Prediction of childhood problems at three years in children experiencing disorders of regulation during infancy

The objective of this study was to determine if symptoms of regulatory diso rder (RD) during infancy were related to clinical status at three years. Tw o age-matched RD groups based on severity (N = 10 in mild RD group; N = 22 in moderate-severe RD group) and an age-matched control group (N = 38) were evaluated at 7 and 30 months. A fourth group with pervasive developmental disorders (N = 18) also were tested. Problems with self-regulation, includi ng sleep, feeding, state control, self-calming, sensory reactivity, mood re gulation, and emotional and behavioral control, were documented during infa ncy. Children were retested at 36 months in their development, behavior, an d play. Two child psychiatrists unfamiliar with the subjects' diagnostic cl assification during infancy provided diagnoses at 36 months. At 36 months, 60% of children with mild regulatory disorders did not meet criteria for an y disorders, while 95% of infants with moderate regulatory disorders had di agnoses that fell into two diagnostic clusters: (1) delays in motor, langua ge, and cognitive development and (2) parent-child relational problems. Mos t toddlers in the pervasive developmental disorder group were diagnosed as having PDD or autism with mental retardation or borderline intelligence at 36 months. Early symptoms are discussed as they relate to later diagnostic outcomes for the clinical samples.