INTRODUCTION:

Child behavioral problems are serious and may have indirect effect in the child’s life in the future if not taken care of fast. The growing years of a child are perhaps the most difficult a family ever has. It is during these years that a child comes to terms with various concepts of life, like family belonging, discipline, social norms etc. It is necessary to differentiate between mischievous children and child behavioral problems. There is no known medical treatment for such behavioral problems in children. However, the proper time may help to solve this problem.

In India, about 35% of total populations are primary school children. Today’s kids are tomorrow’s pillars of our country.

The investment on our child in terms of developing environment both physical and emotional is going to reap rich individuals in future.

A study was conducted on behaviour disorders among 305 schoolboys aged 8-12 years in Abha. The subjects were assessed using the children's behaviour questionnaire developed by Rutter. The frequency of behaviour disorders was 13.4%. Behaviour disorder was associated with family size, mother’s employment, crowding index, parents' education, birth order, parental death and social class. Families in the lower socioeconomic classes were 11 times more likely to have children with behaviour problems than families in the higher socioeconomic classes. Also large families of four or more children were 2.5 times more likely to have children with a behaviour disorder as compared to small families⁴.

A case study was conducted in Ludhiana to assess the impact of women’s education level and employment status on parent-child relationship. The sample comprised of 300 Sikh families (150 families with employed mothers and 150 families with unemployed mother).A socio-demographic questionnaire was used to identify families for sample under the study. Parent-child relationship in the selected families was evaluated using Parent-Child Relationship Scale. Arithmetic mean, standard deviation and t test were used to analyze the data. The result suggested that fathers’ and mothers’ protective, rejecting and loving nature and use of symbolic reward was uninfluenced by mothers’ educational level and employment status⁷.

NEED FOR THE STUDY:

A prospective study was conducted to investigate the childhood emotional and behavioral problems. Attention problem aggressive behaviour and anxious/depressed problems were the most persistent problems over this period of children’s lives. In general the strongest relationship over time occurred when reports were obtained from mothers on each occasion. A weaker relationship existed between earlier mother reported problem and later teacher reported problems which occupied an intermediate position.

At least 3% of school children suffer from serious emotional disturbances, such as depression, suicidal thoughts, psychosis and serious attention problems. Attention deficits and hyperactivity is the most common behavioural disorder of childhood. The prevalence of attention deficits and hyperactivity among paediatric out patients in New Delhi was 11.2%. Sarkar, Kapur and Kaliaperumal (India) reported a prevalence rate of emotional disturbance of 10-54%in school going children of the age of group 8-12 years.

The emotional and behavioural problems found to be in 44% of the children. Anxiety related symptoms 67%, emotional problems, particularly depression 62% and conduct problems 49% were found. A big group of the population in any city/country is that of students and the life of students is becoming more and more stressful. Family is the nuclear of all social groups because of its functional importance of the child. It is where healthy habits are learnt by the child. According to Tyrer and Tyrer(1974) absenteeism in the later years of schooling is predictive of depression in adult hood

REVIEW OF LITERATURE:

The review of literature of the study was done under the following heading

Literature related to behaviour problem:

Behaviour or distressed emotions, which are common or normal in children at some stage of development, but become abnormal by virtue of their frequency or severity, or their inappropriateness for a particular child’s age compared to the majority of ordinary children’¹⁵.

A statistical survey was conducted to assess the effect of separation of school children from their parents. A questionnaire was used for 292 children whose parents were working at a society as missionaries in East Asia. Questions were aimed at opinion of these adults on education, their relationship, marriage, job satisfaction and emotional problems in relation to their childhood experiences. Among them 93% responded and only a few felt that their educational preparation had been unsatisfactory. Ninety-five percent had tertiary training. Married males and females considered their adjustment more satisfactory than the singles did. Questions related to psychiatric problems showed that 7.6% had emotional and behaviour problems. The results showed that there was association between behaviour problems and separation from parents.¹⁶

Literature related to jealousy and sibling rivalry:

A descriptive study was conducted to examine sibling jealousy and its relations to child and family characteristics in USA. They conducted the study in 60 families with a 16 month old toddler and an older preschool age sibling. The result showed that sibling jealousy was elicited in social triads consisting of a parent and two siblings. Younger siblings displayed more behaviour deregulations in mother sibling triads, if there was greater sibling rivalry reported by mothers. They also recommended considering social relationships as developmental context for young children’s emotion regulation.³²

