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Published on: September 19, 2019
Parent identification of early emerging child behavior problems: predictors of sharing parental concern with health
Katherine D Ellingson1, Margaret J Briggs-Gowan, Alice S Carter
1School of Epidemiology and Public Health, School of Medicine, Yale University, New Haven, CT 06520-8034, USA. katherine.ellingson@yale.edu
Insights
Parental worry about child behavior problems strongly predicts seeking professional help. Low social-emotional competence in children also increases parental concern and help-seeking behavior for early identification.
Area of Science:
- Child Psychology
- Pediatric Healthcare
- Behavioral Health
Background:
- Early identification of child behavior problems is crucial for timely intervention.
- Parental communication with healthcare providers is a key pathway for identifying these issues.
- Understanding predictors of parental help-seeking is essential for improving early detection rates.
Purpose of the Study:
- To identify factors that predict parental discussions with pediatric care providers about early child behavior problems.
- To suggest strategies for healthcare settings to elicit early identification of behavioral issues from parents.
Main Methods:
- Cross-sectional survey of parents of children aged 11-39 months from a healthy birth cohort.
- Utilized the Infant-Toddler Social Emotional Assessment to identify elevated problematic behavior symptoms.
- Assessed parental worry regarding behavior and collected demographic data.
Main Results:
- Only 17.7% of parents with elevated problematic behavior symptoms discussed these concerns with a provider.
- Parental worry (OR, 3.47) and low child social-emotional competence (OR, 2.68) were associated with discussing behavior problems.
- Low child competence (OR, 2.18) and disrupted family routines (OR, 2.38) predicted parental worry.
Conclusions:
- Parental worry is a significant predictor of help-seeking for child behavior problems.
- Deficits in social-emotional competence contribute to parental concern and the likelihood of seeking help.
- Systematic inquiry by healthcare providers is vital for identifying early behavioral health issues in children.
Objectives:
To better understand the predictors of parental discussions with pediatric care providers (pediatricians, psychologists/psychiatrists, social workers, early intervention providers, or other medical specialists) regarding early child behavior problems and to suggest strategies for eliciting early identification from parents in health care settings.
Design:
A cross-sectional survey of parents of children from a representative healthy birth cohort. The survey included the Infant-Toddler Social Emotional Assessment, measurement of parental worry regarding problematic behavior, and demographic factors.
Setting:
Fifteen urban and suburban towns in the northeastern United States.
Participants:
The study sample consisted of all parents of 11- to 39-month-olds (n = 269) who exceeded the 90th percentile on 1 or more Infant-Toddler Social Emotional Assessment problem domain scores (representing elevated problematic behavior symptoms) from an original sample of 1278.
Results:
Few parents (17.7%) who reported elevated problematic behavior spoke to a provider about such problems. In adjusted models, speaking to a provider was associated with reported worry about behavior (odds ratio [OR], 3.47 [95% confidence interval (CI), 1.74-6.92]) and with low reported child social-emotional competence (OR, 2.68 [95% CI, 1.23-5.84]). In adjusted models, worry was most likely among parents who reported low child competence (OR, 2.18 [95% CI, 1.07-4.22]) and disruption in family routines attributed to the child's behavior (OR, 2.38 [95% CI, 1.31-4.33]).
Conclusions:
Parental worry is a robust predictor of help seeking among parents of children with behavioral problems. Further, lags in social competence contribute to both parental worry and help seeking. These findings, in conjunction with previous evidence that child behavior problems amenable to early intervention are often unidentified, suggest that systematic inquiry by health care providers about parental concerns is important in the identification of early emerging behavioral health problems.
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