Triple Risk: Do Difficult Temperament and Family Conflict Increase the Likelihood of Behavioral Maladjustment in Children Born Low Birth Weight and Preterm?

Objective This study examined the impact of family conflict on internalizing and externalizing behavior at age 8 for children born low birth weight (LBW) and preterm (PT), with specific attention to the moderating role of early temperament. Methods The sample included 728 families enrolled in the longitudinal study of the Infant Health and Development Program. The study relied on maternal reports of child temperament at age 1, family conflict at age 6 years and 8 years, and child behavior at age 8 years. Results Children exposed to high levels of family conflict had more internalizing problems. Child temperament assessed in infancy moderated the impact of family conflict on externalizing but not internalizing problem behavior. Discussion LBW/PT children with a difficult temperament are more at risk for poor developmental outcomes, such as externalizing behavior problems, when exposed to family conflict than children with a less difficult temperament. Key words behavior problems; family conflict; temperament. School-aged children born low birth weight (LBW) and preterm (PT) carry an increased risk of behavioral maladjustment such as elevated internalizing and externa-lizing behavior and delinquency (Bhutta, Cleves, Casey