A study was conducted to investigate a range of child, parent and family factors as predictors of sibling adjustment outcomes. The respondents were Forty-nine siblings (aged 7-16 years) and parents provided information about sibling daily hassles and uplifts; sibling coping; parent stress; parenting and family resilience. Multiple regression techniques were used. The siblings’ perceived intensity of daily uplifts significantly predicted sibling prosaically behaviour. The results revealed that the family level of risk and resilience factors were better predictors of sibling adjustment than siblings' own experiences of stress and coping resources, highlighting the importance of familial and parental contributions to the sibling adjustment process. The implications of these results for the design of interventions and supports for siblings.³⁶

A study was conducted on similarities in sibling’s experiences of neglectful parenting behaviour, the objective is to investigate the extent to which siblings reported similar parental neglectful behaviours, the study participants were 59 sibling pairs representing both clinical and community, Multidimensional Neglectful behaviour scale were used. The result of the study was there were no differences in correlations for family-level and child-specific items. Opposite sex siblings reported greater differences in parental neglectful behaviour, with boys reporting more neglectful behaviour than girls. Siblings report similar neglectful parenting behaviour, regardless of whether the family is high-risk or not, and whether neglectful behaviour are measured as a family-level or child-specific phenomenon.³⁷

Literature related to hyperactivity:

Children with Attention Deficit Hyperactivity Disorder (ADHD), characterized by developmentally excessive levels of inattention, over-activity and impulsiveness, are most frequently identified and treated in primary school. Studies worldwide identify a prevalence rate for ADHD equivalent to 5.29% (95% Confidence Interval: 5.01-5.56) of children and adolescents. Rates are higher for boys than for girls, and for children under 12 years of age compared with adolescents. Prevalence estimates vary based on method of ascertainment, diagnostic criteria used, and whether functional impairment criteria are included. Overall, estimates are remarkably similar from country to country with the exception of African and Middle Eastern countries where rates are lower compared with North America and Europe.

Studies show that interventions that include intensive parent education programs can help decrease ADHD problem behaviour because parents are better educated about the disorder and better prepared to manage their child’s symptoms. They are taught organizational skills and how to develop and keep a schedule for their child. They are also taught how to give immediate and positive feedback for behaviour they want to encourage, and how to ignore or immediately redirect behaviour they want to discourage.

Group-based parent-training/education programmes are usually the first-line treatment for parents and cares of children and young people of school age with ADHD and moderate impairment. This may also include group psychological treatment (cognitive behavioural therapy [CBT] and/or social skills training) for the younger child. For older age groups, individual psychological treatment may be more acceptable if group behavioural or psychological approaches have not been effective, or have been refused. Drug treatment may be tried next for those children and young people with ADHD and moderate levels of impairment.

Literature related to school phobia and fighting:

Correlations between perceived school performance (PSP) and self-reported average school grade scores were between 0.51 and 0.65, representing large effect sizes. Differences between the median school grades in the 4 categories of the PSP item were statistically significant in all 3 samples. The PSP item showed predominantly small associations with some randomly selected HBSC items or scales designed to measure different concepts. The PSP item seems to be a valid and useful question that can distinguish groups of respondents that get good grades at school from those that do not. The meaning of PSP may be context-specific and may have different connotations across student populations from different countries with different school systems⁴⁹.

PROBLEM DEFINITION:

“Prevalence of behaviour problem among school going children in rural area of Sawangi Wardha.

AIMS OF STUDY:

The aim of this study was to investigate the evidence of behaviour problem in school going children.

OBJECTIVES OF THE STUDY:

1. To assess the evidence of behavior problem in school going children.

MATERIAL AND METHODS:

a) Research Approach - Descriptive approach is used in this study

b) Research Design- Survey study design

c) Study Population: School going children in the rural area of Sawangi Meghe Wardha.

d) Study Group: school age children

e) Setting Of The Study: Rural area of Sawangi Meghe Wardha.

f) Sampling Technique - Non probability convenience sampling technique used in this Study

g) Sample Size - 200 school going children

h) Criteria for sample selection

Inclusive criteria:

School going children between age 6yrs to 12yrs.

Exclusion criteria:

School going children with physically handicap.

i) Description of the tool:

The structured questionnaire consisted of 2 sections.

1. Demographic data -

It includes the demographic data such as age, number of children, educational qualification, and type of family, monthly income (Rs), occupation, and religion.

2. Checklist Questionnaire -

There is checklist based on structured questionnaire to assess the prevalence of behavioural problem of school going children. A blue print was prepared.

Scoring:

· Score 1 was given to those who are having the behaviour problem.

· Score 0 was given to those who are not having the behaviour problem. Based on the percentage of scores, level of behaviour problem was graded as follows.

