence. aggression-regression reactions, poor school
Research has shown that the emergence of early grades and others.12
onset conduct problems in young children in Further, problem behavior research has focused on
related to a variety of health and behavior home environment, social aspects, knowledge
problems such as peer rejection, drug addiction, among teachers, single-dual parent families,
depression, juvenile delinquency, school drops in children with special needs or about parent
later years.6,7 perception on its causes and management,
A distinction is often made (WHO, 2013) between discipline practices and others.13
behavior problems of non-clinical nature from Early childhood is the critical period in behavior
those which is part of full-fledged clinical formation. The recent investigations by
diagnostic conditions like Opposition Defiant psychologists, educationists, pediatricians and
Disorder, Attention Deficit Hyperactivity others stress the intranatal importance of early
Disorder, Conduct Disorder, etc. The etiology of family experiences especially maternal care on the
behavior problems vary enormously. Environ- child's behavior, attitudes and his future mental
mental or familial factors are primarily implicated health.

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At no other period in his life the child more is 2. Socio-economic status
responsive to positive environmental influences, 3. Maternal employment status
which enhance and expand his development.
Emphasis should be assigned to programmes of B. TOOLS USED FOR COLLECTION OF
prevention and early intervention rather than late DATA
remediation. Finding out the prevalence of such For collecting data, the following tools were used.
conditions with their socio-economic distribution 1. Child Behavior Inventory
and prevalence of various types of disorders is the The first part of the inventory is intended to
first step in preventing behavioral problems in collect information such as sex and age of
pre-school children. preschoolers, the locality of the preschool and
socio-economic status of parents of preschoolers.
AIMS & OBJECTIVES The second part is used to identify the problem
1. To study prevalence of behavioural behaviors of the pre-school children as rated by
problems in pre-school children in Karad their mothers and teachers. Method adopted for
based on age, sex, socio-economic weighing the various categories.
conditions and family size.
2. To study prevalence of specific behaviour a) Parental Education
problems in children. The level of education of parents is divided into
seven categories which beings from the illiterate
MATERIALS & METHODS to post graduate level. The illiterate is awarded
After the approval of institutional ethical 1Score, Score of 2 to those who have education
committee and inform consent this descriptive of primary standard , Middle school score 3, High
cross sectional study was carried out on 350 school score of 4, 5score for pre -university, pre-
preschool children aged 3 to 6 years. Children degree, T.T.C. etc., Post graduates, graduates and
with organic neurological diseases and medical diploma score of 6 given and professional or
diseases are excluded. Honours given score of 7 .
For collecting data, in the field area 6 anganwadi
schools, 6 english medium nursery schools and 5 b) Parental occupation
marathi medium nursery schools were used and by The different occupations are classified into six
simple random sampling 20 preschool children categories. They are the following:
from each centre were selected. (i) Unemployed (1 score)
Those who are having no work at all.
Method of Collection of Data (ii) Unskilled (2 score)
This study deals with the design of the study Coolies, ordinary laborers, watchman, peons, etc.
which is described under the follows heads. will form the unskilled
A. Variables of the study (iii) Semi skilled (3 score)
B. Tools used for collection of data Farmers, small merchants, laboratory attenders,
C. Sample for the study etc. will come under this category.
D. Procedure for collection of data (iv) Skilled (4 score)
E. Scoring and consolidation of data Mechanics, fitters, electricians, drivers, photogra-
A. The main variable of the present study is phers, document writers, policemen, laboratory
'Behaviour Problems' of preschool children. It is assistants
treated as the dependent variable. The following (v) Semiprofessionals (6score)
variables are Chemists, druggists, qualified, nurses, teachers,
1. Gender managers, superintendents of offices, minor

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businessmen, contractors, assistant educational c) Parental Income
officers, block development officers, officers of The Family income (Rs) is divided into six
sub -district levels, public health workers etc categories:
(vi) High professionals (10 sc ore) i. 19575-Score 12
Ministers, judges, bank executives, doctors, ii. Rs. 9788 to Rs. 19574/- 10 Score
engineers, lawyers, university level teachers, iii. Rs. 7323 to Rs. 9787/- 6 Score
heads of research organizations, heads of iv. Rs. 4894 to7322/- 4 Score
government departments, secretaries of v. Rs. 2936 to 4893/-3 Score
government, business executives . vi. Rs. 980 to 2935/ -2 Score
vii. Rs. < 979/ -1 Score.

