Predicting conduct problems: Can high-risk children be identified in kindergarten and grade 1?

Externalizing behavior symptoms (EBS) in childhood are a strong predictor o f future conduct problems. This study evaluated their predictive accuracy u sing logistic regression and receiver operating characteristic curve techni ques. EBS, alone and in combination with other child and familial risk fact ors, were used to predict conduct problems 30 months later in a nonclinic p opulation of kindergartners and Grade 1 children. The sensitivity (Sn) and positive predictive value (PPV) of EBS alone were below preset criteria of greater than or equal to 50% for each (prevalence less than or equal to 15% ). Sn and PPV increased when other child and familial factors were combined with symptoms but did not exceed the preset criteria. From a developmental perspective, substantial stability of EBS exists over time. However, from the perspective of prevention science, significant levels of misclassificat ion will occur when EBS are used to designate high-risk status under the lo w-prevalence conditions of normal populations.