Screening for behavioral and emotional problems in children and adolescents with congenital or acquired limb deficiencies.

Children with chronic physical handicaps have been found to be at risk for psychological and social adjustment problems. Accurately identifying in a timely manner those physically handicapped children who are functioning at clinically significant levels of maladjustment may aid in preventing further psychosocial morbidity. The parents of 111 children and adolescents with congenital/acquired limb deficiencies completed the Child Behavior Checklist as a screening instrument to facilitate the identification of behavioral and emotional problems and social incompetence. Based on normalized T scores, the children manifested significantly greater behavioral and emotional problems and lower social competence than the normative community sample. Twenty-three percent of the children were reported to function in the clinically significant maladjustment range for behavioral and emotional problems; 14% were reported in the social maladjustment range. Correlations between parent report and child, adolescent, and teacher reports of adjustment ranged from r values of .23 to .41. The findings are discussed in terms of the "new hidden morbidity" in pediatric practice.