Identification of children with psychosocial problems differed between preventive child health care professionals

Area of Science:

• Child and Adolescent Psychiatry
• Public Health
• Pediatrics

Background:

• Psychosocial problems in children are a significant concern for Preventive Child Health Care (PCH) professionals.
• Variability in identifying these problems among healthcare providers may impact early intervention and care.
• Understanding the sources of this variability is crucial for standardizing child mental health assessments.

Purpose of the Study:

• To determine if differences in the identification of psychosocial problems among individual PCH professionals exceed chance variation.
• To investigate whether parent-reported problems or risk indicators explain these inter-professional differences.
• To analyze the impact of child characteristics, such as scores on the Child Behavior Checklist (CBCL), on identification rates.

Main Methods:

• Utilized data from three community-based studies involving 3,170 Dutch children aged 8-12 years.
• Parents completed the Child Behavior Checklist (CBCL) and demographic questionnaires.
• PCH professionals recorded identification of psychosocial problems post-examination; multilevel logistic regression analyzed inter-professional differences.

Main Results:

• Significant variations in psychosocial problem identification rates were observed among PCH professionals (P<0.001).
• These differences were not attributable to parent-reported problems or demographic risk indicators.
• The greatest discrepancies in identification occurred for children scoring above the CBCL clinical cut-off point.

Conclusions:

• Individual PCH professionals exhibit differing propensities to identify psychosocial problems in children.
• These variations persist independently of parent-reported issues or other identified risk factors.
• The findings underscore the need for further investigation into factors influencing PCH professionals' diagnostic judgments.