Emotional and behavioral problems in children and adolescents with and without intellectual disability

Background: The main objective of this study was to assess and compare the prevalence of a wide range of emotional and behavioral problems in children with and without intellectual disability (ID). Methods: We studied 1,041 non‐residential children randomly selected from special schools for educable (IQ 60 to 80) and trainable (IQ 30 to 60) children without severe additional physical or sensory impairments, and compared them to 1,855 children randomly selected from the general population (both ages 6 to 18). Parents completed the Child Behavior Checklist (CBCL), and teachers the Teacher's Report Form (TRF). Results: Controlling for sex, age, and socioeconomic status, we found that both educable and trainable children had significantly higher mean scores on all CBCL and TRF scales than children without ID, except for trainable children on the scales Anxious/Depressed and Somatic Complaints. Almost 50% of children with ID had a Total Problem score in the deviant range compared to about 18% in children without ID. Compared to children without ID, the most prominent problem behaviors of educable children were Social Problems, Attention Problems, and Aggressive Behavior, and trainable children had an increased risk for Social Problems, Attention Problems, Withdrawn and Thought Problems. Conclusions: Elevated scale scores reflected differences between children with and without ID over a broad range of items, and not solely on items more likely to be related to developmental delay. Therefore, problem areas covered by the items in these scales deserve special attention in the mental health care of children with ID.