Socio-Demographic Characteristics and Presenting complains among children with Behavioural Disorders Attending a Tertiary Care Hospital in Colombo, Sri Lanka

Abstract

Abstract

Background: Children's behavioural disorders, which range from moderate defiance to severe disorders such as Attention Deficit Hyperactivity Disorder (ADHD), have a profound impact on their emotional, social, and intellectual development. While developed countries have established systems for early identification and intervention, low- and middle-income countries (LMICs), such as Sri Lanka, confront significant obstacles in addressing these concerns. Limited resources, cultural stigma, and a lack of understanding exacerbate the situation. The purpose of this study is to describe the socio demographic characteristics and presenting complaints of behavioural disorders among children attending a child guidance clinic in Colombo.

 Method: A cross-sectional study was conducted at the Child and Adolescent Clinic of Lady Ridgeway Hospital for Children in Colombo (LRH). The study included 183 parents or caregivers of children aged 5–18 years, selected through systematic sampling, who had confirmed diagnoses of behavioural disorders and were under continued clinical follow-up. A standardised questionnaire administered by an interviewer was used to assess behavioural disorders and sociodemographic factors. Descriptive statistics and cross-tabulations were used to uncover patterns and relationships between behavioural disorders and various socio-demographic characteristics.

 Results

A total of 183 children aged 5 to 18 years (M = 10.42, 95% CI: 9.98–10.86) participated in the study. The majority were male (72.7%) and from the Colombo district (51.9%). Most children were in middle childhood (8–12 years; 56.3%), and 69.4% belonged to nuclear families. behavioural issues were the most common presentation (93.4%), followed by poor academic performance (35.0%), school refusal (24.0%), and hyperactivity (23.5%) of children who had a diagnosis of a behaviour disorder. Family structure showed a significant association with hyperactivity (p = 0.010). Poor academic performance was seen in about one-third of the children, without significant demographic differences.

Conclusion: Overall, the findings indicate that behavioural challenges were the most common presenting complaint. The association of hyperactivity with  family structure that warrant future investigation. It would be important to collect nationwide data, to better understand the trends in order to help establish a national plan that includes comprehensive intervention measures. In the setting of limited resources, such data will help to build multi-layered care models that incorporate existing community services to enhance outcomes for Sri Lankan children with behavioural disorders.

Keywords: Behavioural disorders, Children, Socio-demographic factors, Sri Lanka