Generally problem behaviour refers to behaviour which may lead to different types of psychological problems. These problem behaviours are incomprehensive to others, and those that are antisocial, destructive broadly maladaptive. When child demonstrate behaviour which is extreme, hard to manage, have lasted for long time or are not appropriate for his or her age is problem behaviour (Kazdin, 1992). Problem behaviors are common in children which occur in about one quarter of all young children. This problem behaviour often remains persistent from early childhood to later childhood particularly when the problems are severe and the child has difficulties in learning. Behavior problem manifest a variety of emotional and conduct problems, ranging from aggressive and disruptive behavior to anxiety, lack of motivation in study and other activities, low self esteem, lack of concentration etc (Yule and Rutler; 1985). These behaviours are often termed as challenging behaviour that his or her parent, teachers and others cannot deal effectively.
Normally behavior is considered as problematic when it differs markedly as well as chronically from current social and cultural norms for the children (Richman & Graham, 1971).Problematic behavior of children affects physical, emotional or social well- being of the child or others around the child. A range of literature depict that children’s emotional and behavioral problems have a substantial adverse impact on families, schools and children’s own long-term well-being (Hwang & St James-robert, 1998). There is also evidence that many such children remarkably fail to develop appropriate social skills to his or her cultural domain (La Greca; 1981). It has been recognized that several behavior problems are common in child such as – lying, over activity, over dependence, attention demanding, shyness, irritability, temperament, jealousy, stealing, aggressive behavior etc. Several researchers have been conducted to assess behavioral problem of children in home and abroad.
Definition of Behaviour Problems
The term behavior refers to the way a person responds to a certain situation or experience. Behavior problems addressed the negetive aspects of behavior. Different theories of child psychopathology describes behavior problems in different ways. But there is no single definition of problem behavior that is usually agreed upon or accepted by all (Begum,1997).
According to Herbert M. (2003) “behavioral problems in children refer to those behavior that impair the quality of the child’s life, resulting in underachievement in normal social contexts (for example, school), with failure of social development and integration”.
D’Sliva (2007) defined behavior problem as “when children have shown a permanent pattern of hostile or disruptive behavior towards oneself or towards the society are known as behavior problem or behavior disorder of children”.
Zarakowska and Clements (1988) and Lamb and Ketterlinus (1994) provided some criteria to indicate problem behaviour. These were as follows:
- If the degree of severity of the behavior does not match up with the chronological age group and the developmental level of the child.
- If the behavior affects the child himself/ herself in a negetive way as well as other persons in the immediate environment.
- If the behavior causes undue stress to persons close to the child.
- If the behavior is regarded in terms of acknowledged social norms and values as socially unacceptable.
Prevalence of behaviour problems in children
Children may suffer many types of behavioural and emotional problems. Many studies have been done to estimate the prevalence of behavioural and emotional problems among children.
Literature regarding behaviour problems among children is limited in developing countries. However, Graham (1986) reported that 10 it 20 per cent of children in developing counties suffer from various problems.
In US, nearly 21 % of children (1-15 years) have a diagnosable mental or behavioral disorder with at least minimal impairment (Shaffer, 1996). In a representative sample of 6 to 12 years old, Lapouse & Monk (1964) found that 31 percent of boys and 21 percent girls were considered by their mothers to have behavior problems.
According to Alan Carr (1993) between 10 and 20 percent of children and adolescent undergo from psychological problems serious enough to demand for psychological treatment.
Epidemiological studies point out that over the course of 1 year some 5-15 per cent of 9-10-year-old children suffer from emotional or behavioral disorders of sufficient to handicap them in their everyday life (Rutter et al., 1970; Graham, 1979: Rutter, 1989). Prevalence is greater where measures of impairment are less demanding (e.g. Verhulst et al., 1985-26%), and lower where they are more severe (Rutter et al., 1970).
Bird e al. (1988) used Behavior Checklist 9 (CBCL) to find out the prevalence of maladjustment in children aged 4-16 years in Puerto Rico. They mentioned the rate of maladjustment to be 15.85%.
In Mauritius 23.3% children (29% boys and 17% girls) aged 7 to 8 years have behavioral problems (Venables et al. ,1983)
Childhood behavioral problems are very common in the school-going period. In an epidemiological longitudinal study (Esser, Schmidt and Woerner, 1990) in Germany, the researchers have found that prevalence rates for psychiatric disorders in 8 and 13 year olds were in the range of 16-18% and between one quarter and third of these children manifested serious disturbances.
After studying 828 representative sample of children aged between 5 and 14 years , Almeida – Filho (1984) found that 23.3% of the children had varying degree of psychological problems.
Giel et al. (1981) stated that the children aged 5-15years have identical behavioral disorders and the rate of childhood mental disorders varies from 12% to 29%.
Prevalence of behavior problems in children of Bangladesh
By using the CBCL Rahman (2008) conducted a study on 200 children of sex workers in Bangladesh aged 6 – bellow 12 years. The results showed that 53.5% of children fall in the clinical range of behavior problem scores.
Azad (2006) conducted a study on 300 primary school children in Dhaka city aged 6 – 10 years by using the TRF. The results showed that 10.33% of children fall in the clinical range of behavior problem scores.
Parveen (2001) has conducted a study on child behavior problem in Dhaka city aged 6 – 16 years. She found that in Dhaka city 15% of children living with their families, 45% of institutionalized children and 75% of trafficked children have behavior problems in the clinical range.