Table 1:-The total level of behaviour problem score were categorized

Grade	Percentage Score	Marks
Normal	0-25%	1-5
Mild	26-50%	6-10
Moderate	51-75%	11-15
Sever	>75%	16-20

METHOD OF DATA COLLECTION:

Data was collected by using structured questionnaires checklist methods. The investigator introduced herself and obtained consent from parents who were willing to participate in study, purpose and important of research study was explained before collection of data. The structured Checklist questionnaire was used collecting the information from the parents about the behaviour problem of school going children.

Permission from the concerned authority:

Prior to collection of the data, permission was obtained from the sarpanch and the informed consent from the entire participants was taken before starting the study.

Plan for data analysis:

The analysis was made on the basis of objectives and assumptions. The data analysis was planned to include descriptive and inferential statistics. The following plan of data analysis was developed on the basis of the advice given by the experts.

Table 1: Percentage wise distribution of school going children according to their demographic characteristics. n=200

Demographic Variables	No. of school going children	Percentage (%)
Age of child(yrs)
6-7 yrs	76	38.0
8-9 yrs	46	23.0
10-11 yrs	57	28.5
12 yrs	21	10.5
Gender of the child
Male	91	45.5
Female	109	54.5
Birth order
Two	147	73.5
Three	48	24.0
Four	5	2.5
Types of family
Nuclear	80	40.0
Joint	88	44.0
Extended	32	16.0
Monthly family income(Rs)
Below 5000 Rs	12	6.0
5001-10000 Rs	90	45.0
10001-15000 Rs	64	32.0
>15000 Rs	34	17.0
Religion
Hindu	70	35.0
Muslim	15	7.5
Buddhist	91	45.5
Others	24	12.0

Observations and Result:

The analysis and interpretation of the observations are given in the following section:

SECTION A:

This section deals with distribution of school going children with regards to their demographic characteristics. A convenient sample of 200 subjects was drawn from the study population, who were from rural area of Sawangi (Meghe), Wardha. The data obtained to describe the sample characteristics including age, gender, number of children, family type, income and religion respectively.

SECTION B:

Assessment of evidence of behavior problems in school going children in selected rural area of Sawangi (Meghe), Wardha

Table 2: Assessment of behaviour problem n=200

Behaviour Problems	Percentage score	Behaviour Problems
Behaviour Problems	Percentage score	Frequency	Percentage
Normal	1-5(0-25%)	2	1.00
Mild	6-10(26-50%)	72	36.00
Moderate	11-15(51-75%)	115	57.5
Sever	16-20(>75%)	11	5.5
Minimum score	5
Maximum score	20
Mean score	12.68 ±3.12
Mean %	55.13 ± 13.60

The above table shows that 2(1%) of the school going children had normal behaviour, 36% had mild behaviour problems, 57.5% had moderate and 5.5% of them had sever behaviour problems. The minimum score was 5 and the maximum score was 20, the mean score was 12.68 ±3.12and mean percentage score was 55.13 ± 13.60.

Graph 1: Assessment of behaviour problem

SECTION C:

Association of behaviour problem score in relation to demographic variables

Table 3: Association of behaviour problem score in relation to age. n=200

Age (yrs)	No. of children	Mean behaviour problem score	F-value	p-value
6-7 yrs	76	13.65±3.01	5.77	0.001 S,p<0.05
8-9 yrs	46	12.30±2.74
10-11 yrs	57	12.36±3.28
12 yrs	21	10.80±2.87

This table shows the association of behaviour problem score with age in years of children. The tabulated ‘F’ values was 3.78(df=3,196) which is much less than the calculated ‘F’ i.e. 5.77 at 5% level of significance. Also the calculated ‘p’=0.001 which was much less than the acceptable level of significance i.e. ‘p’=0.05. Hence it is interpreted that age in years of children is statistically associated with their of behaviour problem score.

Summary, discussion, conclusion, implication and recommendations

In the present study assess the prevalence of behaviour problem in rural area Sawangi Meghe Wardha was high 98% school going children had behaviour problem the data was obtained by parents of school going children, On the bases of structured questioner checklist of behaviour problem (Such as jealousy, school phobia, hyperactivity, sibling rivalry and fighting). Only 2% school going children had normal behaviour, 36% had mild behaviour problems, 57.5% had moderate behaviour problems and 5.5% of them had sever behaviour problems on the basis of questioner checklist that was used in research and data was collected by parents of school going children . The following study are supported to my study

The prevalence of attention deficits and hyperactivity among pediatric out patients in New Delhi was 11.2%. Sarkar, Kapur and Kaliaperumal (India) reported a prevalence rate of emotional disturbance of 10-54%in school going children of the age of group 8-12 years. At least 3% of school children suffer from serious emotional disturbances, such as depression, suicidal thoughts, psychosis and serious attention problems. Attention deficits and hyperactivity is the most common behavioural disorder of childhood.

