“Behavioral and Emotional Dysregulation and Its Associated Factors in Children with Neurodevelopmental Disorder: A Cross-Sectional Study”

Abstract

Background: Children with neurodevelopmental disorders (NDDs) frequently experience emotional and behavioral regulation difficulties that limit learning, participation, and daily functioning. In Bangladesh, limited context-specific evidence exists, highlighting the need for research to inform effective, culturally responsive interventions. Aim: The study aimed to assess the level of behavioral and emotional dysregulation among children with neurodevelopmental disorders and to explore the factors associated with these difficulties. Methods and Materials: A cross-sectional study was conducted with 160 children diagnosed with Autism Spectrum Disorder, ADHD, Cerebral Palsy, and Intellectual Disability, recruited from special schools and therapy centers through purposive sampling. Caregivers completed a validated Behavioral and Emotional Checklist. Data were analyzed using descriptive statistics and Fisher’s Exact Test to explore associations with age, gender, parental education, family structure, and screen time. Results: Among the 160 children with neurodevelopmental disorders, 67.5% exhibited poor behavioral regulation, whereas 58.8% demonstrated poor emotional regulation. Behavioral dysregulation was significantly associated with parental education (P = .001), family structure (P=.001), daily screen time (P=.001), constipation (P =.013), regular playtime (P=.001), and diagnostic category (P =.001). Emotional dysregulation was significantly related to excessive screen exposure (P =.001) and parental education (P < .05).Behavioral regulation difficulties were slightly more prevalent than emotional challenges, highlighting the strong influence of environmental and caregiving contexts. Conclusion: Children with NDDs often face serious emotional and behavioral regulation problems that reduce their participation and quality of life. The findings highlight the need for early, family-centered occupational therapy that focuses on structured routines, caregiver education, and reducing excessive screen time. From a humanitarian perspective, stronger public awareness, inclusive education, and early identification programs are essential to reduce stigma, support families, and ensure equal access to services. Collaboration among occupational therapists, educators, healthcare professionals, and policymakers is crucial to promote inclusion, resilience, and better developmental outcomes for children with NDDs. Key Words: Neurodevelopmental disorders; Behavioral regulation; Emotional regulation; Occupational therapy; Parental education; Screen time; Family-centered intervention.