Temperament in Children with Developmental Disabilities

Temperament refers to a child’s behavioral style, or tendency to act in a certain way in a specific situation.  Researchers define dimensions of temperament in many different ways, but most writers discuss emotionality (i.e., how intense is the child’s emotional reaction), adaptability (i.e., how well does the child adjust his/her behavior to changes in the environment), and approach/withdrawal (i.e., does the child tend to go toward or away from new experiences).  Other dimensions include:  activity level, persistence, and distractibility.  For years, pediatricians and psychologists have written about how a child’s temperament influences various important outcomes for the child, such as physical health, resiliency under stress, acceptance by peers, achievement in school, and the development of problem behaviors.  Researchers have also discovered that a child’s temperament affects the well-being of the family, impacting upon parenting stress and feelings of competence, as well as an overall sense of harmony or cohesiveness within the family.

Surprisingly little work has been directed towards understanding the impact of temperament in children with developmental disabilities.  We think this is an important area of research because understanding a child’s temperament helps us to identify a child’s strengths and determine what kinds of interventions and/or educational environments would be a good “fit” for the child.  In addition, temperament information can help us to anticipate situations that might be especially challenging for certain children, thus enabling us to prevent the occurrence or escalation of problem behaviors.  Also, thinking about temperament is a way of remembering that a child with a disability is a child first, with a unique personality and behavioral style. 

So, what have we discovered?  We had to do some background science to demonstrate the usefulness of temperament measures in children with disabilities and we found out that the tools are valid and reliable in children with developmental disabilities.  Mothers are very consistent reporters of their children’s temperament, and kids with disabilities are just as varied in their behavioral style as typically-developing children.  Approximately 40% of the children meet criteria for an “easy” temperament (i.e., laid-back, go-with-the-flow kinds of kids) and approximately 30% are described as being “difficult” in temperament (i.e., emotionally intense, highly active, resistant to changes) and the remaining 30% are somewhat mixed in profile.  When we looked a little closer, we found that children who have autism and are verbal were more likely to be described as difficult than were nonverbal children, or children with other developmental disabilities.  Children with Down syndrome were the most likely to be described as “easy” at young ages.

In a large study of children with autism, we found that their temperaments were very stable from the preschool to school years.  Poor adaptability and negative mood in preschool-aged children with autism predicted the likelihood of problem behaviors three years later.  Early problems with adaptability were also associated with more parenting stress.  These findings support the need for early preventative interventions for young children with autism who have difficulties adapting to changes.  Examples of interventions include:  use of transition routines, providing advanced notice of changes, and use of visual schedules and cues to signal changes.  Clinical experience tells us that it is important not to “protect” these children from changes in their lives, but rather to present them with many opportunities to learn how to cope at young ages, given plenty of support and reassurance.  Strengths commonly reported by parents of young children with autism include:  persistence (especially during favorite activities) and an overall positive mood.

In our work in Fragile x syndrome, we discovered that many of these children are described by their parents as being highly active and distractible, with a tendency to “give up” quickly on tasks or activities that are challenging.  Helping young children to be more persistent and focused on things can be challenging, but some basic strategies include:  keeping adult-directed activities brief, teaching the child a consistent work-break routine, teaching functional communication (i.e., teaching a child to indicate “all done” instead of doing something inappropriate to end an activity), and giving the child enough support and prompts so that he/she feels successful.  Low persistence was strongly related to overall motor functioning in young children with Fragile x syndrome, suggesting that gentle physical prompts (particularly in the first steps of an activity) might be very helpful for these children.  Strengths commonly reported by parents of young children with Fragile x include an overall pleasant mood and interest in new activities.

Finally, in our work in Down syndrome, we are beginning to understand that persistence can also be a challenge, which we suspect might be related to motor performance in this group as well.  Overall, the young children with Down syndrome are described by their parents as being very curious about new activities and people and less intense in their emotional reactions to events than most other children.  We have recently expanded our study to include more children with Down syndrome and we hope to explore this area in more detail.

Our next step is to examine in greater detail the links between child temperament and problem behavior…we’ll keep you posted!