By using CBCL and TRF in Bangladesh Begum (1993) studied the behavior problems of 627 (341 boys and 286 girls) ten years old children in Dhaka city, Bangladesh. The results revealed that mothers reported 11.8 % of boys and 10.7% of girls and teachers reported 12.8% of boys and 11.2% of girls to have behavioural problems in the clinical range.
Chowdhry and Afrose (1998) have studied on the problems of adolescents in Bangladesh and found that 45 percent adolescent have academic problems, 35 percent have psychological problems, and 31 percent have physical problems and 35 percent have social problems.
Hoque (1999) in a study found that among the male juvenile offenders (age ranged from 10-18 years) at Tongi Correction Centre of Dhaka, 86 percent have disruptive behaviour disorder (conduct disorder, attention deficit hyperactivity disorder and oppositional defiant disorder) and 29 percent have emotional disorders (anxiety and depression).
By using the Bengali translated version of ‘Strengths and Difficulties Questionnaire’ (SDQ, Goodman et al., 1998) Goodman et al., in 2000 found that in Dhaka City among referred cases aged 11-16 years, 24 % have conduct disorder, 52 % have emotional disorder, 10% , have hyperkinesis and 20% have other problems.
Sex Differences in Behavioral Problems
Sex of the children has been playing a very essential part in the sign of behavioral problems in them. Boys on the whole tend to be more valuable than girls in the face of a wide range of physiological and psychosocial stresses (Werner and Smith, 1992). Boys’ problems were more likely to persist than those of girls (Richman et al., 1982).
A comparatively recent study conducted by Yang et al., (2008) examined gender differences in internalizing and externalizing behavioral problems in a large sample of Chinese children aged 6–15 (N = 4472). The Chinese Child Behavior Checklist (CBCL) and Teacher Report Form (TRF) were used to assess these problems. Results showed that boys were scored higher than girls on externalizing problems by both parents and teachers, while girls were rated higher than boys on somatic problems by teachers.
In another study researchers have found that the prevalence of conduct disorders is 6% for boys and 3% for girls aged 5-10 years (Meltzer H et al., 2000).
Weine et al. (1995) have found that girls scored higher on the somatic complaints syndrome of the CBCL, on the other hand boys scored higher on attention problems, delinquent behavior and aggressive behavior syndromes of the CBCL.
Rutter (1994) reported that boys are more affected by developmental and behavioral problems. For example, hyperkinesis, oppositional defiant disorder and conduct disorder are more common in boys than in girls. On the other hand, depressive disorders are more common in girls, particularly in the post pubertal years.
Begum (1993) conducted a study in Bangladesh on the behavior problems of children. The result showed that boys scored significantly higher than girls on most of the items of the CBCL and the TRF.
Begum (1994) reported both mothers and teachers rated boys to have significantly more behavior problems (p< .001) than girls.
According to Achenbach and Edelbrock (1981), most of the problems reported frequently for boys were under-controlled , externalizing behaviors, but problems more frequently reported for girls were over controlled, internalizing behavior.
Age Differences in Behavioral Problems
Children’s behavior problems vary according to age and developmental stages of the children. Because various kinds of development such as physical, emotional, cognitive, moral occur as the child grows older. For example, temper tantrums turn out to be less recurrent among older children because older children have discovered that temper tantrums are considered babyish.
In a study conducted by Yang et al., (2008) examined age differences in internalizing and externalizing behavioral problems in a large sample of Chinese children aged 6–15 (N = 4472). The Chinese Child Behavior Checklist (CBCL) and Teacher Report Form (TRF) were used to assess these problems. Results showed that older children tended to have higher scores than younger children on anxious and somatic problems as reported by teachers
In USA, a household survey of 1,285 youths aged 9 to 17 years carried out by Lahey BB et al., (2000). They found that levels of oppositional behavior were greater at younger ages, aggression pointed near the middle of this age range.
Except depression, for all disorders, prevalence rates go down gradually as boys develop from 10 to 20 years of age. For example, rates of conduct disorder were 16 percent for pre-adolescent boys, 15.8 percent for boys in mid-adolescence, and 9.5 percent for late-adolescent young men (Cohen et al., 1993).
For girls, compared with childhood there appears to be an increased prevalence of conduct disorder, oppositional defiant disorder and major depression around mid-adolescent. Rates of conduct disorder for girls were 3.8 percent in pre-adolescence, 9.2 percent in mid-adolescence, and 7.1 percent in late adolescence (Cohen et al., 1993).
According to DSM-IIIR (1987) hyperactivity occurs with greatest frequency before age 8 and tends to become less frequent and with briefer episodes thereafter.
While there are more boys with behavioral problems in the 4-11-year-old age group, girls predominate amongst 12-16-year-olds (Offord et al., 1987). There was a general tendency that behavior problems decline with age ( Achenbach & Edelbrock, 1981).
Classification of Behavior Problems
Behaviour problems in children can be classified into two major domains of dysfunction, namely externalizing behaviours and internalizing behaviours (Achenbach & Edelbrock, 1978). The externalizing behaviours are marked by defiance, impulsivity, hyperactivity, aggression and antisocial features. The internalizing behaviours are evidenced by withdrawal, dysphoria and anxiety. Boys exhibit more externalizing behaviors (aggression) and girls exhibit more internalizing behaviors (depression) (Campbell, 1995).
The construct of externalizing behavior problems refers to a grouping of behavior problems that are manifested in children’s outward behavior and reflect the child negatively acting on the external environment (Campbell, Shaw, & Gilliom, 2000; Eisenberg et al., 2001). Attention Deficit Hyperactivity disorder, conduct disorder, oppositional defiant disorder are some example of externalizing behavioural problem.
