A Descriptive Study to Assess the Behavioral Problems among Preschool Children at Selected Anganwadi centers of Distt. Roopnagar (Punjab)

 

Ms. Poonam Kumari¹, Mrs. Jeen Mexina Settipalle², Mrs. Amiteshwar Kaur³

¹M Sc. Nursing Student, Saraswati Nursing Institute, Dhianpura

²Associate Professor Child Health Nursing, Saraswati Nursing Institute, Dhianpura

³Lecturer Child Health Nursing, Saraswati Nursing Institute, Dhianpura

 

ABSTRACT:

Introduction: Normal children are healthy, happy and well adjusted. This adjustment is developed by providing basic emotional needs along with physical and physiological needs for their mental well being. Common behavioral problems of preschool children are destructiveness, selfishness, temper tantrum, bed time problems, hurting others, thumb sucking, nail biting, enuresis, encopresis, disobedience, self control, refusal to food and stuttering or stammering, delayed speech and attention deficit disorder. Behavior problems in preschool children are due to parents negligence poor supervision or poor attention, family conflict and maladjustment. Behavioral problems during preschool period is the strongest predictor of more serious problems later which includes delinquency, substance abuse, antisocial behavior, academic failure, conduct problems and depression. Objectives: To assess the behavioral problems of preschool children (3-6 years) as expressed by mothers using Modified Jacqueline McGuire and Naomi Richman Pre- School Behavior Checklist. To determine the association between behavioral problems of preschool children and selected demographic variables. Methods: A Non-Experimental, Quantitative research approach and descriptive research design was adopted to conduct the research study. Non probability consecutive sampling technique was used to collect the data. Tool used for the present study was Socio-demographic data sheet, modified Jacqueline McGuire and Naomi Richman Preschooler Behavior Checklist. Results: The results of present study revealed that21% of subjects had behavior problems and 79% of subjects had no behavior problem. Findings showed that behavioral problems were significantly associated with number of children in the family (0.001*, at df -3) at p value (<0.05). No association was found with age, sex, religion, type of family, sibling order, residence and income of family.

 

 

 

 

 

INTRODUCTION:

Children of today are the citizens of tomorrow. The prosperity of the nation depends upon the health of its future citizens. Children with sound mind in sound body are essential for the future development of the country¹. The preschool period refers between 3 to 6 years². Preschoolers are emerging as creative persons who are preparing for their future role in society. The family continues to be a significant influence and support. Preschoolers continued to need physical affection and love from their parents. These needs may be less frequent or may take a different form from those of the toddler period. Individual needs and preferences of each child should be respected³.

 

In India, about 35% of total population is children below 15 years of age. As said by Karl Menninger “what is done to children, they will do to the society”. Today’s kids are tomorrow’s pillars of our country. The investment on our child in terms of developing environment (both physical and emotional) is going to reap rich individuals in future⁴. The preschooler is an inquisitive learner and absorbs new concepts like sponge absorbs water⁵.

 

Behavior is the manner in which one acts or behaves. The actions or reactions of a person in response to external or internal stimuli⁶. Early childhood is the critical period of behavior formation. The preschool period is an exciting period of transition from a time of limited language ability, primarily sensory motor engagement with the surrounding environment to mastery of communication, a high degree of motor activity, a significant competence in self regulation, expanding cognitive, behavior and emotional changes and a heightened ability to empathize with others⁷.

 

All children will at some development stage display repetitive behavior but whether they may be considered as problem depend on their frequency and persistence and the effect they have physical, emotional and social in fluency. These habit behaviors may arise originally from the intentional movement which become repeated and then become incorporated in to the child’s customary behavior⁸. 

 

The child’s mind may vary in temperament, development and behavior. It is very difficult to identify normal and abnormal behavior. Behavior problems are diagnosed when a child exhibits persistent and repetitive patterns that break social rules and impair social interaction with others. Academic performance, feelings of inadequacy in daily situations, a tendency to develop physical symptoms, and excessive fear in ordinary situations also require investigation⁹.

