Externalisierende Verhaltensstörungen in der frühen Kindheit: Risikofaktoren und Früherkennnung

Comprehensive knowledge about origins and maintaining conditions of externalizing behavior disorders in early childhood provide many opportunities for an early identification and development of prevention and intervention approaches. The aim of this dissertation was first to give an overview of the current state of research on selected environmental and child-related risk and protective factors, which have an impact on child s development from pregnancy to preschool age (publications I-III). Even though children with externalizing disorders also often show impairment in basic skills, there are few studies which assess children at preschool age. Therefore, the aim of one of our empirical studies was to investigate possible deficits in a number of different basic skills as potential predictors for externalizing behavior disorders in preschoolers (n=201; publication IV). The results show that the more severly children are impaired in their development, the more likely is it that they show also behavior problems. Especially deficiencies in social and emotional skills were closely associated with an increased risk of behavioral problems. Based on the findings from publications I to IV then the possibilities and limitations of an early identification were examined critically. The systematic observation and documentation of a child's education and learning processes by educational professionals constitutes an important access to the identification of children at risk. However, the methods used differ considerably in their psychometric quality. Therefore, in a further empirical study (publication V) 127 four- to six-year olds were investigated by applying the EBD 48 - 72 as well as other psychological instruments (SSV 4-6, KET-KID, SDQ). Findings suggest that the EBD 48-72 is a valid instrument which can be used to identify children with special needs. The present dissertation reveals the importance of preceding stages of development, the psychosocial situation and the psychological conditions of pregnant women should emphasized both in research and clinical practice. The results of our work also indicate that further longitudinal studies are needed to examine early impairment in different areas of development in children with externalizing behavior disorder. These early impairment should be considered essential in the diagnostic process as well as in preventional and interventional settings.