week 2: Wakschlah et al (2007) dvlpmntl framework distinuishing disruptive bhv form normative bhv in preschool children

What are the tree core behaviours considered “normative misbehaviours” in early childhood?

The three core normative misbehaviours” in early childhood are noncompliance, temper loss, and aggression.

Hey is validating Disruptive Behaviour Disorder (DBDs) in preschool children particularly challenging?

Validating preschool DBDs is challenging because the core features of these disorders overlap significantly with common and expected behaviours in young children.

According to the study, what are two key limitations of an “adelevopmental” approach to diagnosing psychiatric disorders in young children?

An “a developmental” approach can lead to under-identification because some symptoms are developmentally impossible or improbable, and over-identification because symptoms with overlap to normative misbehaviour lack precise parameters for clinical concern.

Beyond parental report, why are observational methods considered valuable for assessing disruptive behaviour in preschoolers?

Observational methods are valuable because they provide information not readily reported by young children, allow for the discovery of new phenomena, capture qualitative features that distinguish typical for atypical behaviour, and permit direct assessment of contextual features.

What two critical features of behaviour are proposed as necessary for distinguishing normative misbehaviour from disruptive behaviour in preschoolers?

The two critical features are the quality of behaviour and its pervasiveness across contexts.

Define “quality of behaviour” as described in the study, including its two main components.

Quality of behaviour is defined as the extent to which behaviour is modulated (intensity, flexibility, organisation) and expectable in context.

How is “pervasiveness” defined in the context of this study’s assessment of disruptive behaviour?

Pervasiveness is defined as the extent to which a behaviour occurs across everyday contexts, specifically referring to clinically concerning behaviour occurring in two or more DB-DOS contexts in this study.

What is the purpose id the Disruptive Behaviour Diagnostic Observation Schedule (DB-DOS)?

The purpose of the DB-DOS is to provide a standardised method to capture the patterns of behaviour that distinguish normative behaviour form disruptive behaviour symptoms in young children.

Based on the results, how did the quality and pervasiveness of observed behaviours generally differ between Non-Disruptive, Sub-Clinical, and Disruptive groups?

While patterns varied depending on the specific behaviour, clinically concerning patterns on the DB-DOS generally distinguished the Disruptive group from the Non-Disruptive and often the Sub-Clinical groups, particularly when considering pervasiveness.

Did the observed patterns of clinically salient behaviour during the DB-DOS provide unique information about impairment beyond what mothers reported about behavioural frequency?

Yes, the observed patterns of clinically salient behaviour added significant incremental utility in predicting impairment above and beyond maternal report of behavioural frequency for the majority of behaviours assessed.

What is the main challenge in diagnosing disruptive behaviour disorders in preschool children?

The main challenge in diagnosing disruptive behaviours (DBDs) in preschool children is distinguishing clinical symptoms from the normative misbehaviours common in this developmental period. Many behaviours like noncompliance, temper loss, and aggression are typical for young children, making it difficult to determine when these behaviours indicated a clinical concerns rather than expected developmental variability. Current diagnostic criteria for DBDs often lack developmental precision for this age group, potentially leading to both under-identification (missing symptoms that are developmentally improbable in preschoolers) and over-identification (mistaking common behaviours for clinical problems).

How does the developmental psychopathology perspective inform the understanding of disruptive behaviour in preschoolers?

The developmental psychopathology perspective is a fundamental principle that emphasises conceptualising clinical phenomenology within its developmental context. This means recognising that behaviours considered problematic might be typical at one developmental stage but concerning at another. For preschool disruptive behaviours, this perspective highlights the need for a sensitive and specific clinical framework that can differentiate between normative misbehaviours common and clinically significant symptoms by considering whether a behaviour is “maladaptive and inconsistent with developmental level”.

What are the “normative misbehaviours” commonly observed in early childhood?

The source refers to noncompliance, temper loss, and aggression as the triad of “expectable early childhood behaviours” or “normative misbehaviours”. These behaviours are very common; for instance, approximately 75% of children exhibit aggression and tantrums by age 2. While these are typical developmental phenomena, they also represent core features of disruptive behaviour disorders, which is why distinguishing between normative and clinically significant symptoms presentations is crucial.

What key dimensions are proposed for distinguishing disruptive behaviour from normative misbehaviour in preschoolers?

The study proposes that the critical dimensions for distinguishing disruptive behaviour form normative misbehaviour in preschoolers are the quality of behaviour and its pervasiveness across contexts. Quality refers to the extent to which a behaviour is modulated (intensity, flexibility, and organisation) and expectable in a given context. Pervasiveness refers to consistently the behaviour occurs across different everyday settings and interactional partners (like parents and examiners).

How does the “quality of behaviour” helping differentiating typical form atypical behaviour?

Quality of behaviour is defined by its modulation (intensity, flexibility and organisation) and expectability in context. High-intensity aggression, stubborn and inflexible noncompliance that doesn’t respond to support, or prolonged and highly dysregulation tantrums are examples of qualitative features that suggest clinically concerning behaviours, even if the behaviour itself (aggression, noncompliance, temper loss) is also seen normatively. For example, mild aggression is expectable during peer disputes, but aggression directed towards an adult is not developmentally expected and may indicated a clinical concern.

What is the Disruptive Behaviour Observation Schedule (DB-DOS) and how is it used?

The DB-DOS is a 50 minute structured laboratory observation designed to systematically identify clinically salient patterns of disruptive behaviour in preschoolers. It includes tasks structured to elicit behaviours relevant to DBDs across different “interaction al contexts” (with an actively engaged examiner, a busy examiner, and the parent) and varying demand characteristics (compliance tasks, frustration tasks, social play). The DB-DOS coding system assesses behaviour along a clinical continuum form “normative variation” to “clinically concerning” by evaluating its qualitative features.

How did the study findings support the importance of quality and pervasiveness in identifying disruptive behaviour?

The study found that both the quality of observed behaviour (highest level of atypical behaviour) and its pervasiveness across DB-DOS contexts significantly distinguished children classified as non-disruptive, sub-clinical, and disruptive. Children in the disruptive group were significantly more likely to exhibit clinically concerning levels and greater pervasiveness of noncompliance and temper loss behaviours compared to the other groups. This supports are hypothesis that these dimensions are crucial for clinical discrimination in young children.

Why is structured diagnostic observation, like the DB-DOS, considered valuable in assessing preschool disruptive behaviour?

Structured diagnostic observation methods are considered valuable because they provide a standardised way to systematically identify clinically relevant phenomena that may not be easily captured by parent interviews alone. They are designed to “press” for the full range of behaviours relevant to a diagnosis within a controlled environment. Observation is particularly useful for young children who cannot self-report, for discovering salient phenomena not previously identified, for capturing qualitative features of behaviour, and for assessing behaviour in different contexts. The study showed that observed patterns of behaviour using the DB-DOS added significant incremental utility i predicting impairment beyond maternal report of behavioural frequency.