 

Age up to six years is more crucial period. Preschool behavior problems are now being recognized as clear indicator of difficulties that may persist into later childhood and that may indicate family dysfunction. Screening is necessary to detect developmental problems among preschool children¹⁰ According to world health report 2001in India, 15% of children have serious emotional disturbance¹¹. According to ICMR 2001, overall prevalence of mental and behavioral disorder in Indian children is 12.5%. Studies conducted in rural and urban areas of different parts of India suggest prevalence of behavior disorder ranging from 1.6%-41.3%¹².

 

While working in hospital and community posting investigator herself observed that there were several children with behavior problem. Investigator also experienced such kind of behavior among preschool children of her neighborhood and relatives. Through extensive literature review and investigators experience, the investigator has strong desire to conduct the study to assess the behavioral problems among preschool children. 

 

MATERIALS AND METHODS:

A Non-Experimental, Quantitative research approach and descriptive research design was adopted in the present study to assess the behavioral problems among preschool children at selected anganwadi centers of distt Roopnagar (Punjab). Non probability consecutive sampling technique was used to collect the data. The population for this study was mothers of preschool children of selected anganwadi centers. The sample size for the present study was 200.

 

Modified Jacqueline McGuire and Naomi Richman Preschooler Behavior Checklist was used to assess the behavioral problems among preschool children comprised of two parts. Part A: Socio demographic profile sheet includes: Age, gender, number of sibling, sibling order, type of family, religion, residence and family income.  Part B: Modified Jacqueline McGuire and Naomi Richman Preschooler Behavior Checklist (PBCL). It consists of 22 items and each item has 3 statements which are scored as 0, 1 and 2. Maximum score is 44 and minimum score is 0. Items are categorized into seven subareas i.e. conduct problems, habits, temper tantrums, emotional difficulties, speech problems, social problems and capacity to concentrate and play. The cutoff point is at the score of 12. Children achieving score Below 12 has no behavior problem and children achieving score 12 and above 12 has behavior problem.

 

Hypothesis:

H₁: There is a significant association between behavioral problems of preschool children with their selected demographic variables at 0.05 level of significance.

 

Ethical consideration:

1    Written permission was taken from Principal, Saraswati Nursing Institute, Dhianpura, Kurali.

2    Written permission was taken from ethical clearance committee of the Saraswati Nursing Institute, Dhianpura.

3    Written permission was taken from Anganwadi Workers of each Anganwadi Center.

4    Informed consent was taken from mothers of each study subject.

5    Confidentiality and anonymity of the subjects was maintained throughout study.  

 

RESULTS:

Major findings related to demographic variables:

Study results revealed that 46% of the subjects were 3 years old, 33.5% were 4 years old, 19.5% were 5 years old and only 1% were 6 years old. More than half 53.5% of the subjects were male and 46.5% were females. Out of 200 subjects 60% were Hindu, 37.5% subjects were Sikh, only 2.5% subjects were Muslim. According to type of family 51% of the subjects were from nuclear family and 49% were from joint family. According to number of children in the family, most of the subjects 45% were having two children, 19% subjects were having more than three children in the family 18.5% of the subjects were having 3children and 17.5% subjects were having single child. Whereas 40.5% of subjects had one sibling, 39.5% subjects had no sibling, 12% of subjects had two siblings and only 8% of subjects had more than two siblings. Most 71% of the subjects are residing in urban area and 29% of the subjects reside in rural area. The family income of 76% parents were less than 10000 per month, 16% parents were 10001-20000 per month, 6.5% parents were 20001-30000 per month and only 1.5% parents were 30000 per month.