Scoring scheme of the socio-economic status:

Sl. No. Education level Score Occupation level Score Income level Score
1. Illiterate 1 Unemployed 1 < 979 1
2. Primary school 2 Unskilled 2 Rs. 980-2935 2
3 Middle School 3 Semiskilled 3 Rs.2936-4893 3
4 High School 4 Skilled 4 Rs. 4894-7322 4
5 Intermediate/ Post High 5 Clerck,Shop owner, 5 Rs.7323-9787 6
school diploma Farmer
6 Graduate/Post graduate 6 Semiprofession 6 Rs 9788-19574 10
7 Professional or Honours 7 Profession 10 Rs. >19575 12

E. Scoring and Consolidation of Data Statistical Analysis

As the study is to identify the behavior problems, For analyzing data chi-square test was used to find
data was collected by interviewer technique by the association between probable behavioral
using Preschool behavior check list (PBCL), problem with socio demographic factor.”P” value
devised by McGuire and Richman .The scale less than 0.05 is considered significant. The
consists of 22 items, each scored 0, 1 and 2 sample size required for the study was estimated
giving a maximum possible score of 44.Children based on the prevalence rate of 22% observed by
scoring 12or above were considered to have Rai S. et al4, with an allowable error of 20%.
behavior problems. The responses were counted Calculated sample size is 350.
and percentage calculated. Data given by
teachers/care takers was used for cross checking OBSERVATIONS AND RESULTS
with the responses given by the mothers. The sex-wise distribution of children enrolled in
Scoring Procedure our study is comparable as shown in Graph 1.The
The respondents (mothers and teachers of age and gender wise distribution showed that there
preschoolers) are to answer in a three point scale were 165 (47.14%) children in 3.1-4 yrs of age
with any one of the responses like 'often' group of that 95 were boys 70 were girls, while
'sometimes' and 'never'. The frequencies of the 113 (32.28%) in 4.1-5 yrs of age group 58 were
responses were counted and the respective boys and 55 girls, while only 72 (20.57%)
percentage calculated for identification of children belonged to the 5.1-6 yrs age group of
behavior problems. that 32 boys and 40 girls.Out of a sample size of
If the behavior problems never occurred in the 350 children in our study from rural Maharashtra,
child a score of 'zero' was given. If the problem conducted at preschool level, 15.14% of the
occurred 'sometimes' a score of 'one' is assigned children with behavioral problems were boys
and a score of 'two' is assigned in cases where it while only 8.86% were girls. A total of 84
occurred often. children had some behavioral problem (24%) as

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shown in table 1 and figure 2.The age distribution Restlessness and Temper Tantrums as shown in
shows that the percentage of children having table 10.
behavioral problems was higher (12.86%) in the
youngest age group of children i.e. 3.1-4 yrs. Figure 1: Sex Wise Distribution
Thereafter, there was a gradual decrease in the
SEX WISE DISTRIBUTION
prevalence in behavioral problems i.e. 7.43% in
4.1-5 yrs while only 3.71% in the 5.1-6 yrs of age
group. While the prevalence of of girls with
behavioral problems was also half of that in the 166
boys in all the 3 age groups. The children enrolled 184 Male
in the study were from 6 English & 6Marathi Female
medium schools while the rest were enrolled from
5 Anganwadis. 39.43% children belonged to
English medium schools while 35.71% children
went to Marathi medium schools & 24.86%
children went to Anganwadis as shown in table
Figure 2: Age distribution in boys and girls with
2,3,and 4.The prevalence of behavioral problems
behavioral problem:
in children belonging to English medium pre-
30
schools was 37/138 i.e. 26.81% while in children
25
belonging to Marathi medium pre-schools it was
20
33/128 i.e. 25.78% while in children belonging to
15
Anganwadi pre-schools it was 27/87 i.e. 31.03%
10
as shown in table 5 and figure 3.There was
5
equitable distribution of boys & girls belonging to
0
nuclear & joint families. The prevalence of 3.1-4 yrs 4.1-5 yrs 5.1-6 yrs
behavior problem was noted to be higher in both
Boys Girls
the sexes in the children belonging to a nuclear
family set-up. It was 67.92% in boys belonging to
nuclear family while it was 75.86% in the girls Figure 3: Preschool school distribution &
belonging to a nuclear family set-up as shown in behavior problem:
table 6 and 7.The distribution of children in Class 160
I to Class VII as per Socio-economic status of the 140
family was equitable amongst both the sexes. The 120
prevalence of behavioral problems in both boys 100
80
and girls was higher in the Class II & Class III
60
which is proportionate to their higher prevalence 40
in the 2 groups amongst the 350 children 20
belonging to the study as shown in table 8 and 9.It 0
was also noted that children who handled more English Marathi Anganwadi

modern gadgets like Smartphones and Behavioural Problems No Behavioural Problems

Videogames tend to have a higher chance of
having behavioral problems. As this was not the
main objective of our study, details of these were
not obtained. Common behavioral problems due
to overuse of gadgets were Fights & Bites,

