Oral health and oral health risk behaviour in children with and without externalising behaviour problems.

AIM: This was to study children with early detected externalising behaviour problems compared to matched controls regarding oral health, oral health risk behaviour and the parental evaluation of the child's oral health and dental care. METHODS: Children aged 10-13 years and with externalising behaviour problems, were compared to matched controls. Behavioural characteristics were based on the Strength and Difficulties Questionnaire. The children and their parents completed questionnaires regarding dental fear, tooth brushing, dietary habits and evaluation of oral health and dental care. Data on dental caries risk assessments, caries, behaviour management problems and dental trauma were obtained from dental files. RESULTS: There were no differences in caries prevalence in children with early detected externalising behaviour problems, compared to controls. However, the former group consumed more sweet drinks when thirsty and brushed their teeth fewer than twice daily; they also had more dental trauma in both dentitions and a higher risk range for dental fear, compared to controls. CONCLUSIONS: This study points out potential oral health risk factors in children with early-detected externalising behaviour problems. Although no difference in caries prevalence was observed, externalising behaviour may affect oral health. Therefore, dental professionals should support the families and the children to preserve dental health by offering increased prophylactic measures. There were no differences between children with externalising behaviour problems, compared with controls, regarding the parent evaluation of their child's dental health. However, more parents in the study group evaluated the dental care as poor or not functioning.

Behavioural characteristics in externalising children with low and elevated risk for dental caries.

AIM: To compare two groups of children with externalising behaviour problems, having low and elevated caries risk, respectively. Those parameters were assessed in relation to behavioural characteristics and family structure, and to compare the caries risk assessment and gender differences in relation to children in general in the Region of Västra Götaland, Sweden. METHODS: Families (228) with children, aged 10-13 years, participating in parent training programmes, were recruited. Parents provided information through questionnaires regarding parental knowledge and monitoring, family warmth and conflict and family structure. Children's behavioural characteristics, based on the Strength and Difficulties Questionnaire and the Disruptive Behaviour Disorder rating scale, were used as outcome. Data about caries risk assessment were obtained from dental records. RESULTS: Children in the elevated caries risk group showed higher mean values for conduct problems as well as impulsivity. Parents of the children in the elevated caries risk group reported more parental solicitation and less family conflicts. Children with an elevated caries risk lived more often in households with more than two children and had more often a father from a non-Nordic country. CONCLUSION: There were statistically significant more children with an elevated caries risk in the study group compared to children in general in the Region of Västra Götaland, both totally and within gender. Differences were observed with regard to behavioural characteristics in externalising children with an elevated risk for caries. Increased knowledge regarding behavioural characteristics in externalising children is an important parameter to be considered in caries risk assessment.

ADHD in Swedish 3- to 7-year-old children.

OBJECTIVE: To study characteristics of attention-deficit/hyperactivity disorder (ADHD) in a representative group of clinically impaired young children in Sweden with the disorder. METHOD: One hundred thirty-one children with ADHD (aged 3-7 years) were examined, and their parents were interviewed. Independent parent questionnaire data (Child Behavior Checklist, ADHD Rating Scale-IV, Conners) were collected. For comparison 131 children without ADHD were matched for age, gender, parents' marital status, child's adoption status, and social class. RESULTS: Children with ADHD had extremely high ADHD symptom levels--on average four to eight times higher than the comparison group. Sociodemographic correlates of ADHD symptoms were more pronounced in parent questionnaire data than in parent interview data, underscoring the importance of diagnostic interview when dealing with clinical issues. Very few of the children with ADHD (6%) appeared "normal" with regard to attention/activity level at clinical examination. CONCLUSIONS: Clinic children with a diagnosis of DSM-IV ADHD have typical and impairing symptoms already before starting school. The variance of ADHD in this age group appears to be accounted for by primary psychosocial factors only to a limited degree. It would seem reasonable to establish supportive and treatment measures for these young children so that the psychosocial and academic problems shown by so many individuals with ADHD later in their development might be reduced.

[DAMP and ADHD as "hidden" functional disabilities. Carefully prepared care of children at risk is beneficial for an optimal development]. / DAMP och ADHD "osynliga" funktionshinder. Genomtänkt omhändertagande av riskbarn främjar optimal utveckling.

A current study of seven-year-olds in Karlstad showed the incidence of DAMP (deficits in attention, motor function and perception) to be 1.7 per cent, and that of ADHD (attention deficit hyperactivity disorder) to be 2.0 per cent, figures consistent with those obtained in previous studies. A further 4.9 per cent were found to have milder forms of DAMP. Research during the past few decades has yielded comprehensive knowledge of the effect of such disability on the child's development. Manifestation of the child's problems is dependent on how the child is treated by others, and on the understanding and help deriving from the family and from the preschool or school. It is essential to evolve a well considered management programme of health care for which the school or preschool is responsible. The programme should include methods for early detection, access to a competent investigatory team, support and treatment facilities for the child and the parents, and assistance at school or preschool.