Screening for behavioural problems in children aged 3 to 5 years
Betty Del Rio Rodriguez1,2, Deepa Dongarwar2, Hamisu M Salihu2,3
1Academic General Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Insights
Behavioral screening in young children, especially when combined with parental input, significantly increases the likelihood of diagnosing behavioral problems and receiving medication treatment.
Area of Science:
- Pediatric Health
- Behavioral Science
- Public Health
Background:
- Early identification of behavioral problems in children aged 3-5 is crucial for timely intervention.
- Current rates of formal behavioral screening in this age group are low.
- Understanding factors influencing diagnosis and treatment is essential for improving pediatric care.
Purpose of the Study:
- To investigate the association between behavioral screening and diagnosis of behavioral problems in children 3-5 years old.
- To explore factors associated with treatment choices (counseling vs. medication) for diagnosed behavioral problems.
- To assess the impact of formal and informal screening methods.
Main Methods:
- Cross-sectional data analysis of the 2017-2018 US National Study of Children's Health.
- Inclusion of 7837 children aged 3-5 years.
- Statistical analysis using Pearson's chi-squared test and survey binomial logistic regression.
Main Results:
- Combined formal and informal screening was associated with a tenfold increase in the likelihood of diagnosing behavioral problems.
- Children with behavioral problems who underwent both formal and informal screening were five times more likely to receive medication treatment.
- Informal screening alone was associated with a fourfold increase in diagnosis likelihood.
Conclusions:
- Formal behavioral screening rates are low in 3-5 year olds.
- Combining formal screening with informal methods (e.g., addressing parental concerns) is linked to higher diagnosis rates.
- Integrated screening approaches may influence treatment decisions, particularly favoring medication.
Objective:
We aim to investigate the association between undergoing behavioural screening and having a diagnosis of behavioural problems and to explore factors associated with receiving treatment with counselling versus medication in children 3 to 5 years old.
Methods:
This cross-sectional data analysis consisted of children 3-5 years old from the US National Study of Children's Health, 2017-2018. Pearson's χ2 test was used to assess the association between formal and informal screening and having a behavioural problem. Prevalence of behavioural screening, behavioural problems, and covariates were calculated. Survey binomial logistic regression was used to evaluate the association between formal and informal screening and treatment with counselling versus medication in children with behavioural problems.
Results:
A total of 7837 children 3-5 years old were included in the analysis. Combined formal and informal screening for behavioural problems was 18.1%, 12.3% of children had informal screening only, and 10.8% had formal screening, as reported by parents. Five percent of children had a diagnosis of behavioural problem, for which 6.8% had formal screening only, 16.5% had informal screening only, and 58% had both. Children who had both types of screening were about 10 times as likely to have behavioural problems, and about 4 times as likely if they only had informal screening. Children with behavioural problems who had both types of screening were about 5 times as likely to be treated with medication.
Conclusion:
Formal behavioural screening was low in children 3 to 5 years old but, when done in conjunction with informal screening such as addressing parental concerns, was associated with a diagnosis of behavioural problems and receipt of treatment with medication.
