Internalizing and externalizing behavior problems of children with learning disability

Sarath S and Suresh Kumar M 1) Consultant Clinical Psychologist, Mandiram Hospital, Manganam, Kottayam-686018 2) Assistant Professor in Clinical Psychology, Sri Ramachandra University, Chennai-600116 e-mail: sunsar26jan@yahoo.co.in

Abstract
With the increase in number of children with learning disability consulting mental health professionals, it became a major concern for professionals to consider the various aspects in formulating effective management plan. As children with learning disability finds it difficult to meet the demands of curriculum its likely to develop many forms of behavior and emotional problems. Therefore the present study is an attempt to shed the light of attention onto the presence and severity of behavioral problems of children with learning disability which should be taken into consideration as it is essential for helping them. To achieve the aim study included 20 students with Specific developmental disorders of scholastic skills and 20 normal students. Sampling techniques used was purposive one. They were evaluated using CBCL and DPCL. Both the students and their parents were interviewed to rate the items on CBCL and DPCL. Results showed that students with learning disability were found as have more hyperkinesis, emotional problems, somatic symptoms and poor psychosocial factors. Girls showed more emotional problems than boys. Externalizing as well as Internalizing behavior problems and attention problems were more in children with learning disability as compared to those without problems in academics. Children with internalizing behavior problems were found as having poor psychosocial factors. The study findings can be concluded as students with specific developmental disorders of scholastic skills were found as having more hyperkinesis, emotional problems, somatic complaints, and poor psychosocial factors in comparison to normal children. The study findings also suggest that a proper evaluation and treatment program for the students with learning disability should also include emotional, behavioral and other psychological aspects in addition to cognitive and academic domain. Key words: Learning Disability, Internalizing and Externalizing behavior, emotional problems

Introduction

Method Participants: The data for this study were gathered from those students brought by their parents for psychology consultation. Among them twenty students who have received a diagnosis of Specific developmental disorders of scholastic skills based on their performance on intelligence test and NIMHANS index of LD. Also twenty normal school going students fulfilling the inclusion and exclusion criteria were taken up for the study. Instruments: 1. Child Behavior Checklist (CBCL) (Achenbach, 1991) The CBCL obtains reports from parents, other close relatives, and/or guardians regarding childrens competencies and behavioral/emotional problems. The CBCL has 113 items that describe specific behavioral and emotional problems, plus three open-ended items for reporting additional problems. Parents rate their child for how true each item is now or within the past 6 months using the following scale: 0=not true; 1=somewhat or sometimes true; 2=very true or often true. The cross-informant syndromes scored from the CBCL are Internalizing Problems, Externalizing Problems, Attention Problems; Social Problems and Thought Problems. It is designed to assess in a standardized format the behavioral problems and social competencies of children as reported by parents. It will take approximately 15 minutes to complete the scale. 2. Developmental Psychopatholology Checklist (DPCL) (Kapur et al., 1995) It consists of 124 items under 6 subsections, namely, Developmental history, Developmental problems, Psychopathology, Psychosocial factors, Social support and assets of the child. It will take around 15-20 minutes to complete the entire questionnaire. This tool is considered to be an appropriate tool for Indian children. Procedure: Written informed consent was taken from the parents of the children after explaining the objectives and procedure of the study in detail. Basic Socio-demographic and clinical data were collected first. Then the CBCL and DPCL were given to the parents to rate the severity of the problems. Likewise, the normal controls, fulfilling the inclusion and exclusion criteria, were selected through the school visit also followed the same method in completing the questionnaires.

Results

Table 1: Comparison of Socio-demographic Profile between the patient and normal group Groups Variables Patients (N=20) n (%) Age 6 yrs to 9 yrs 10 yrs to 13 yrs Sex Males Females Education 1 std to 4 std 5 std to 8 std Medium of Language English Malayalam Syllabus Kerala CBSE Family Type Nuclear Joint Work status of parents Both parents working Only father is working Only mother working Father working abroad Both the parent working abroad 4 (20) 10 (50) 1(5) 3(15) 2(10) 4 (20) 12 (60) 0 (0) 3 (15) 1 (5) 1.515 4 0.824 16 (80) 4 (20) 14 (70) 6 (30) 0.533 1 0.465 10 (50) 10 (50) 9 (45) 11 (55) 0.100 1 0.752 14 (70) 6 (30) 14 (70) 6 (30) 0.000 1 1.000 13 (65) 7 (35) 12 (60) 8 (40) 0.744 1 0.744 13 (65) 7 (35) 13 (65) 7 (35) 0.000 1 1.000 13 (65) 7 (35) 12 (60) 8 (40) 0.107 1 0.744 Normal (N=20) n (%) 2 df p

Family history of mental illness Present Absent 5 (25) 15 (75) 0 (0) 20 (100) 5.174 1 0.017

Table 1 shows the socio-demographic profile of the sample consisting of the patient and normal group. Chi-square test was applied for the comparison of the sociodemographic variables like age, sex, education, medium of language, syllabus, type of family, parents work status and family history of mental illness. There was no significant difference found between patient and normal group in every variable except family history of mental illness. 25 percent of children in the patient group were reported as having a positive family history of mental illness.

Discussion Conclusion Reference