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PEDIATRICS Vol. 109 No. 6 June 2002, pp. 1054-1060

Persistent Infant Crying and Hyperactivity Problems in Middle Childhood

Dieter Wolke, PhD, Patrizia Rizzo, BSc and Sarah Woods, MSc

From the University of Hertfordshire, Department of Psychology, Wolke Research Group, Hatfield Campus, Hatfield/Herts, United Kingdom

--> Objective. To investigate whether persistent infant crying is associated with an increased risk for externalizing behavior problems in childhood.

Methods. Sixty-four infants who were referred for persistent crying in infancy (PC; mean age: 3.8 ± 1.3 months) were reassessed at 8 to 10 years of age and compared with 64 classroom controls (CC). The major outcome measure was pervasive hyperactivity or conduct problems defined as parent, child, and teacher ratings that across informants were within the borderline/clinical range according to the Strengths and Difficulties Questionnaire (SDQ). Ratings of other behavior problems, parent ratings of temperament, and teacher assessment of academic achievement were also obtained.

Results. Ten (18.9%) of 53 PC had pervasive hyperactivity problems (child, parent, and teacher reported) compared with 1 (18.9%) of 62 CC (odds ratio: 14.19 [1.75–114.96]). Parents (29 [45.3%] of 64 vs 11 [17.2%] of 64; 4.00 [1.77–9.01]) and children (30 [46.9%] of 64 vs 17 [26.6%] of 64; 2.44 [1.16–5.12]) but not the teachers reported more conduct problems. Parents of PC rated the temperament of their children to be more negative in emotionality (PC mean: 3.0 ± 1.0; CC: 2.4 ± 1.0; effect size: 0.6) and difficult-demanding (PC mean: 5.2 ± 1.3; CC: 6.3 ± 0.9; effect size: 1.0). Academic achievement was reported by teachers to be significantly lower for PC than CC, in particular for those children with pervasive hyperactivity problems.

Conclusions. Infants who are referred for PC problems and associated sleeping or feeding problems are at increased risk for hyperactivity problems and academic difficulties in childhood.

Key Words: persistent crying • colic • hyperactivity • conduct disorder • academic achievement • temperament

Abbreviations: PC, persistent crying • CC, classroom control subjects • D, dropout • NS, not significant • df, degrees of freedom • CA, Cronbach’s {alpha} • SDQ, Strengths and Difficulties Questionnaire • TAAS, Total Academic Achievement Score • ES, effect size

Received for publication Nov 28, 2001; Accepted Dec 3, 2001.




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