Attention-Deficit Hyperactivity Disorder
Attention-deficit hyperactivity disorder is characterized by impulsivity, hyperactivity and inattention. Children with this disorder have a hard time concentrating, sitting still, acting in socially appropriate ways and taking turns.Hyperactivity is found to be more common in boys than girls and is thought to affect between 3% and 5% of the school-age population (APA, 1994; Hinshaw, 1987).
Oppositional Defiant Disorder
Oppositional defiant disorder is characterized by consistently bad and deviant behavior. Symptoms include throwing tantrums, arguing, and disobedience, revenge-taking and even violence. To have this diagnosis, a child must display the symptoms for at least six months and have trouble in his daily life because of his behavior.
A child with a conduct disorder behaves in socially unacceptable ways. They have difficulty following the rules.Children with this condition are aggressive all the time in a way that causes problems for them and their family. They may run away from home, steal, set fires, destroy property or harm animals, siblings or peers.They often lie or try to fraud other people. They frequently skip school.
Research shows that conduct disorder predisposes a child to delinquency in adolescence and crime as an adult. Conduct disorder is the most frequently diagnosed childhood disorder in outpatient and inpatient mental health facilities. It is estimated that 6 percent of all children have some form of conduct disorder, which is far more common in boys then in girls (AmericanAcademy of Child Adolescent Psychiatry, 2010 ).
Children may develop internalizing behavior problems such as withdrawn, anxious, inhibited, and depressed behaviors, problems that more centrally affect the child’s internal psychological environment rather than the external world. Other terms for this cluster of behavior problems include “neurotic” and “over controlled” (Campbell et al., 2000; Eisenberg et al., 2001; Hinshaw, 1987). Internalizing behaviours are included but not limited to separation anxiety disorder, obsessive compulsive disorder.
Separation anxiety disorder
Separation anxiety disorder is a condition in which a child becomes fearful and nervous when away from home or separated from a loved one, usually parent or other caregiver to whom the child is attached. Some children also develop physical symptoms, such as headaches or stomach-aches, at the thought of being separated. The fear of separation causes great distress to the child and may interfere with the child’s normal activities, such as going to school or playing with other children (APA, 1987). Separation anxiety is more common in girls (Bernstein & Borchardt, 1991).
Posttraumatic stress disorder (PTSD)
Posttraumatic stress disorder (PTSD) in children occurs as a result of a child’s exposure to one or more traumatic events that were life-threatening. Or the child perceived the event to be likely to cause serious injury to self or others. In addition, the child must have responded with intense fear, helplessness, or horror. Traumatic events can take many forms, including physical or sexual assaults, natural disasters, traumatic death of a loved one, or emotional abuse or neglect.
Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder may begin in childhood, although it usually begins in adolescence or early adulthood (Flament et al., 1990). It is characterized by recurrent intense obsessions or compulsions that cause severe discomfort and interfere with day-to-day functioning. Obsessions are recurrent and persistent thoughts, impulses, or images that are unwanted and cause marked anxiety or distress. Frequently, they are unrealistic or irrational. They are not simply excessive worries about real-life problems or preoccupations. Compulsions are repetitive behaviors or rituals (like hand washing, hoarding, keeping things in order, checking something over and over) or mental acts (like counting, repeating words silently, avoiding). In OCD, the obsessions or compulsions cause significant anxiety or distress, or they interfere with the child’s normal routine, academic functioning, social activities, or relationships (APA, 1987).
Children can suffer from mood disorders such as major depression and bipolar disorder. Depression is often marked by a lack of interest in activities, sadness and exhibition of poor self-esteem. Bipolar disorder is characterized by periods of depression cycle with periods of mania, can also become apparent by childhood. About 2.5% of children in the U.S. suffer from depression. Depression is significantly more common in boys under the age of 10. But by age 16, girls have a greater incidence of depression (APA,1987).
Assessment of Behaviour problem
Assessment involves an evaluation of an individual’s strength and weaknesses, a conceptualization of the problem and some preparation for alleviating the problem. It is a precondition for planning, implementing and evaluating effective and efficient service (Achenbach & Rescorla, 2006a; Mash & Hunsley, 2005a). Comprehensive assessment of childhood behavior problems requires measures of behavioral, cognitive and psychological responding, as well as a determination of the social and cultural context in which the problems occur (Barrios, Hartmann and Shigetomi, 1981).
Assessment of development constitutes one of the core components of any psychological evaluation. This is because evaluation of psychopathology generally entails determining the extent to which behaviours and experiences are appropriate for an individual’s age and stage of development (Berger,1994).
Development assessment is a comprehensive evaluation of a child’s development. This assessment provide an information about the child’s cognitive abilities as well as many other areas, including academic skills, motor skills, communication and language skills, social skills, and self-help or adaptive skills (Alpern & Shearer ,2007).
Behavioral assessment is an integrated set of principles, beliefs, values, hypothesis and methods primarily advocated by behavior analysts and therapists. In this broad sense, behavioral assessment is not different from other psychological paradigms (Haynes, 1998). It includes hypothesis about the best level of measurement precision such as accuracy and validity (Cone, 1998a), the causal variables most likely to affect behavior, the mechanism that underlie functional relations, the role of assessment in the design and evaluation of treatment, and the best methods for obtaining assessment data ( Forsyth, Lejuez, Hawkins & Eifert, 1996).
