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Do child healthcare professionals and parents recognize social-emotional and behavioral problems in 1-year-old
Jaana Alakortes1,2, Susanna Kovaniemi3,4, Alice S Carter5
1PEDEGO Research Unit, Clinic of Child Psychiatry, University of Oulu, P.O. Box 26, 90029, Oulu, Finland. jjalakortes@gmail.com.
Insights
Early identification of infant social-emotional/behavioral (SEB) problems is low. Combining child healthcare nurse and parental concerns improved detection but still missed many infants needing attention. Routine screening is recommended.
Area of Science:
- Pediatric Healthcare
- Developmental Psychology
- Child Mental Health
Background:
- Clinically significant social-emotional/behavioral (SEB) problems are increasingly recognized in infants.
- A significant number of these early SEB issues go undetected by healthcare professionals.
- Early identification is crucial for timely intervention and improved long-term outcomes.
Purpose of the Study:
- To assess the identification rates of infant SEB problems by child healthcare nurses (CHCNs) and parents.
- To evaluate the effectiveness of combining multiple informant reports for detecting SEB concerns.
- To explore the utility of screening tools like the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) in preventive child healthcare.
Main Methods:
- Cross-sectional study involving 1008 CHCNs and 518 parents of 12-month-old infants in Finland.
- Collected data on SEB worries from CHCNs and parents.
- Utilized maternal and paternal BITSEA ratings to assess SEB problems and competencies.
Main Results:
- Low reporting rates of SEB worries: 1.4-1.8% by CHCNs, 3.9% by mothers, and 3.2% by fathers.
- Combined reports from CHCNs and parents identified SEB worries in 7.7% of infants.
- Even combined reports identified only 7.0-13.8% of infants with concerning BITSEA ratings.
Conclusions:
- Current identification of early infant SEB problems in primary care is insufficient.
- Combining multiple informants increases detection but remains suboptimal.
- Routine use of validated screening tools like BITSEA is recommended to enhance early identification and intervention for infant SEB issues.
Abstract:
Growing evidence supports the existence of clinically significant social-emotional/behavioral (SEB) problems among as young as 1-year-old infants. However, a substantial proportion of early SEB problems remain unidentified during contacts with child healthcare professionals. In this study, child healthcare nurse (CHCN; N = 1008) and parental (N = 518) reports about SEB worries were gathered, along with the maternal and paternal Brief Infant-Toddler Social and Emotional Assessment (BITSEA) ratings, for 12-month-old infants randomly recruited through Finnish child health centers. Only 1.4-1.8 % of CHCNs, 3.9 % of mothers, and 3.2 % of fathers reported of being worried about the assessed child's SEB development. When the CHCNs' and parental reports were combined, 7.7 % (33/428) of the infants assessed each by all three adults had one (7.0 %), two (0.7 %) or three (0 %) worry reports. Even the combination of the CHCN's and parental worry reports identified only 7.0-13.8 % of the infants with the maternal and/or paternal BITSEA Problem or Competence rating in the of-concern range. Identified associations across the three informants' worry reports, parental BITSEA ratings and sociodemographic factors are discussed in the paper. Routine and frequent use of developmentally appropriate screening measures, such as the BITSEA, might enhance identification and intervening of early SEB problems in preventive child healthcare by guiding both professionals and parents to pay more attention to substantial aspects of young children's SEB development and encouraging them to discuss possible problems and worries.
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