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Detection of behavioral, developmental, and psychosocial problems in pediatric primary care practice
1Department of Pediatrics, St. Francis Hospital and Medical Center, Hartford, CT 06105-1299.
Insights
Pediatric primary care providers can improve early detection of behavioral and developmental issues in children. Strategies include parent input, history taking, observation, and utilizing screening tools for better child health outcomes.
Area of Science:
- Child development
- Pediatric primary care
- Behavioral health
Background:
- Pediatric primary care providers are uniquely positioned for early detection of child behavioral, developmental, and psychosocial problems.
- Existing research indicates that many of these significant issues are often missed or detected late.
Purpose of the Study:
- To highlight the importance of early detection of behavioral and developmental problems in children within primary care settings.
- To suggest strategies for enhancing the identification of these issues by healthcare providers.
Main Methods:
- Eliciting parental concerns and opinions.
- Obtaining comprehensive behavioral and developmental histories.
- Observing parent-child interactions.
- Consulting with other professionals (e.g., preschool teachers).
- Utilizing parent questionnaires and developmental screening tools.
- Developing a primary care-specific classification system.
Main Results:
- Early detection of behavioral and developmental problems in children is frequently suboptimal.
- Proactive elicitation of parental concerns and detailed history taking are crucial.
- Observational skills and interprofessional collaboration enhance detection rates.
- Screening tools and a tailored classification system can aid surveillance.
Conclusions:
- Pediatric primary care settings are vital for the early identification of children's behavioral and developmental challenges.
- Implementing specific strategies, including enhanced surveillance and tailored tools, can significantly improve detection rates.
- A primary care-focused classification system could further support early intervention and management.
Abstract:
By virtue of their ongoing relationship with families and young children, pediatric primary care providers are well positioned to participate in the early detection of children's behavioral, developmental, and psychosocial problems. Yet research suggests that many such problems elude early detection. Awareness of the prevalence of such problems should encourage pediatric providers to carefully elicit parents' opinions and concerns, obtain a relevant behavioral and developmental history, skillfully observe parent and child behaviors, and obtain, when indicated, the opinions of such other relevant professionals as preschool teachers. Possible strategies to improve early detection include the use of parent questionnaires, parent record-keeping of children's behavior, and a developmental screening tool as an aid to surveillance. The development of a classification system for such problems designed for primary care, rather than psychiatry, should also facilitate early detection.