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Published on: August 25, 2014
Preschool parent-pediatrician consultations and predictive referral patterns for problematic behaviors
John H Fanton1, Brittany MacDonald, Elizabeth A Harvey
1Department of Psychiatry, Baystate Medical Center, Springfield, MA, USA. john.fanton@bhs.org
Insights
Pediatricians can identify persistent preschool behavior problems, but many children with ADHD or ODD do not receive early referrals. Early intervention is crucial for behavioral disorders.
Area of Science:
- Child Psychology
- Pediatric Medicine
- Behavioral Health
Background:
- Preschool behavior problems are common and can indicate developmental disorders.
- Early identification and intervention are critical for positive long-term outcomes.
Purpose of the Study:
- To investigate parental reports on pediatrician consultations for preschool behavioral issues.
- To analyze the nature and outcomes of pediatric interventions for disruptive behaviors.
Main Methods:
- Longitudinal study involving parental reports on preschool children's behavioral problems.
- Analysis of pediatrician consultation frequency and intervention types.
Main Results:
- Children later diagnosed with ADHD or ODD received different interventions at age 4.
- 89% of referred children met ADHD/ODD criteria, but 56% of diagnosed children were not referred by age 4.
Conclusions:
- Pediatricians show some ability to distinguish transient from persistent behavioral issues.
- A significant number of children with behavioral problems do not receive timely early assistance or referrals.
- Further research is needed on pediatrician interventions and resources for children with behavioral problems.
Objective:
The present study examined parents' reports of the frequency, nature, and outcome of pediatrician consultation and interventions about significant preschool behavior problems.
Method:
Parents were asked whether they consulted with their pediatric providers about disruptive behavioral problems during a longitudinal study of preschool children.
Results:
Eighty 4-year-old children had parents who had consulted with their pediatricians versus 90 children whose parents did not. Children who eventually met criteria for attention-deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) 2 years later, received different pediatric interventions at age 4 years than children who did not have a diagnosis, chi (2) = 9.28, based on parent report. Eighty-nine percent of children who were referred for evaluation or treatment by pediatricians later met criteria for ADHD or ODD. However, 56% of children who later met criteria for ADHD or ODD were not referred by age 4 years.
Conclusion:
Pediatricians were able to differentiate between preschool children with transient versus persistent behavioral problems significantly better than chance, though a large number of children with behavioral problems were not provided with early assistance or referrals. Additional research is needed to obtain data directly from pediatricians about their interventions and resources for this vulnerable population.
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