Child Development and Behavior Connected

Cognitive delays in children may indicate later behavior issues

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Young children who have delays in learning and development might face multiple obstacles as they grow, including behavior difficulties.

A recent study found that children with cognitive delays had more behavior problems as they got older. The increase in behavioral issues was evident between 9 months and 24 months old.

At 5 years old, the children who still had slower thinking skills or other cognitive delays had slightly more behavioral difficulties than children without delays.

"Discuss your child's milestones with your pediatrician."

The study, led by Erika Rose Cheng, PhD, of Harvard Medical School and Massachusetts General Hospital for Children in Boston, looked at the relationship between cognitive delays and behavioral problems in children.

The researchers analyzed infections on 8,000 children whose development and behavior was assessed when they were between 9 months and 2 years old.

Then the researchers assessed the children's behavior again at ages 4 and 5.

Children scoring in the top ten percent of total scores on behavioral difficulties were considered to have behavioral problems.

Then the researchers looked at which children had behavioral problems and how many of them had cognitive delays. They first found that the cognitive delays identified in children when they were young went away on their own for 80 percent of the children.

Among children who had cognitive delays that went away, 19 percent had behavior problems at 24 months old. However, among those who had developed new cognitive delays at 24 months, 22 percent had behavior problems.

Among those who had cognitive delays identified early on that had not gone away, more than a third (36 percent) had behavioral problems.

Meanwhile, only 13 percent of typically developing children—those who never had cognitive delays—had behavior problems.

As time passed, children with greater cognitive delays tended to have behavior problems that worsened, especially if their cognitive delays did not improve.

By the time the children were 5 years old, those with cognitive delays had moderately higher scores for behavior problems than typically developing children.

"Behavior problems among children with cognitive delays increase as children move toward school age," the authors wrote.

"Efforts to promote the earliest identification, evaluation, and service referral may be necessary to improve outcomes for these children," they concluded.

These findings are not very surprising, said Thomas Seman, MD, a pediatrician at North Shore Pediatrics in Danvers, Mass.

"Children with disabilities and delays have a very tough life," he said. "If you consider that the bulk of our learning comes from our interactions with others and our environment, think of how tough this would be when you have a harder-than-normal time processing or understanding the information that is constantly being presented to you."

He added, "It does not take long before you feel so overwhelmed that you can either shut down and not respond at all or you will 'act out' with bad behaviors."

Dr. Seman said these frustrations can add up over time, but he noted that parents can play a role in helping children.

"We know that a child learns what is proper and inappropriate behavior from the guidance the parent provides," he said. Yet the study did not address parent behaviors.

"Are the children without the behavioral issues being parented differently with a different set of expectations on how they are to behave, and are they given proper consequences to their behaviors?" he said. "That would be a nice follow up study."

The study was published August 11 in the journal Pediatrics. The authors reported no conflicts of interest.

The research was funded by the University of Wisconsin, the Fahs-Beck Fund for Research and Experimentation and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Review Date: 
August 10, 2014
Last Updated:
September 1, 2014