The logic behind behavioral assessment is that particularly all child behavior is purposeful. It satisfies a need and is related to the context in which it occurs (Lane, Gresham & O’Shaughessy, 2002). The clinician typically focuses on objective characteristics such as the duration, intensity and frequency of problematic behavior. For the assessment of child’s behavior it is important to monitor child behavior and record them. This will help parents to understand the child’s problem very well. Sometimes parents misinterpret or exaggerate the problem. When parent observe and record the problem, they can understand the actual nature and severity of the problematic behavior. The behavioral assessment must include the context of the problem behavior and parent’s reaction on it ( Rahman, 2008).
The goal of behavioral assessment is to specify the relationship between contextual and situational variables and behavior with the purpose of developing an individualized treatment programme ( Haynes & O’Brien, 2000).
Family is particularly significant context in child’s life (Compas, 2004). Family plays powerful roles and influence on child’s development (Collins & Laursen, 2004). An individual in a family system is affected by the activities of other members of the family. Problems arise from the relationship and interactions among family members (Begum, 1997).
Children’s problems are rooted in the overall family circumstance. The child is shaped by the family, in turn, the family is shaped by the child ( McCubbin & McCubbin, 19880). There is a great quantity of experimental facts that experiences in the family comprise an important sway on child’s psychological development and take part in a major role in the causation of psychological disorder. A number of research findings show that family features, family discord, disorganization, disruption show strongest relations with psychiatric disorder (Rutter,1991). So to understand the child’s problem and intervene appropriately, also understand the family system.
Family can be assessed and observed on a variety of dimentions such as patterns of communication,process of dicision making, cohesion dusfunctional pattern ( Lask, 1980 ; Vetere and Gale, 1987). For the assessment of child’s difficulty it is significant to assess four connected but different areas in concerning the family influences when setting up intervention.
These areas are:
- Parental psychopathology
- Familial history of disruptive disorder
- Parenting skills
- Current familial relations and functioning
Family assessments inform the clinician about the formulation of the problems, which further helps to set goals for treatment.
METHODS OF ASSESSMENT
There are different methods of assessment including interviews, psychological testing, self-report questionnaires, behavioural measures, and physiological measures. A careful assessment provides a wealth of information about individual’s problem behavior. The data from the various methods complement each other and provide a more absolute picture of the individual (Meyer et al., 2001).
Interview is the most widely used means of assessment. It is typically a major component of the initial session. An initial interview focuses on gathering information. Clinician generally gathers demographic information and information about various aspect of current problems ( Goldfried & Davison , 1994).
A structured interview is usually used to acquire a broader outlook of the child and family. A semi structured interview is the main medium for the preliminary assessment. Such interview provides two kinds of information:
- They allow an opportunity for direct observation of rather inadequate sample of behavior manifested during the interview circumstances itself.
- The interviewer seeks to secure directly as much information of exact or individual nature from the client as is related to the purpose of the interview ( Herbert,1987).
(a) Interview with the Child
The interview is the prime diagnostic tool in child and adolescent psychiatry. The clinical interview covers different purposes.
Firstly: the interview serves as initial contact between child and clinician to establish a therapeutic relationship.
Secondly: collected information will help the clinician to make diagnosis and formulating treatment plans.
Thirdly: the interview creates the opportunity to view behavior that could be related diagnostic information.
An interview with the child provides opportunities to explore sensitive material to assess children’s coping strategies and the child’s view of the problem (Edlebrock & Costello, 1988; Angold , 1989).
Research on interviews has also provided some important information about diagnostic child interviewing:
First: usually children are better informants than their parents about their problem ( Angold, et al.,1995).
Second: the most noticeable problems may not be the child problems, there be determined attention on co-morbidity ( Angold & Costello,EJ,1995).
Over the years many structured diagnostic interviews were developed for children and adolescence. Only a few gained broader acceptance and are well known and currently used. Among these are the following:
- Child and Adolescent Psychiatric Assessment (CAPA; Angold et al.,1991);
- Child Assessment Schedule (CAS ; Hodge et al., 1981);
- Diagnostic Interview for Children and Adolescents (DICA; Herjanic & Campbell,1977);
- Diagnostic Interview Schedule for Children (DISC; Costello et al., 1984);
- Interview Schedule for Children (ISC ; Kovacas,1983);
- Schedule for Affective Disorders and Schizophrenia for school aged
children (K –SADS ; Puig – Anitch & Chambers, 1978)
( b ) Interview with Parents :
Interview with parents is another important and relevant research tools for collecting data about child behaviour problems. Interview with parents is crucial while conducting research about child health and mental health for several reasons (Alldred, & Gillies,,2002):
Firstly, parents have the first hand experience and effort to handle behaviour problem among children.
Secondly, interviewing children can be difficult sometimes, as they cannot always communicate their feelings and thoughts accurately.
Thirdly, parental consent is required to collect data from child.
Fourthly, it is always necessary to collect information from other people in addition to the child to gather actual information about child from all possible aspects.
There are some specific tools to conduct interview with parents and significant others. Some interviews are available in both child and parent version.
Observation refers to unobtrusive watching of behavioural patterns of peoples. It is the most basic method of all research methods is observation (Becker & Geer, 1957). An observational method refers to any procedure or techniques that are used in research to assist in making accurate observations of event. It may use as a major instruments to assess behaviour problem. To assess and understand behaviour researchers first have to know that what they are dealing with. Behavioural assessment employs observation as a primary research technique ( Brenner, Brown & Canter 1985).
There are some advantages to use observation as a research tool.
Firstly, it helps to collect information about frequency and pervasiveness of the problem behaviour
Secondly, it can explore the maintaining factors for certain behaviour.
