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Behavioral Strength and Difficulty Profiles among Children with Neurodisability

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Abstract

Background: Given the significant behavioral heterogeneity characterizing children with neurodevelopmental disorders and disabilities (NDD/D), the current study examined whether cluster analysis could classify a diverse sample into more homogeneous subgroups. Aims: We first utilized cluster analysis to identify subgroups of children demonstrating similar behavior profiles. Second, we investigated the distribution of children’s primary diagnoses represented within each cluster. Finally, we compared the clinical utility of clusters versus diagnoses for indices of child and family health. Methods: Caregivers provided data for 222 children with NDD/D (M = 8.22 years), completing measures of child behavior and child and family health. Results: A 4-cluster solution was revealed: Social Difficulties, Cross-domain Difficulties, Hyperactive-inattentive, and Low difficulties, and a range of conditions was found within each. For all indices of child and family health, clusters explained greater variance than did diagnoses. Conclusions: The current study provides new insight into the heterogeneous nature of behavior among children with NDD/D. Considering a child’s unique constellation of strengths and difficulties may serve as a clinically meaningful supplement to diagnosis that more fully elucidates functional profile.

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Acknowledgments

The authors would like to thank Dr. Peter Rosenbaum for his contribution to the diagnostic coding of children in the study dataset and Dr. Rollin Brant for statistical consultation.

Funding

Dr. E. Gardiner was funded by a BC Children’s Hospital / Kids Brain Health Network Postdoctoral Fellowship. Drs. E. Gardiner and A. Miller receive support from the Sunny Hill Foundation for Children. The larger study, from which our data originated, was supported by a Canadian Institutes of Health Research Emerging Team Grant (PI: Dr. L. Lach).

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Authors and Affiliations

  1. Division of Developmental Pediatrics, Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, 4480 Oak Street, Room F614, Vancouver, BC, Canada

    Emily Gardiner & Anton R. Miller

  2. School of Social Work, Department of Pediatrics, Neurology and Neurosurgery, McGill University, Montreal, QC, Canada

    Lucyna M. Lach

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  1. Emily Gardiner
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Correspondence to Emily Gardiner.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The current study is based on a secondary analysis of de-identified data, and received independent ethics approval from the associated University hospital’s Research Ethics Board.

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Gardiner, E., Miller, A.R. & Lach, L.M. Behavioral Strength and Difficulty Profiles among Children with Neurodisability. J Dev Phys Disabil 33, 163–179 (2021). https://doi.org/10.1007/s10882-020-09742-0

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