Behavioral and emotional problems among Turkish children at ages 2 to 3 years.

Objective: Within the framework of the Mental Health Surveys of Turkey, the authors investigated the distribution and prevalence of parent-reported behavioral and emotional problems in a nationally representative sample of 2- to 3-year-old children.

Method: A cross-sectional population-based survey from October 1996 through March 1997 using a self-weighted and equal probability sample of Turkish toddlers (N = 638) was conducted. The Child Behavior Checklist Total Problem scores and Household Questionnaire reports by parent informant source (response rate 94.3%) were examined for the effects of child gender, age, urban/suburban/rural residence, and geographic region using multiple regression analyses.

Results: Overall, the total problem scores placed 11.9% of the children in the clinically significant range and 18.6% of the children in the borderline range. Urban residence was significantly correlated with the Total Problem scores, Internalization and Externalization scores, and six Child Behavior Checklist syndrome scale scores. The child's age, gender, or parental employment status did not affect Total Problem scores. With respect to the Child Behavior Checklist syndrome scale, girls had higher Anxious/Depressed scores than boys, and 2-year-olds had higher Somatic Complaints scores than the 3-year-old children. None of the children with reported emotional and behavioral problems were referred to any mental health services.

Conclusion: As part of a national mental health policy in Turkey, there is an urgent need to develop early childhood intervention services that emphasize home visits, center-based child care in the community, and caregiver and provider education and training.