A variety of observational methods are available. For example, there are naturalistic, analogue, participant and self observational techniques for use with children. Researchers can use a specific type of observation method according to their research objectives.
standardized Interviews, Questionnaires, Check-lists and Rating Scales
As an assessment method many interviews, questionnaires, check-lists and rating scales have been developed for use in research settings and in clinic. Because these are highly reliable and valid compared to clinical interviews ( Azad,2006). These tools can be administered parents, teachers and others who are in frequent contact with the child, because these people can respond in terms of their observations and inferences about their child’s problem behaviors.
A number of structured interviews for children and adolescences have been developed which are the most directive of all clinical interviews, because the interview set-up, topics, and sequence predetermined. They are concerned with quantification and dimension and consequently with evaluation with respect to either a criterion or norm. Some cover up a comparatively broad range of disorders, others are standardized interview formats for a single disorder or group related disorder. The mainly used structured interviews are DICA and DISC. Some structured interviews differ from this set-up and identified as “semi structured” interviews. The semi structured interviews make use of a present series of subjects, as well as many fully structured segments. The mainly used semi structured interviews are Kiddie – SADS, the CAS, ISC and the CAPA which have both child and parent versions.
Questionnaires are typically used to screen normal populations for the presence or absence of any psychological problems. Lots of questionnaires are developed to assess child behavior problems. Conner’s Teacher and Parent questionnaire are satisfactory for screening for hyperactivity (Conner, 1973). The Richman Behavior Screening Questionnaire is another widely used tool for assessment (Edelbrock & Costello, 1988).
Checklist is the simplest of all the devices. The use of a checklist ensures a more complete consideration of all aspects of the object, act or task. It requires the respondent to indicate whether a behavior, a problem, a feeling or some other types of response occurs. It may be used as an independent tool or as a part of a questionnaire. If emotional disorders are a real focus of interest, the Child Behavior Checklist (CBCL ; Achenbach & Edelbrock, 1983) which is much longer, may be more satisfactory.
Rating scale is a recording form used for measuring individual’s attitudes, aspirations and other psychological and behavioural aspects. Behavior rating scales provide global vision of the child’s behavior as perceived by significant others in the child’s environment, usually parents or teachers. This is naturally be used with very little instruction. They can be finished quickly, and their following scoring and explanation are rarely time consuming ( Atkenson & Forehand; Hayens , 1978).
Psychological Tests are formal and structured tool for assessment. Their use has a special place in clinical practice with children and young people. It helps the clinician to gather objective information for the purpose of making decisions and sorting out questions about the particular child, adolescent, or adult. A comprehensive test can identify requirements in therapy and emphasize issues that may come up in treatment. It also recommends particular forms of intervention and offer guidance about potential outcomes of treatment (Cohen, 2012).
Psychological tests were formed for three main reasons, all of which are interconnected:
- It’s easier to get information from tests than by clinical interview
- The information from tests is more scientifically consistent than the information from a clinical interview
- It’s harder to get away with lying on a test than in a clinical interview.
Psychological tests can include assessments of personality styles tests of emotional well-being, intellectual (or IQ) tests, tests of academic achievement, tests for possible neurological damage, and tests for specific psychological disturbances and their severity (Richmond,2011).
Risk Factors of Behavior Problems
Several factors have been linked to the development of behavior problem. The interaction between environmental and social condition and the characteristics of the child can combine to cause significant problems.
Behavior problems stem from a variety of risk factors. There is a great deal of assumption about which factors cause problem behavior in children (Gerdes, 1998; Carson & Butcher, 1992). Behavior is affected by temperament, which is made up of an individual’s innate and unique expectations, emotions and beliefs. Behaviour can also be influenced by a range of social and environmental factors including parenting practices, gender, and exposure to new situations, general life events and relationships with friends and Siblings. Risk factors are those which increase the possibility of a child developing an emotional disorder in comparison with a randomly selected child from the common population (Garmezy, 1983).
The risk factors associated with behavior problems can be divided into three groups:
- Child factors which include biological and genetic attributes of the child.
- Family factors which effect both child and family members.
- Community factors that impose on the child and family environment.
Risk factors in the child
There are some vulnerability factors that make some children more prone to develop behaviour problems than other children. Genetic vulnerabilities, the consequences of prenatal and perinatal complications, and the result of early insults, injuries and illness may predispose the child to developing problems in later life (Rutter and Casaer, 1991). A number of psychological characteristics like low intelligence, difficult temperament, low self esteem and an external locus of control are also important factors in this category (Rolf et al., 1990).
Many studies show that the development of many psychological characteristics such as temperament and intelligences is influenced by genetic factors (Rutter, 1991). Research findings suggest that heredity is an important predisposing causal factor for a number of different disorders such as depression, schizophrenia and alcoholism (Plomin et al., 2001). Genetic factors play a role in developing depression in later life (Klein, Lewinsohn, Seeley &Rhode, 2001). Research suggests that parents who have ADHD, half of their children are likely to have the disorder (Biederman et al., 1995).
Prenatal and Perinatal Complications
The intrauterine may involve hazards which facilitate the unhealthy development of the foetus (Rutter & Casaer, 1991). Maternal age, blood-type, incompatibility, malnutrition, smoking, alcohol use and drug use are among the factors that may negatively impact on the intrauterine environment (Steinhausen et al., 1994). Perinatal brain insults associated with anoxia or cortical tissue damage can lead to later cognitive impairment. A variety of birth complications are associated with such neurological damage including forceps delivery, breech delivery , a difficult passage through the birth canal and accidental twisting of the umbilical cord (Carr,1991). Neurological damage sustained during the perinatal period by premature infants is most commonly associated in later life with attention problems and hyperactivity (Hinsaw, 1994).
