Preschool Problems 183Box 22.1The Preschool to School Study (Richmanet al., 1982)Method
This study is a random 1 in 4 sample of 3-year-olds from an outer London borough.
A two-stage design (see Chapter 3) involved an initial screening interview,
followed by detailed assessments at 3, 4 and 8 years of age for all ‘screen positive’
children and a matched sample of ‘screen negative’ children.Main findings at age 3
Moderate or severe problems were present in 7%, with mild problems in a further
15%. There was a slight male excess. Boys were more hyperactive; girls were
more fearful. Psychiatric problems were commoner in the presence of specific
language delay or adverse social and family factors, including marital discord,
low warmth, high criticism, maternal depression, large family size and high-rise
housing.Main findings at age 8
Of the 3-year-olds with problems, 73% of boys still had problems five years later
as did 48% of girls. Over-activity and low intelligence predicted persistence in
boys, but not in girls. Over-activity predicted disruptive behavioural disorders
while fearfulness predicted emotional disorders. Adverse family factors were
more relevant as predisposing than as maintaining causes, that is, they predicted
the onset of new problems but were not good at predicting whether established
problems would persist of not.
Percentage with marked problems definitely present at different ages3 years 4 years 8 years
Fears 10 12 2
Overactive, restless 17 13 11
Tempers 5 6 9
Worries 41021
Hard to manage 11 10 11
Soiling at least once a week 16 3 4
Many comfort habits 17 14 1
Waking at night at least 3 times a week 14 12 3Outcome in later childhood
Though some preschool problems are transient, others persist. The chro-
nicity of some preschool problems is evident both prospectively and
retrospectively. Prospectively, follow-up studies such as the Preschool
to School study have shown that a substantial proportion of severely
troubled preschoolers do develop clear-cut ADHD, disruptive behavioural