title: Problem and pro-social behavior among Nigerian children with intellectual disability: the implication for developing policy for school based mental health programs.
abstract: BACKGROUND
  School based mental health programs are absent in most educational institutions for intellectually disabled children and adolescents in Nigeria and co-morbid behavioral problems often complicate intellectual disability in children and adolescents receiving special education instructions. Little is known about prevalence and pattern of behavioral problems existing co-morbidly among sub-Saharan African children with intellectual disability. This study assessed the prevalence and pattern of behavioral problems among Nigerian children with intellectual disability and also the associated factors.
  
  
  METHODS
  Teachers' rated Strengths and Difficulties Questionnaire (SDQ) was used to screen for behavioral problems among children with intellectual disability in a special education facility in south eastern Nigeria. Socio-demographic questionnaire was used to obtain socio-demographic information of the children.
  
  
  RESULTS
  A total of forty four (44) children with intellectual disability were involved in the study. Twenty one (47.7%) of the children were classified as having behavioral problems in the borderline and abnormal categories on total difficulties clinical scale of SDQ using the cut-off point recommended by Goodman. Mild mental retardation as compared to moderate, severe and profound retardation was associated with highest total difficulties mean score. Males were more likely to exhibit conduct and hyperactivity behavioral problems compared to the females. The inter-clinical scales correlations of teachers' rated SDQ in the studied population also showed good internal consistency (Cronbach Alpha=0.63).
  
  
  CONCLUSIONS
  Significant behavioral problems occur co-morbidly among Nigerian children with intellectual disability receiving special education instructions and this could impact negatively on educational learning and other areas of functioning. There is an urgent need for establishing school-based mental health program and appropriate screening measure in this environment. These would afford early identification of intellectually disabled children with behavioral problems and appropriate referral for clinical evaluation and interventions. The need to focus policy making attention on hidden burden of intellectual disability in sub-Saharan African children is essential.
authors.affiliation: Child and Adolescent Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria. mobakare2000@yahoo.com
authors.forename: Muideen O
authors.initials: MO
authors.lastname: Bakare
authors.forename: Vincent N
authors.initials: VN
authors.lastname: Ubochi
authors.forename: Peter O
authors.initials: PO
authors.lastname: Ebigbo
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Orovwigho
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D008607:Intellectual Disability / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D011050:Policy Making; D012574:Schools; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
references.citation: Behav Brain Funct. 2009 Sep 15;5:39
references.pmid: 19754953
references.citation: J Intellect Disabil Res. 2008 May;52(Pt 5):446-57
references.pmid: 18331560
references.citation: J Child Psychol Psychiatry. 2007 Aug;48(8):785-92
references.pmid: 17683450
references.citation: J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1337-45
references.pmid: 11699809
references.citation: J Intellect Disabil Res. 2006 Apr;50(Pt 4):259-68
references.pmid: 16507030
references.citation: J Child Psychol Psychiatry. 2000 May;41(4):407-17
references.pmid: 10836671
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2009 Jan;44(1):8-14
references.pmid: 18604619
references.citation: J Intellect Disabil Res. 1996 Apr;40 ( Pt 2):99-109
references.pmid: 8731467
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2007 May;42(5):421-7
references.pmid: 17450455
references.citation: Child Care Health Dev. 2003 Mar;29(2):141-9
references.pmid: 12603359
references.citation: JAMA. 2006 Oct 25;296(16):1981-9
references.pmid: 17062861
references.citation: J Child Psychol Psychiatry. 1999 Jul;40(5):791-9
references.pmid: 10433412
references.citation: Int J Epidemiol. 2006 Jun;35(3):683-8
references.pmid: 16492712
references.citation: J Intellect Disabil Res. 2001 Dec;45(Pt 6):515-20
references.pmid: 11737538
references.citation: Curr Opin Psychiatry. 2009 Sep;22(5):457-61
references.pmid: 19561504
references.citation: J Autism Dev Disord. 2006 Oct;36(7):863-70
references.pmid: 16897401
references.citation: J Child Psychol Psychiatry. 1997 Jul;38(5):581-6
references.pmid: 9255702
references.citation: Int Rev Psychiatry. 2008 Jun;20(3):271-80
references.pmid: 18569179
references.citation: J Intellect Disabil Res. 1996 Jun;40 ( Pt 3):198-207
references.pmid: 8809661
references.citation: Res Dev Disabil. 2009 Nov-Dec;30(6):1297-305
references.pmid: 19525090