Physical insults, injuries and diseases
Physical insults and injuries can cause psychological and behavioral problem to the children. Development of cognitive impairment, disinhibition and behavioral problems are associated with head injuries later in childhood. The nature and extent of these sequelae depend upon both the severity and location of the injury. Also depend on the social context within which the injury and recovery occur (Goodman, 1994a; Snow & Hooper, 1994).
Chronic disease such as asthma or diabetes and life threatening illness such as cancer or cystic fibrosis all may cause psychological problem to the child and family (Gross &Drabman, 1990; Lask & Fosson, 1989).
Rothbart and Bates (1998) defined temperament as “inherent, constitutionally based individual differences in emotional, motor, and attentional reactivity and self regulation”.
Temperament refers to an individual’s behavior style and characteristics way of responding (Santrock, 1995). Chess & Thomas (1995) classified infants into three subgroups like easy, difficult and slow to warm up temperament children. Temperament patterns act as causative factors in the occurrence of behavior and psychological difficulties (Chess & Thomas, 1995)
Children who were characterised by difficult temperament had more conflict with parents, peers and teachers. For that negetive reaction in early life they tended to choose a peer group later in life that engaged in deviant, risky activities. They also developed more conduct and adjustment problems (Thomas & Chess, 1995). Researchers have found that boys who have a difficult temperament in childhood are not willing to continue their formal education as adults. Girls with a difficult temperament in childhood are more likely to experience marital conflict as adults (Wachs, 2000).
Intelligences, Self-esteem and Locus of control
Intelligences, self-esteem and locus of control all these personal characteristics also predispose children to develop psychological difficulties (Rolf et al., 1990). Low intelligence as measured by IQ test is a risk factor for conduct disorder. Low self esteem and locus of control places children at risk for both conduct and emotional disorders (Rotter, 1966).
Risk factors in the family Environment
A variety of familial factors also make children vulnerable to developing psychological difficulties. These factors also play a significant role in perpetuating such problems (Plomin, 1991; Rutter, 1991). The specific feature of the parent-child relationship, exposure to various ongoing family problems, and specific stresses are the influential factors to make child vulnerable (Carr, 1999).
Parent-Child Factors in Early Life
Research findings show that bonding, attachment, intellectual stimulation and parenting style influence the child problem behaviors. Children develop psychological difficulties if they have anxiously attached or anxiously avoidant attachment with care giver (Grossman et al., 1988; Fonagy et al., 1991). Lack of children’s age appropriate intellectual stimulation at home environment can impair the child intellectual development (Carr, 2006).
Parenting style and use of harsh discipline have related with behavior problems (Deater- Deckard, Dodge, Bates & Pettit, 1996). If parents are less affectionate to their child behavior problems may arise. Children who have either been harshly disciplined or had little or inconsistent supervision develop adjustment problem. Children are at risk for developing conduct problems and becoming involved in bulling who have been physically punished (Olweus, 1993). By coercive interchanges, lacks of monitoring and consistent discipline children are trained by the family directly in antisocial behavior (Capaldi & Patterson, 1994).
A child can be vulnerable or may develop psychological disorder by parental problems such as depression, alcohol abuse or criminality ( Carr,1999). Research suggests that such family background experiences influence the type of distress (Nilzon & Palmerus, 1997). Because such problems decrease parent’s ability to give their child secure attachment relationship. The physical health of the parents also affects the whole family functioning in a variety of ways such as economic, social etc.
Rutter and Quinton ( 1984) found that parental psychiatric illness have greatest effect on the behaviors of younger boys. Depression is recognized as very disruptive to the normal bonding processes of parents with their infants, whose development can be affected in a variety of ways ( Orvaschel, 1983).
Parental alcohol abuse is one that has attracted considerable theoretical and empirical attention. Those children who were raised in homes where a parent abused alcohol are believed to be at risk for developing psychopathology in childhood, adolescence, and perhaps into adulthood ( Black, Bucky & Wilder-Padilla, 1996).
Marital conflict appears to have significant effect on children’s behavioral problems (Cummings & Davies, 1994; Dadds & Powell, 1991). Family discord such as the conflict or disharmony accompanying divorce can be instrumental in the development of conduct disorders (Chess & Thomas, 1984; Robins1991). Recent studies have shown that children with recent experience of parental divorce or separation are at a relatively high risk of behavioural and emotional problems as reported by parents (Harland P, et al., 2002). Moffit and Caspi (1998) stated that exposure to marital discord and violence may predispose young stars to developing psychological problems.
Domestic violence is an extreme form of conflict in which parents behave violently toward one another (American Academy of Paediatrics, 1996). The effects of witnessing parental violence have been clearly shown to predispose boys to use violence as a means of conflict resolution (Jaffe, Hurley & Wolfe, 1990).
According to Kazdin (1995) inconsistent rules, unclear roles and the absence of regular routines may predispose children to developing psychological problems specifically conduct disorder. As these family environments are highly stressful so they fail to give children secure attachments. Then the authoritative parenting they require for their needs to be met (Carr, 1999).
Child behavior can be also affected by some community factors such as poverty, lack of social support, environmental stress, deviant peer group etc. Children’s conduct and school based psychological difficulties may be maintained by variety of community factors
( Garmezy Masten, 1994 ; Goodyer, 1990 ).
