Infant mental health: an emerging field for children with developmental disabilities

Behavior problems are common in toddlers and preschoolers. Richman, Stevenson, and Graham (1975) identified difficulties with eating, sleeping, toileting, temper, fears, peer relations, and activity as typical in this young population. While all young children should be expected to experience behavior problems as part of their normal development, an ongoing challenge in the field has been to determine when these “normal” developmental problems rise to the level of being considered “clinical” behavior problems (Keenan & Wakschlag, 2000). For example, when does a two-year-old child's tantrum behavior, a three-year-old's urinary accidents, and a four-year-old's defiance become clinically significant? To answer these questions, clinicians must examine the frequency, intensity, and durability of these difficulties, their potential to cause injury to the child or others, the extent to which they interfere with the child development, and the degree to which they disrupt the lives of their siblings, caregivers, peers, teachers, and others.