Childhood Social-Emotional Functioning Linked To Early-Onset Mental Health Conditions

The shadow of two young boys fighting projected against a red brick wall.
Researchers investigated early childhood social-emotional functioning and mental health condition development.

More than 40% of children entered the school system in British Columbia, Canada, with vulnerabilities in social-emotional functioning associated with early-onset mental health conditions, according to research results published in JAMA Network Open.

Because many mental health disorders emerge during early adolescence and early mental health indicators are difficult to identify, researchers investigated early childhood social-emotional functioning and mental health condition development.

The prospective cohort study included 34,323 children from birth to age 14. Researchers collected and analyzed data from the Developmental Trajectories cohort. Children’s kindergarten teachers rated social-emotional functioning (defined as social competence, internalizing and externalizing symptoms). Researchers calculated occurrences of physician-assessed mental health conditions including depression, anxiety, conduct disorder, attention-deficit/hyperactivity disorder using public health insurance data.

Related Articles

Analysis determined that 41.6% of children exhibited comparative vulnerabilities in internalizing or externalizing behaviors. Prevalence of childhood mental health conditions was 4.0% for depression, 7.0% for anxiety, 5.5% for conduct disorder, 7.1% for attention-deficit/hyperactivity disorder, and 5.4% for multiple conditions. Poisson analyses revealed the association between social-emotional functioning profiles at kindergarten and physician-assessed mental health conditions by age 14. For example, children with more consultations for conduct disorder, ADHD, and multiple conditions had higher teacher ratings for aggression and hyperactivity.

The study was limited by its reliance on public health insurance data, which likely underestimated the pervasiveness of mental health conditions, and the possibility that some mental health conditions were misclassified.

The researchers stated, “The observed prevalence and inequity of young children’s social-emotional vulnerabilities…illuminate that addressing childhood mental health requires population-level interventions that start early, with the school system being a key point of preventative intervention, as demonstrated in other studies.”

Future research should continue to identify factors in children’s social and structural environments that can promote social-emotional development and mental health.


Thomson KC, Richardson CG, Gadermann AM, Emerson SD, Shoveller J, Guhn M. Association of childhood social-emotional functioning profiles at school entry with early-onset mental health conditions. JAMA Netw Open. 2019;2(1):e186694.