Profile and associated factors of challenging behaviour in Children with developmental disabilities in Mulago national referral hospital.

Abstract

Introduction: Approximately half of individuals with developmental disabilities (DD) exhibit some form of challenging behaviour (CB), with 5–10% displaying very severe behaviour. This behaviour is often associated with age, severity of the disability, and comorbid medical or developmental conditions. However, there is limited research on challenging behaviour among children with developmental disabilities in low-resource settings.Study aim: To profile and assess factors associated with challenging behaviour in children with developmental disabilities attending Mulago National Referral Hospital.Methods: A cross-sectional study was conducted among children aged nine years and below with DD and their primary caregivers in fourteen weeks. Data collected included sociodemographic characteristics (socio-demographics’ questionnaire), types of CB(ABC), clinical features (medical records), primary caregiver coping strategies (Brief-COPE), and perceived social support (MSPSS). Data were analysed using SPSS version 26.0, Excel, and STATA version 16.0. Sample characteristics were described using frequencies, percentages, means and standard deviations. Associations between dependent and independent variables were examined using Chi-square tests at the bivariate level and structural equation modelling at the multivariate level.Results: 295 children and their primary caregivers were enrolled. Most children were male (64.1%), aged more than 5 years (36.3%), not attending school (70.5%), and from Uganda’s central region (56.6%). Over half (57.6%) exhibited challenging behaviour. Three categories of challenging behaviour were identified: (1) hyperactivity, inattention, and disruptive behaviour; (2) social withdrawal and isolation; and (3) self-injurious behaviour. Challenging behaviour was significantly associated with the child’s age (p = 0.007), number of developmental disabilities (p = 0.019), primary caregiver’s education level (p < 0.001) and coping strategies (p = 0.005).Conclusion: Challenging behaviour is common among children with DD and is associated with their age, number of DD, primary caregiver education and coping strategies. Routine screening for CB among children with DD and appropriate management strategies are recommended for better outcomes.