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Table 1: Age distribution in boys and girls with Table 6: Distribution amongst different types of
behavioral problem: families:
Age: Boys: (n/%) Girls: (n/%) Type: Boys: Girls:
3.1-4yrs 28 (33.3%) 17 (20.23%) Nuclear 111 105
4.1-5yrs 17 (20.23%) 9 (10.71%) Joint 73 61
5.1-6yrs 8 (9.52%) 5 (5.95%) Total: 184 166
Total: 53 (63.1%) 31 (36.9%)
Fisher’s Exact Test applied. The two-sided P
Table 2: English medium school age distribution: value is 0.6510.
Age Boys Girls Total
3.1-4yrs 35 28 63
4.1-5yrs 24 23 47 Table 7: Distribution of behavior problem
5.1-6yrs 12 16 28 amongst different types of families:
Total: 138 Type of family: Boys with Girls with
problem: problem:
Chi-squared for trend = 1.215 (1 degree of Nuclear 36 (67.92%) 22 (75.86%)
Joint 17 (32.07%) 7 (24.14%)
freedom). The P value is 0.2703. Total: 53 31

Table 3: Marathi medium preschool age Fisher’s Exact Test applied. The two-sided P
distribution: value is 0.6160.
Age Boys Girls Total
3.1-4yrs 36 24 60
4.1-5yrs 20 20 40 Table 8: Socio economic distribution according to
5.1-6yrs 11 14 25 sex:
Total: 125 Socio economic class: Boys: Girls:
Class I 4 3
Chi-squared for trend = 2.082 (1 degree of Class II 111 96
Class III 49 43
freedom). The P value is 0.1491. Class IV 9 8
Class V 6 5
Table 4: Anganwadi preschool distribution: Class VI 4 6
Age Boys Girls Total Class VII 3 4
3.1-4yrs 24 18 42 Total: 184 166
4.1-5yrs 14 12 26
5.1-6yrs 9 10 19 Table 9: Socio economic distribution according to
Total: 87 behavior problems:
Socio economic class: Boys: Girls:
Chi-squared for trend = 0.4860 (1 degree of Class I 3 2
freedom). The P value is 0.4857. Class II 16 10
Class III 12 8
Class IV 7 4
Table 5: Preschool school distribution & behavior Class V 6 4
problem: Class VI 6 3
3.1-4yrs 4.1-5yrs 5.1-6yrs Class VII 2 0
School B Total: 53 31
B G B G
G
English 9 4 6 9 3 6
Marathi 10 5 8 4 3 3
Anganwadi 9 8 3 3 2 2
B: Boys/G: Girls

