Emotional problems in preschool and school-aged children with neurodevelopmental disorders in Spain: EPINED epidemiological project

Background: Children with neurodevelopmental disorders (NDD) are often at risk of developing emotional problems.Aims and methods: The co-occurrence of anxiety and depression with ASD and/or ADHD was determined by exploring the association with children's clinical and neuropsychological func-tioning and their parent's mental health. To this end, we assessed 295 preschoolers (PRE; 4-5 years old) and 486 school-aged children (SCH; 10-11 years old) in Tarragona, Spain. NDD di-agnoses were based on DSM-5. Emotional problems were assessed using Achenbach's scales.Results: Emotional problems (PRE: 36%-78%; SCH: 32%-81%) were more common and more severe in participants with NDD than in controls and children in the ASD + ADHD school-aged group were the most affected. In ADHD, emotional problems were associated with more severe symptoms of attention deficit (PRE) and hyperactivity/impulsivity (SCH). In ASD + ADHD, emotional problems showed a trend of association with more severe ASD repetitive behaviours and impaired working memory, whereas in ASD were associated with greater overall ASD severity.Conclusions and implications: Children with NDD are vulnerable to emotional problems, which become more prevalent and interfering with age. Early detection and intervention aimed at tackling emotional problems can improve NDD prognosis.