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Chuan-Yu Chen, PhD, John P. Lawlor, Anne K. Duggan, ScD, Janet B. Hardy, MDCM and William W. Eaton, PhD

Chuan-Yu Chen is with the Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Taiwan. John P. Lawlor and William W. Eaton are with the Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md. Anne K. Duggan and Janet B. Hardy are with the Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.

Correspondence: Requests for reprints should be sent to William W. Eaton, PhD, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, HH 852, 624 N Broadway St, Baltimore, MD 21205 (e-mail: weaton{at}jhsph.edu).

Objectives. We assessed the extent to which borderline mental retardation and mental retardation at preschool ages are related to emotional and behavioral problems in young adulthood. We also explored early risk factors for having mental health problems as a young adult that might be related to preschool differences in cognitive ability.

Methods. We used data from a cohort of births studied in the Johns Hopkins Collaborative Perinatal Study and followed up in the Pathways to Adulthood Study. Preschool cognitive functioning was assessed at 4 years of age. Individual characteristics, psychosocial factors, and mental problems were prospectively evaluated from birth through young adulthood.

Results. Children with subaverage cognitive abilities were more likely to develop mental health problems than their counterparts with IQs above 80. Inadequate family interactions were shown to increase 2- to 4-fold the risk of emotional or behavioral problems among children with borderline mental retardation.

Conclusions. Subaverage cognitive functioning in early life increases later risk of mental health problems. Future research may help to delineate possible impediments faced at different developmental stages and guide changes in supportive services to better address the needs of children with borderline mental retardation.