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Table 10: Distribution of different types of The higher prevalance of behavioural problems in
Behavioural Problems children belonging to a nuclear family across all
Sr. No. Behavioural problems Frequency Percentage the 3 age groups is higher compared to joint
1 Shyness 6 7.14% family could be due to the fact that children in
2 Stubborness 10 11.90%
3 Bed wetting 6 7.14% nuclear families get lesser time & care compared
4 Negativism 4 4.76% to those in the joint family set-up. Since the
5 Temper tantrums 12 14.28% responsibility of rearing a child is shared by many
6 Habit disorders(nail bitting, 4 4.76%
elders in a joint family, such children could have
Thumb sucking,Pica)
7 With drawal 0 0% less behavioural problems.
8 Not liked by peers 2 2.38% Singh et al16 found that 74.8% of all emotionally
9 Restlessness 8 9.52% distrubed children belonged to a nuclear family.
10 Poor concentration 2 2.38%
11 Learning problems 4 4.76%
Wardsworth et al also showed that family type
12 Specific fears 2 2.38% had a highly significant association with the
13 Sweating 2 2.38% development of behaviour.17
14 Refusal to food 4 4.76% The prevalence of behaviour problem in children
15 Overreactivity 4 4.76%
16 Attention seeking 4 4.76% belonging to a lower socioeconomic class was
17 Attention deficit 2 2.38% higher compared to the upper socioeconomic
18 Unhappy 0 0% class. Singh et al found a similar higher preva-
19 Teasing 0 0%
lence amongst children belonging to the lower
20 Destructive 2 2.38%
21 Difficulty in management 0 0% socioeconomic class (48.5%).16Verhulst et al
22 Fights and bites 6 7.14% found that enuresis was higher amongst children
belonging to the lower socioeconomic class.18
DISCUSSION Symptoms like temper tantrums, fights & bites,
The prevalance of behavioural problems amongst destructive nature, management problems
pre-school children conducted in our study was hyperkinesis and distract ability were more
24%. In a similar study conducted by Rai S et al common in boys. On the other hand being over-
(1992) in Delhi & Richman et al (1982) was 22% sensitive, having fearful reactions and attention
each. Jenkins et al reported 23% prevalence in seeking was more common in girls in our study.
children of 3 yrs age & 15% in children belonging These results are similar to the findings of other
to 4.5 yrs age group.14 studies conducted in both Indian children as well
Earls et al reported it to be 24% in children aged 3 as abroad.14,16,17,18
yrs whereas Mcfarlaneet al15 reported prevalence Though the prevalence of behaviour problems was
of 50% in the same age group. The difference in higher amongst the study population, none of the
prevalence in the latter age group was attributed to parents were aware that there was any help
the inclusion of children less than 3 years in the available for children with such problems like
study too. A lower prevalence of behavioural enuresis, temper tantrums & hyperactivity.
problems has been noted in different studies too Common behvioural problems in our study due to
which had screened children above the age of 6 overuse of gadgets were Fights & Bites,
years. Restlessness and Temper Tantrums.
The prevalence of behavioural problems was Perhaps the number one concern regarding the
much higher in boys compared to girls. Similar influence of technology among the general public
reporting has been done in various other studies. is the potential for media to increase behavioral
In the present study, the differences in prevalance aggression and violent conduct. Children are often
in both the sexes was marked in all the 3 age exposed to violent media, whether it is through
groups i.e. 3.1-4 yrs, 4.1-5 yrs & 5.1-6 yrs. television or video games (60% of TV programs

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JMSCR Vol||04||Issue||12||Page 14641-14649||December 2016
contained violence in 1997 and this number is 5. Coleman ER. Psychological problems of
unlikely to be lower now; 94% of games that are pre-school children in an urban area.
rated as appropriate for teenagers contain some British Journal of Psychology. 1977: 43,
violence). 623-630.
Because young children develop beliefs about 6. Dorman, Lynn, M. The expression of
social norms and acceptable behavior based on the agression in pre -school children. Head
content of their experiences, any activity that Start Evaluation and Research Centre,
promotes violence is likely to be a risk factor for Boston University 1967.
violent behavior in adulthood and is worthy of 7. Feil, GR. Identification of critical factors
careful scientific examination. Meta-analyses, in the assessment of preschool behaviour
combining data from hundreds of individual problems. Education and Treatment of
studies, confirm an association between exposure Children, 1995 18, 261-71.
to violence in media and antisocial tendencies 8. Anthony, L. G., Anthony, B. J., Glanville,
such as aggression. D. N., Naiman, D. Q., Waanders, C.,
Shaffer, S. (2005). The relationships
CONCLUSIONS between parenting stress, parenting
Symptoms like temper tantrums, fights & bites, behavior and preschoolers' social
destructive nature, management problems competence and behavior problems in the
hyperkinesis and distractability were more classroom. Infant and Child Development,
common in boys. On the other hand being over- 14, 133–154.
sensitive, having fearful reactions and attention 9. Venkatesan, S. (2013). Preliminary try out
seeking was more common in girls in our study. and validation of problem behavior survey
Our study suggests that similar studies should be schedule for children with developmental
conducted on a larger scale in the community with disabilities. Journal of Disability
more emphasis on individual behaviour problems. Management and Special Education. 3(2),
Such studies would increase the awareness 9-22.
amongst parents that if behaviour problems are 10. Andrew, J. (2005). Problem behaviors and
given due care in the early years of life it would associated risk factors in young children.
prevent future psychological abberations. Australian Journal of Guidance &
Counseling. 15, 1–16.
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