A study conducted on 1- 8 and 11-year-old girls and boys (N = 110) were interviewed individually and asked about why children in general, and themselves in particular, fight with fellow pupils in the playground. A substantial proportion of children (51 per cent) reported having had at least one aggressive fight during the previous year. The most common reasons for children resorting to fighting were retaliations to teasing, retaliations to unprovoked assaults, and disagreements over aspects of the game that was being played, because another child was disliked, and to settle dominance disputes.

A study was conducted on behaviour disorders among 305 schoolboys aged 8-12 years in Abha. The subjects were assessed using the children's behaviour questionnaire developed by Rutter. The frequency of behaviour disorders was 13.4%. Children's parents were interviewed to obtain social and demographic information about the family. Behaviour disorder was associated with family size, mother’s employment, crowding index, parents' education, birth order, parental death and social class. Families in the lower socioeconomic classes were 11 times more likely to have children with behaviour problems than families in the higher socioeconomic classes. Also large families of four or more children were 2.5 times more likely to have children with a behaviour disorder as compared to small families.

TITLE OF THE STUDY:

“Prevalence of behaviour problem among school going children in rural area of Sawangi Wardha

OBJECTIVES:

1. To assess the evidence of behaviour problem in school going children.

Major findings of the study and discussion:

The following are the major findings of the study.

SECTION II:

Assess the evidence of behaviour problem in school going children.

The 2(1%) of the school going children had normal behaviour, 36% had mild, behaviour problems 57.5% had moderate behaviour problems and 5.5% of them had sever level of behaviour problems. The minimum score was 5 and the maximum score was 20, the mean score was 12.68 ±3.12 and mean percentage score was 55.13 ± 13.60.

DISCUSSION:

The finding of the study was discussed with reference to the objectives stated and with the findings of the other studies in this section. The present study was undertaken “Prevalence of behaviour problem among school going children in rural area of Sawangi Wardha”

CONCLUSION:

After the detailed analysis, this study leads to the following conclusion:

The present study has shown the prevalence of behaviour problem in school going children in rural area of Sawangi Meghe Wardha and Demographic variables shown significant association with age of children and behavioural problem score.

IMPLICATIONS:

The findings of this study have implications for nursing practice, nursing education, nursing administration and nursing research.

Nursing Practice:

It is the primary responsibility of the nurses to assess the behavioural problem of school age children of working and non working mothers. By a well- planned structures teaching programme we can enhance the knowledge regarding behavioural problem of working and non working mothers.

Nursing Education:

The awareness on behavioural problem should be emphasized to prevent from the behavioural disorders not only among the health professional but also the general public. Nurses should have to update knowledge about the common behavioural problem.

Nursing Research

In India, only few research studies have been done on assessment of behavioural problem. All nursing personnel must join hands to provide scientifically tested material or programs to evolve a time bound plan for the prevention measure on behavioural problems.

RECOMMENDATIONS:

On the basis of the findings of the study, it is recommended that the following studies can be conducted.

1. A similar study may be conducted on a larger population for generalization of findings.

2. A study can be carried out to evaluate the efficiency of various teaching strategies like SIM, pamphlets, leaflets and computer-assisted instruction on behavioural problems of children.

3. A study can be carried out to assess the effectiveness of structured teaching programme on behavioural problem among parents of school age children in hospital setting.

4. An experimental study can be undertaken with control group for effective comparison of result.

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· synopsis of psychiatry, Behavioural sciences, Clinical psychiatry,9^th edition, Lippincott Williams Benjamin James Sadock, Virginia Alcott Sadock.MD, Kaplan and Sadock’s and Wilkins publishers, Philadelphia:2002,Page no:1152-1164.

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JOURNALS:

1. Muntz. R, Hutchings. J, Edwards. RT, Hounsome. B, O’Ceillachair. A, Economic evaluation of treatments for children with severe behavioural problems – A study centre for the economics of health, Institute of medical and social care research, University of Wales, Bangor,UK,2008,July.

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Received on 30.08.2016 Modified on 16.09.2016

Int. J. Adv. Nur. Management. 2016; 4(3): 353-358.

DOI: 10.5958/2454-2660.2016.00062.4