Poverty status has statistically significantly effects on child’s behavior. Poor children suffer from emotional and behavioral problems more frequently than do non poor children (Gunn & Duncan, 1997).
In USA a recent study has shown that poverty links with lower levels of child well-being. For a variety of reasons, when compared with children from more well-off families, poor children are more likely to have low academic achievement, to drop out of school, and to have health, behavioral, and emotional problems ( Moore et al.,2009).
Lack of Social Support
Social support increases personal scenes of well being and offer a forum for receiving guidance on managing problems (Carr, 1999). Parents and children are usually involved in problem – maintaining interaction patterns if they belong socially isolated families that have poorly developed social support networks, with little positive contact with the extended family and few friends ( Garmezy and Masten , 1994).
Living in a overcrowding and in subsidized housing also have been found to be the risk factor for conduct problems ( Rutter & Quinton, 1977; Hawkins et al.,1992).
Deviant Peer Group membership
Children with conduct or substance abuse problems are members of a delinquent or drug abusing peer group. Interaction with these peers may maintain the children’s problem behaviors through modelling and reinforcement ( Kazdin , 1995 ; Hawkins et al., 1992).
Generally child abuse refers to any form of physical and psychological mistreatment of a child by parents or guardians’. The most common form involves severe and repeated physical injury, sexual assault and emotional and psychological degradation. The psychological consequences of child abuse and neglect include the immediate effects of isolation, fear, and an inability to trust. When children cannot trust that someone will be there to meet their needs, they tend to develop low self‐esteem, anxiety, depression, and hopelessness. These difficulties can lead to life‐long relationship problems and may also lead to the development of anti‐social behavioral traits. These children are also more likely to engage in violent behaviors and to be diagnosed with conduct and personality disorders.
Definition of Madrasa
According to Encyclopaedia of Islam the Arabic word “madrasah” generally has two meanings:
(1) in its more common usage, it simply means “school”;
(2) in its secondary meaning, “a madrasa is an educational institution offering instruction in Islamic subjects including, but not limited to, the Quran, the sayings (hadith) of the Prophet Muhammad, jurisprudence (fiqh), and law” .
Boransing, Manaros B(2008) reported that “Madrasah generally refers to Muslim private schools with core emphasis on Islamic studies and Arabic literacy. It is a privately-operated school which relies on the support of the local community or foreign donors, particularly from Islamic or Muslim countries”
Types of Madrasah
There are primarily two types of Madrasahs in operation in Bangladesh
- The Aaliyah Nissab Madrasahs
- The Qawmi Nissab Madrasahs
There are some other types of Madrasah available in education system in Bangladesh. These are as follows:
- Maktab or Forqania Madrasah
- Hifzul Quran Madrasah
- Cadet Madrasah
The present study
During childhood and adolescence mental and behavioral problems are found very common and frequent. WHO (World Health Report, 2001) estimated that around the world 10-20 percent of all children have one or more mental or behavioral problems, with 3-4 percent requiring treatment.
There is a huge lack in information related to identification and treatment of the emotional and behavioral problems of children living in developing countries (Fayyad, Jahshan & Karam 2001). Knowledge base regarding child mental health in developing country is highly needed in respect of the nature, frequency and the extent of emotional and behavioral problems in different arena as well as finding culture-specific risk factors for developing such problems to prevent behavioural problems among child and adolescents.
According to literature most of the behavioral problems in children occur in childhood and many of them are identified only after they enter the school (Schwarz, 1985). Behavioral and emotional problems can lead to school failure, underachievement leading to dependency, family discord, and involvement in criminal activity, the use of illicit drugs and co-morbid medical conditions (Scott et al., 2001). In addition to these, many of the disorders more commonly found among adults can begin during childhood. But no study so far has been conducted in Bangladesh to have a clear picture of childhood emotional and behavioral problems of primary school children.
Children are the future of a nation. Every child has the “right to education”. This right refers to attitudes, skills and knowledge that every person in a given society requires for an effective and satisfying adulthood. Hence, the objectives of primary education include emotional development, social development, moral development as well as intellectual development. Emotional and behavioral problems affect the overall development of the child. Untreated mental illness at this stage of life can have lifelong consequences.
In Bangladesh, the number of children below age 14 years is 49.6 million, which constitutes 39 percent o the total population and the number of primary school going children is 19.6 million (BBS, 2003). Early detection, treatment and prevention of behavioral problems of primary school children are very essential. It is hoped that the present study will help us to understand the various aspects of behavioral problems school children of Bangladesh and to take appropriate measures accordingly.
Madrasah education is a different type of education in our country. Its teachers, teaching methods, syllabuses are different. Not only education system, it is well known in general community that family background and socio-economic status of madrasah students’ usually deferent from students’ of traditional education system. Behavioral problems among madrasah students may not identified or properly treated in generally.
The present study is an attempt to find out childhood behaviour problems and identify some family factors as risk factors among Madrasah students in Dhaka city.
The objectives of the present research are:
To find out the nature of behaviour problems of Madrasah students.
- To identify the total number and percentages of Madrasah students who are in the clinical range of behaviour problem score.
- To see whether the total behaviour problem scores of Madrasah students vary according to sex, age, no of siblings and types of madrasah .
- To see whether each individual item scores of behaviour problem varies according to sex, age, no of siblings and types of madrasah.
- To find out whether problem and non-problem children vary in family functioning
The current study was conducted in two phases where in first phase the goal is to assess nature and frequency of behavioural problems among madrasah students and in second phase the goal is to assess family functioning among students who got high and low score in problem behaviour.
