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WRITTEN ASSIGNMENT UNIT 1

HS 4241

Written Assignment unit 1

University of the People

Jacinda Andrews
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In a study by Lavigne et al., (2009), 796 children were evaluated through their parents

in order to determine the prevalence of psychopathological disorders such as oppositional

defiant disorder (ODD), attention deficit hyperactivity disorder (ADHD), generalised anxiety

disorder (GAD), and major depressive disorders (MDD).

This study was necessitated due to a lack of information on behavioural and

emotional disorders of pre-school students - despite increasing awareness around their

existence (Lavigne et al., 2009). In a study by Luby et al (2002), as cited in Lavigne et al.,

(2009), it was found that certain conditions associated with depression can be detected in

young children, a phenomenon previously thought to occur exclusively in children much

older.

Increasing knowledge around the psychopathology of pre-schoolers can enable us to

provide treatments early on, which have been shown to be affective for ODD and ADHD,

with successful treatment for separation anxiety disorder (Lavigne et al., 2009). Additionally,

with improved understanding of the social implications of having such disorders, we can plan

interventions in advance and ensure a more inclusive community for the individuals as they

grow up (Lavigne et al., 2009). The purpose of this study, therefore, is aimed at improving

public health epidemiology (Lavigne et al., 2009).

The participants took part in a 3-year longitudinal study that focused on the development

and prevalence of ODD, depression, and anxiety, with the latter also including ADHD

(Lavigne et al., 2009). Parents of pre-schoolers were approached at public schools and

paediatric clinics, and given information on the study at the initial meeting (Lavigne et al.,

2009). In order for the parents and their children to be eligible to take part in the study, there

were six criteria they had to meet:

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• The child had to be 4 years old

• The child could not present any pervasive developmental disorder, or autism spectrum

disorder symptoms

• The parent and child could speak Spanish and English to ensure understanding of the

material

• The child had a caretaker for 6 months or longer, otherwise there would not be

sufficient experience with the child’s functioning

• The child achieved 70 or greater on a language screen

• The child scored at least a 70 on a school IQ test, to ensure participation in certain

tasks for the study

(Lavigne et al., 2009).

The parents first had to fill out a demographic questionnaire which included

information about their socioeconomic status, which was encoded for using the Hollingstead

Four-Factor Index of Social Status (Lavigne et al., 2009). Afterwards, the parents were

presented with the DISC-YC (Diagnostic interview schedule for children–parent scale–young

child version) which is a type of interview that gains information about the child’s overall

degree of symptoms and can detect the presence of any psychiatric disorder (Lavigne et al.,

2009). The questions are structured in such a way that the parent can simply answer ‘yes’ or

‘no’, and subsequent questions are asked depending on the answer (Lavigne et al., 2009).

There is a threshold for diagnosis that upon being met, indicate for questions to be asked

about treatment and impairment (Lavigne et al., 2009).

As part of the DISC-YC test are modules for ADHD (for hyperactive impulsivity,

inattentive, and combination type), ODD, GAD, and major depressive disorder (MDD), and a

rating for impairment is given for each disorder (Lavigne et al., 2009).
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Additionally, parents were presented with the Child symptom inventory (CSI) which

assesses problematic behaviour in children from a 4-point rating scale ranging from 0= never

and 3 = very often (Lavigne et al., 2009). Considering the ratings, the algorithms that are

based on DSM-IV criteria can determine whether the child meets the threshold for any

psychiatric disorder (Lavigne et al., 2009).

The results from the DISC-YC showed that the most common disorders were ODD

and ADHD (any type) (Lavigne et al., 2009). However, when impairment was filtered to be

severe, the prevalence rates for ADHD and ODD dropped by nearly a quarter, showing that

even though they were a majority, many of the cases were mild (Lavigne et al., 2009).

The results from the CSI with regards to GAD and MDD were the same as they were

in the DISC-YC but for the rates of ODD and ADHD, the CSI produced lower levels than did

the DISC-YC (Lavigne et al., 2009).

One of the differences between the DISC-YC and the CSI is that the DISC-YC

assumes a binary system of diagnostic criteria, where individuals either have the symptom or

they don’t; there is not a lot of space for the dimensional nature of symptoms. In opposition

to this, the CSI focuses on the frequency of symptom experience and grades them on a 4-

point scale, and then uses this information to compare to age and gender norms to formulate a

potential diagnosis (Lavigne et al., 2009). Using a latent trait analyses, the results from these

two tests can be compared to determine objective results (Lavigne et al., 2009).

As mentioned in the beginning of this paper, the aim of the study was for

epidemiological research, and what this entails is information about mental illness and it’s

prevalence amongst pre-school students so that we have a foundation with which to perform

further studies. If we have data, research objectives can be refined and at the same time, the
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data we have can provide information for how to modify our current schooling systems, we

can also provide parents with tools for creating a more appropriate environment for their

children, and we can also provide teachers with tools on how to manage expectations in the

classroom. I also believe that it is important to understand that mental health can be the result

of both nature and nurture, and early treatment and intervention can prevent unhealthy coping

mechanisms from being formed.

In my opinion, this study ties into the study of mental health in that it seeks to create a

space where discussions around mental health and their symptoms are common, normalised,

and understood. If we change the narrative, that the media and society for so long has

provided to us about mental health, we can begin creating a safer and more efficient space for

those struggling with mental illness. For an individual to have ADHD, ODD, GAD, or MDD,

and still have to be concerned with ‘fitting in’ to a neurotypical world, is extremely harmful

and slows down the rate at which they could be finding better ways to manage the symptoms.
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References

Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The

prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-

olds. Journal of Clinical Child & Adolescent Psychology, 38(3), 315-328.