Area of problem	Mean	Mean%	Rank
Temper tantrums	0.64	32.00	1
Capacity to concentrate and play	1.65	27.50	2
Emotional difficulties	1.76	17.55	3
Conduct problems	1.79	14.92	4
Social relationships	0.81	13.50	5
Language	0.31	7.75	6
Habits	0.13	3.13	7

 

 

Figure: percentage distribution of behavior problems among preschool children

 

 

Major findings related to association of behavioral problems and demographic variable:

S.No	Demographic variable	Behavioral problem (yes)	Behavioral problem (no)	df	Chi square	P value
1	Age of child (in years)
	a)       3	17	75
	b)       4	15	52	3	1.546	0.672
	c)       5	9	30
	d)       6	1	1
2	Gender
	a)       Male	23	84	1	0.034	0.854
	b)       Female	19	74
3	Religion
	a)       Hindu	22	98
	b)       Muslim	1	4	2	1.366	0.505
	c)       Sikh	19	56
4	Type of family
	a)       Nuclear	20	82
	b)       Joint	22	76	1	0.243	0.622
5	Number of children in family
	a)       First	2	33
	b)       Second	19	71
	c)       Third	5	32	3	16.383	0.001*
	d)       Above third	16	22
6	Sibling order
	a)       First	14	65
	b)       Second	17	64
	c)       Third	6	18	3	1.757	0.624
	d)       Above third	5	11
7	Residence
	a)       Urban	25	117
	b)       Rural	17	41	1	3.401	0.065
8	Income
	a)       <10000	30	122
	b)       10001-20000	9	23
	c)       20001-30000	2	11	3	1.648	0.649
	d)       >30000	1	2

 

The association between the behavioral problems and demographic variables. The results revealed that behavioral problems was significantly associated with number of children in the family (0.001*, at df -3) at p value (<0.05). No significant association was found with age, sex, religion, type of family, sibling order, residence and income of family.

 

DISCUSSION:

A study conducted by Letícia M.et.al ¹³ to investigate the prevalence of behavior problems and associated factors in preschool children. Study was done on 349 children aged 49 to 72 months. Sample was selected randomly. Behavior Checklist was used to measure and describe the frequencies of behavior problems. The overall prevalence of behavior problems was 23.5%. The prevalence of internalizing problems was 9.7%, and that of externalizing problems, 25.2%. The findings of the present study are similar to this study. In the present study the results showed that 21% subjects had prevalence of behavior problem.

 

A study conducted by JiS.Hong et.al ¹⁴to investigate disruptive behavior in preschool children. Caregivers of preschoolers ages 3.0-5.1 years (n = 273) were interviewed using the Preschool Age Psychiatric Assessment. Losing one's temper, low-intensity destruction of property, and low-intensity deceitfulness/stealing in the preschool period were found markers of preschool conduct disorder and predictors of school age conduct disorder. In the present study findings revealed that subjects had highest mean percentage i.e. 32.00% in the area of temper tantrums.

 

A study conducted by Casey A. Holtz et.al¹⁵ to investigate the Incidence of Behavior Problems in Toddlers and Preschool Children from Families Living in Poverty. The study included an ethnically representative sample of 357 children, five years of age and younger, from a diverse, low-income, urban area. Behavior problems were assessed by parent report through a questionnaire specifically designed for low-income families. Boys and younger children were reported as demonstrating a higher rate of externalizing behaviors than girls and older children. The present study revealed the similar results that behavior problems occur at higher rates in children living in poverty. The findings revealed that majority of subjects with behavior problems had family income per month <10000.

 

 

 

 

IMPLICATIONS:

Nursing education:

·      The study emphasizes significance of short term in service education programs for nurses and peripheral health workers related to health education, regarding selected aspects of behavioral problems.

·      The nursing curriculum should consist of increased depth, content and activities which helps to develop skills of nurses in behavioral problems.

·      As a nurse educators, there are an abundant opportunities for nursing professionals to educate the anganwadi workers and mothers of preschool children regarding behavioral problems.

