Prevalence of externalizing behavior problems in Sri Lankan preschool children: birth, childhood, and sociodemographic risk factors

Purpose There is dearth of epidemiological data on externalizing behavior problems among preschool children in many developing countries. The aim of this study was to examine the prevalence and associated birth, childhood, and sociodemographic factors of externalizing behavior problems among a community sample of preschool children in Sri Lanka. Methods Maternal ratings of child behavior were obtained from a community-based sample of 1,117 in the age group of 4–6 years using the Child Behaviour Assessment Instrument, which was developed and validated to assess externalizing behavior problems of preschool children. In addition, mothers responded to a questionnaire on birth and childhood related factors of the index child and sociodemographic status of the family. Results The prevalence of externalizing behavior problems was estimated as 19.2% (95% CI 17.5–20.9%) with the proportion being significantly higher among boys (p\0.0001). Breast-feeding less than 3 months, low socioeconomic status, and child living with only one parent were identified as independent predictors of externalizing problems of preschool children. Conclusions The study suggests the need for implementation of strategies and policies focusing at population and family level to reduce the burden associated with externalizing behavior problems in preschool children in Sri Lanka and similar developing countries