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Screening for disruptive behaviour problems in preschool children in primary health care settings
Alice Charach1,2, Stacey Ageranioti Bélanger1, John D McLennan2
1Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario.
Insights
Early identification of disruptive behaviors in preschoolers is crucial for preventing neurodevelopmental and mental health disorders. Prompt intervention, including parent behavior training, can significantly improve outcomes for children with behavioral challenges.
Area of Science:
- Child psychology
- Developmental pediatrics
- Mental health screening
Background:
- Disruptive behavior problems in preschoolers are linked to neurodevelopmental and mental health disorders.
- While some disruptive behaviors are normal, problematic levels require early identification and intervention.
- Early intervention can positively impact developmental trajectories.
Purpose of the Study:
- To provide an approach for early identification of disruptive behavior problems in preschool children.
- To guide practitioners in assessing the clinical significance of disruptive behaviors.
- To outline management strategies for preschool disruptive behaviors.
Main Methods:
- Clinical screening during periodic health examinations.
- Systematic mental health examinations with standardized measures.
- Consideration of environmental, developmental, family, and parent-child relationship factors.
Main Results:
- A systematic approach to screening and examination aids in identifying problematic disruptive behaviors.
- Evaluation of multiple factors is essential for determining clinical significance.
- Management options range from monitoring and guidance to specialized interventions.
Conclusions:
- Early identification and intervention for disruptive behaviors in preschoolers are vital.
- A comprehensive assessment considering various factors is necessary.
- Evidence-based interventions like parent behavior training and specialized care are recommended for effective management.
Abstract:
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some noncompliance, temper tantrums and aggression between 2 and 5 years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when accompanied by functional impairment and/or significant distress, should be identified because early intervention can improve outcome trajectories. This position statement provides an approach to early identification using clinical screening at periodic health examinations, followed by a systematic mental health examination that includes standardized measures. The practitioner should consider a range of environmental, developmental, family and parent-child relationship factors to evaluate the clinical significance of disruptive behaviours. Options within a management plan include regular monitoring, accompanied by health guidance and parenting advice, referral to parent behaviour training as a core evidence-based intervention, and referral to specialty care for preschool children with significant disruptive behaviours, developmental or mental health comorbidities, or who are not responding to first-line interventions.
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