 

Nursing practice:

·      Nursingprofessionals should be able to render services according to the changing need of the society. They should be tactful to identify the problems of the preschool children because they are at crucial period of development.

·      Pediatric Health nurses are expected to give all essential care to the children residing in the community. Hence they should conduct various teaching program to increase the knowledge and practices related to behavioral problems.

·      A nurse educator can educate the parents regarding emotional and behavioral problems which help them to gain healthy life, reduce and prevent the chances of emotional and behavioral problems and promote the health.

 

Nursing administration:

·      In the context of technological changes and knowledge explosion, nurse administrator should anticipate the need and take responsibility to motivate nurses to learn and provide counseling regarding behavioral problems.

·      Nursing personnel should accept the responsibility of creating awareness to the society regarding behavioral problems and preventive measures to prevent it.

·      Nurse administrator can organize in-service education programme on behavioral problems in clinical fields.

 

Nursing research:

·      Research should be directed towards exploring the various behavioral problems.

·      Nursing research should be conducted towards the consequences of various behavioral problems.

·      Nurses should come forward to take up unsolved aspects in the field of behavioral problems, to carryout studies and publish them for the benefit of preschool children.

 

RECOMMENDATIONS:

·      A comparative study can be undertaken among males and females regarding behavioral problems.

·      A comparative study can be done on rural and urban community and between rural and urban schools.

 

REFERENCES:

1.       Vijayalakshmi K et.al. A. Child rearing practices and psychological problems in children. Nursing and Midwifery Research Journal 2007 Apr;3(2):49-51.

2.       Perry. Potter. Fundamentals of nursing. 7^th ed. Elsevier publishers;160-162.

3.       Marlow R. Dorothy. Redding A. Barbara. Textbook pediatric nursing. 6^th ed. Elsevier publishers;888-999.

4.       ParulDatta. Pediatric Nursing. 2^nded.New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.2009,186-192.

5.       Kyle Terri. Essentials of pediatric nursing. 1^st ed. Lippincot Williams and wilkins publishers: 137.

6.       http://www.thefreedictionary.com/behavior

7.       Ghai OPet al. Essential pediatrics. 6^thed. New Delhi: CBS Publishers; 2005.

8.       Bhatia M.S.et al, a comprehensive textbook of child and adolescent psychiatry, new delhi, CBS publishers and distributors 1996,102-128

9.       Letícia M..al . Prevalence of behavior problems and associated factors in preschool children.RevistaBrasileira de Psiquiatria. 2016 Jan/Mar :38(1):4 available from: URL: :http://dx.doi.org/10.1590/1516-4446-2014-1596

10.     Perera H et alScreening for mental health problems in urban preschool children- a pilot study. Sri Lanka Journal of Child Health 2004; 33 (2):39-42.

11.     World Health Organization The world Health Report 2001, Mental health: New understanding. New scope, Geneva: WHO.

12.     Indian Council Of Medical Research. Epidemiological study of child and adolescent psychiatric disorders in urban and rural areas. New Delhi; 2001.

13.     Letícia M. et.al . Prevalence of behavior problems and associated factors in preschool children.RevistaBrasileira de Psiquiatria. 2016 Jan/Mar :38(1):4 available from: URL: :http://dx.doi.org/10.1590/1516-4446-2014-1596

14.     Ji S.Hong,et.al Disruptive Behavior in Preschool Children. Journal of pediatrics 2015 Mar.166 (3):723–730. Available from: URL: www.jpedes.com

15.     Casey A. Holtz et al. Incidence of Behavior Problems in Toddlers and Preschool Children from Families Living in Poverty. The Journal of psychology.2015;149(2):161-174.Available from: URL:http://www.tandfonline.com/http://doi/full/10.1080/00223980.2013.853020

 

 

 

 

Received on 21.06.2017       Modified on 22.08.2017

Accepted on 11.10.2017      ©A&V Publications All right reserved