The Pediatric Symptom Checklist. Support for a role in a managed care environment

Area of Science:

• Pediatric Health
• Psychosocial Development
• Primary Care Pediatrics

Background:

• Psychosocial problems are common in children attending primary care.
• Identifying risk factors is crucial for early intervention and prevention of morbidity.

Purpose of the Study:

• Identify risk factors for psychosocial dysfunction in primary care pediatric settings.
• Explore the relationship between risk factors and pediatrician-identified psychosocial problems.
• Evaluate the utility of the Pediatric Symptom Checklist (PSC).

Main Methods:

• Retrospective review and cross-sectional, case-referent survey.
• Data collected from 72 children (aged 6-12) across three diverse primary care clinics.
• In-depth structured and clinical interviews conducted.

Main Results:

• Single-parent and economically disadvantaged children showed higher psychosocial impairment.
• PSC demonstrated high specificity (100%) in lower socioeconomic status samples and high sensitivity (95%) in middle-class samples.
• Pediatricians identified more problems in children with familial mental illness/substance abuse or abuse history.

Conclusions:

• Pediatricians should screen for psychosocial dysfunction, particularly in single-parent and low-income families.
• The Pediatric Symptom Checklist can efficiently target resources for early identification and secondary prevention.
• Utilizing the PSC in managed care can improve psychosocial morbidity outcomes.