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Parent report of child behaviour: Findings from the Flint Registry cohort
Nicole Jones1, Jacqueline Dannis2, Lauren O'Connell1
1Division of Public Health, Department of Pediatrics and Human Development, Michigan State University and Hurley Children's Hospital Pediatric Public Health Initiative, Flint, Michigan, USA.
Insights
Flint children show significant behavioral challenges, with nearly half scoring high on behavior problem assessments. This highlights a critical need for comprehensive evaluations and support services for these children.
Area of Science:
- Pediatric Environmental Health
- Child Psychology
- Public Health Surveillance
Background:
- Flint children face numerous risks for behavioral issues, including lead exposure from the water crisis.
- The extent of behavioral health challenges among these children remains largely unknown.
- Data from the Flint Registry is crucial for understanding behavioral outcomes and resource allocation.
Purpose of the Study:
- To evaluate the population-level burden of parent-reported child behavior problems.
- To assess behavioral outcomes for children enrolled in the Flint Registry.
Main Methods:
- Cross-sectional study of 3579 children (ages 2-17) in the Flint Registry (Dec 2018-Dec 2020).
- Utilized Behavior Assessment System for Children (BASC-3) and Behavior Rating Inventory of Executive Function (BRIEF2) parent rating scales.
- Compared demographic data with census data and BASC-3 scores with national norms.
Main Results:
- Nearly half of the children exhibited clinically concerning scores on BASC-3 (44.7%) and BRIEF2 (46.7%).
- Children generally presented with lower adaptive skills and higher behavior symptoms across age and sex groups.
- Demographics indicated high rates of socioeconomic vulnerability (79.7% eligible for free/reduced lunch).
Conclusions:
- A substantial burden of parent-reported behavioral problems exists among Flint children in the Registry.
- Findings suggest a significant number of children may require neuropsychological evaluations and services.
- Longitudinal surveillance is essential to monitor long-term effects of environmental exposures and provide ongoing support.
Background:
Children in Flint, Michigan, have multiple risk factors for behavioural challenges, including exposure to lead during the Flint water crisis. However, their behavioural health status is largely unknown. Robust data from the Flint Registry can help understand the burden of behavioural outcomes and inform the allocation of resources.
Objectives:
This population-level evaluation of Flint children's behavioural outcomes aims to answer the question: What is the burden of parent-reported child behaviour problems in Flint Registry enrolled children?
Methods:
This cross-sectional study describes parent-reported behavioural outcomes of children 2-17 years old who enrolled in the Flint Registry between December 2018 and December 2020. Parents/guardians completed behavioural assessments including the Behavior Assessment System for Children (BASC-3) Parent Rating Scale and Behavior Rating Inventory of Executive Function (BRIEF2) Screening Parent Form. Demographics of enrolees were compared with census data. Composite BASC-3 T scores were compared with national norms. Distributions for clinically relevant categories of BASC-3 and BRIEF2 scores were examined across age and sex groups.
Results:
Of the 3579 children included in this study (mean age 9.73 ± 3.96 years), about half were female and 79.7% were eligible for free or reduced-price lunch. Almost half of the children were reported to have clinically concerning scores on the BASC-3 Parent Rating Scale (44.7%) and the BRIEF2 Screening Parent Form (46.7%). Across most age and sex groupings, the reported adaptive skills were relatively low and behaviour symptoms relatively high.
Conclusions:
Results reveal a substantial burden of parent-reported behavioural problems in Flint Registry children. This is clinically significant and indicates that a large number of children may require comprehensive neuropsychological evaluation and potential medical and/or educational services. Recognising the potential for long-term manifestations of childhood exposures to environmental hazards, longitudinal surveillance is critical to continue to identify and support participants.
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