The total sample of the present study comprised of 360 madrasah students from twelve government madrasah of Dhaka Metropolitan area. Among 360 students half of the participants were boys and half of the participants were girls’ madrasah students. Twelve madrasah were selected using lottery method where four were biys, four were girls and four were co-education madrasah. Six students (3 boys and 3 girls) will select by using systematic sampling procedure from class one to class five. In this way a total of 30 students were selected from a madrasah. To study the behavioural problems, the students will be divided into two age groups, namely 6 to 8 years, 9 to10 years.
To compare different aspects of family functioning in the second phase of the study 20 matched samples were selected in the basis of socio-demographic variables including age, sex, number of siblings and number of family members.
In the present study teachers of the Madrasah were selected as prime informants for assessing Childs’ problem behaviour and parents were the key informants to compare family functioning.
As one of the central adults in many children’s life, teachers are in a position to identify behavioural problems in them. In a study conducted in Bangladesh (Begum, 1993) it was found that correlations between mother’s report and teacher’s report on total behaviour problem scores were highly significant for both boys (r=0.80,p<0.001) and girls (r=o.77,p<0.001). So it can be said that teacher’s information about children is comparable to that of mother’s.
Although parents are a key source of information in the assessment of children’s behavioural problems, teacher’s assessments are often equally important for the following reasons:
- 1. Teachers are often the second most important adults in children’s lives, ranking only behind parents.
- 2. School is a central development arena in which problems arises that may not be evident elsewhere.
- 3. By virtue of training, experience and opportunities for observation of children in groups, teachers can report aspects of children’s functioning no evident to parents.
- 4. Teachers are often involved in the referral and assessment of children for special services, both within the school and elsewhere.
The aim of the present research is to assess the nature of behaviour problems among madrasah students. To fulfil this purpose quantitative research approach, specifically survey design was adopted.
1. Socio-demographic Questionnaire
A socio-demographic questionnaire was developed to get information regarding socio-demographic variables like age, gender, monthly income of parents, number of siblings, and number of family member.
2. Child Behaviour Checklist, Bengali version of Teacher’s Rating Form
The teacher’s version of Child Behavior Checklist (CBCL), the Teacher’s Rating Form (TRF) is the most effective, dependable and most widely used instrument for assessing childhood behaviour problems of school children (ages 4-18). It is one of the most rigorously developed and standardized child behaviour rating scales currently available for assessing the most common dimensions of child psychopathology (Barkley, 1988). This rating instrument was developed by Achenbach and Edelbrock (1986) through cluster analysis of the intercorrelations among rated symptoms of problem children. Briefly, they developed symptom-rating scales for several behavior clusters that fall broadly under two general dimensions, internalizing and externalizing, which describe the tendency to deal with problems through internal processes versus external means of acting against the environment.
Although TRF was developed in America, many researchers have used it to study the nature and prevalence of behavioural and emotional problems in children and adolescents of both developed (Achenbach et al., 1985) and developing (Achenbach et al., 1990; Bird et al., 1988; Weisz et al., 1987) countries and it was also found to be suitable for the children of Bangladesh (Begum, 1993). The TRF has been translated into 69 languages and has been used in thousands of published studies (Berube & Achenbach, 2004).
Advantages of TRF are that it firstly that it provides systematic data collection. The TRF is useful in picking up co-morbidity since it covers a wide range of symptoms (Anderson et al., 1987).
Secondly, as a checklist TRF is economical, teachers can fill it out without any help.
Thirdly, it can be used for both general and more specific purposes as there is provision for both broad-band and narrow-band syndromes (McMahon & Forehand, 1988).
Fourthly, self-report questionnaires can function as self-monitoring instruments.
Fifthly, self-report questionnaires can be valuable in assessing change.
Improvement or deterioration may be assessed in terms of changes in scores along dimensions. Manuals for most checklist give rules for interpreting change scores, which take into account the psychometric properties of the instrument.
For all these reasons the Bengali version of the TRF (Begum, 1993) was used to study behavioural problems of primary school children of Bangladesh.
3. McMaster Family assessment device
The translated version of McMaster Family Assessment Device (Epstein et al,1983) was used to assess and compare the family functioning of the problem and non-problem children in matched group.
It is a 60 item questionnaire developed by Epstein et al, 1983. The questionnaire is able to provide scores of family functioning and can assess the following aspects of family functioning:
- problem solving
- Family roles
- Affective response
- Affective involvement
- Behavior control
- General functioning
The device was translated into Bengali first. Then the translated version was judged by 15 specialist professionals and finding test retest reliability. Correlation co-efficient was found 0.78 which is satisfactory.
A total twelve government Madrasah were selected randomly from the list of government Madrasah in DhakaMetropolitanCity. After taking permission from head of respective Madrasah, data was collected.
All class teachers were informed about the nature and purpose of the research. Teachers were also informed that the confidentiality of their responses will be strictly maintained and data will be use only for research purpose. A written handout about the purpose of the research and notes on confidentiality was given to each teacher before administering the Teachers Report Form(TRF).TRF and additional form containing demographic and other information of the particular student was then given to the teachers of the selected students in the class.
Based on TRF score samples were divided into 2 matched (above clinical score and below clinical score) groups to assess and compare family functioning. McMaster Family Assessment Device was employed to these 2 groups.
Collected data were analyzed and reported following research objectives.
Statistical analysis especially descriptive analysis was done regarding data collected from the field, to accomplish the purpose of the study by using SPSS programme (15.0 versions).
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