title: Cognitive delay and behavior problems prior to school age.
abstract: OBJECTIVE
  To investigate the relationship between cognitive delay (CD) and behavior problems between ages 9 months and 5 years, while adjusting for covariates related to CD.
  
  
  METHODS
  Data were from 4 waves of the Early Childhood Longitudinal Study, Birth Cohort (n = 8000). Children were classified as typically developing (TD) or as having resolved, newly developed, or persistent CD between 9 and 24 months, based on scores from the Bayley Short Form-Research Edition below or above the 10th percentile. Child behavior was measured by using the Infant/Toddler Symptom Checklist (ages 9 and 24 months) and the Preschool and Kindergarten Behavior Scales (ages 4 and 5 years); children in the top 10th percentile were considered to have a behavior problem. Hierarchical linear modeling estimated the effect of CD status on children's behavioral trajectories, adjusted for confounders.
  
  
  RESULTS
  CD resolved for 80.3% of children between 9 and 24 months. Behavior problems at 24 months were detected in 19.3%, 21.8%, and 35.5% of children with resolved, newly developed, and persistent CD, respectively, versus 13.0% of TD children. Behavior problems increased among children with CD over time, and more so among children with persistent CD. By age 5, children with persistent CD had behavior scores moderately (0.59 SD) higher than TD children.
  
  
  CONCLUSIONS
  Behavior problems among children with CD are slightly higher at 9 months, clearly evident by 24 months, and increase as children move toward school age. Efforts to promote the earliest identification, evaluation, and service referral may be necessary to improve outcomes for these children.
authors.affiliation: Harvard Medical School and Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Center for Child and Adolescent Health Research and Policy, Boston, Massachusetts; ercheng@mgh.harvard.edu.
authors.forename: Erika Rose
authors.initials: ER
authors.lastname: Cheng
authors.affiliation: Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;
authors.forename: Mari
authors.initials: M
authors.lastname: Palta
authors.affiliation: Harvard Medical School and Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Center for Child and Adolescent Health Research and Policy, Boston, Massachusetts;
authors.forename: Milton
authors.initials: M
authors.lastname: Kotelchuck
authors.affiliation: Department of Human Development and Family Studies, Waisman Center, University of Wisconsin, Madison, Wisconsin; and.
authors.forename: Julie
authors.initials: J
authors.lastname: Poehlmann
authors.affiliation: Division of Maternal and Child Health Research, Truven Health Analytics, Bethesda, Maryland.
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
mesh_terms: D001724:Birth Weight / Q000502:physiology; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
keywords: behavior problems; cognitive delay; early childhood; early intervention; longitudinal
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