The development, assessment and treatment of behaviour problems in young children: integrating children’s own perspectives

Abstract

Background Studies of child development typically rely on the insights of adults to understand children’s behaviour. The value of integrating children’s own perspectives into these investigations has been more widely recognised in recent years. However, such opportunities are rarely extended to very young children, particularly in populations exhibiting challenging behaviours. This thesis contributes empirical evidence to this field by obtaining child-reported data in a large sample of three- and four-year-olds. Using a play-based story stem battery, children’s narrative representations and their relation to children’s behaviour, parental discipline, parental sensitivity, and a video-feedback parenting intervention are explored. Setting, Participants, and Main Measures This research was embedded in the Healthy Start, Happy Start study, a pragmatic randomised controlled trial. Participants were 300 children, who were 12-36 months old and exhibited elevated behaviour problems at screening, and their caregivers. Families were assessed at baseline, 5-month follow-up, and 24-month follow-up. In this thesis, key measures were child behaviour assessed at all time-points, parental sensitivity assessed at baseline and 5-month follow-up, and children’s narrative representations assessed at 24-month follow-up. Results Results from three studies are presented. The first, a cross-sectional study, revealed modest but consistent associations between constructs derived from children’s narratives and parent- and teacher-reported behaviour. The second and third studies were longitudinal and experimental in design. Behaviour problems in toddlerhood were associated with disruptive story themes at three- and four-years-old. Early parental sensitivity was associated with narrative coherence and observed behavioural dysregulation at three- and four-years-old. A video-feedback parenting intervention was found to have small to medium, positive effects on children’s behaviour problems, narrative coherence, and expression of prosocial themes. There was no evidence that improvements to parental sensitivity mediated these relationships. Conclusion This thesis contributes to our understanding of the influences of early behaviour and parent-child interactions on children’s development and highlights the feasibility and unique value of integrating young children’s own perspectives into such investigations.