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How Early Is Too Early? Identification of Elevated, Persistent Problem Behavior in Childhood

NCJ Number
Prevention Science Volume: 21 Issue: 4 Dated: 2020 Pages: 445-455
Megan. B. Augustyn; Thomas Loughran; Pilar Larroulet; Terrence P Thornberry; Kimberly L Henry
Date Published
11 pages
This study examined how early in childhood children most at risk for problematic patterns of internalizing and externalizing behaviors can be accurately classified.
Yearly measures of anxiety/depressive symptoms and aggressive behaviors (ages 6–13; n=334), respectively, were used to identify behavioral trajectories. The study then assessed the degree to which limited spans of yearly information enabled the correct classification into the elevated, persistent pattern of the problem behavior identified theoretically and empirically as high-risk and most in need of intervention. The true positive rate (sensitivity) is below 70 percent for anxiety/depressive symptoms and aggressive behaviors, using behavioral information through ages 6 and 7. Conversely, by age 9, just over 90 percent of the high-risk individuals were correctly classified (i.e., sensitivity) for anxiety/depressive symptoms, but this threshold for aggressive behavior was not met until age 12. Notably, the false positive rate of classification for both high-risk problem behaviors was consistently low using each limited age span of data (about 5 percent). These results suggest that correct classification into highest risk groups of childhood problem behavior is limited when using behavioral information observed at early ages. Prevention programming that targets those who will display persistent, elevated levels of problem behavior should be aware of the degree of misclassification and how this varies with the accumulation of behavioral information. The continuous assessment of problem behaviors is needed throughout childhood in order to continually identify high-risk individuals most in need of intervention as behavior patterns are sufficiently established. 50 references (publisher abstract modified)