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Screening for behavioral and emotional problems in primary care pediatrics
K A Merritt1, R J Thompson, B R Keith
1Duke University Medical Center, Department of Psychiatry, Durham, North Carolina 27710.
Insights
The Missouri Children's Behavior Checklist (MCBC) improved behavioral problem identification in children compared to pediatricians. Including child reports alongside mother reports enhances screening accuracy in pediatric care.
Area of Science:
- Child Psychology
- Pediatric Behavioral Health
- Screening Tools
Background:
- Accurate identification of behavioral and emotional problems in children is crucial for timely intervention.
- Current screening methods in pediatric settings often rely on maternal or clinician reports, potentially missing key indicators.
Purpose of the Study:
- To compare the effectiveness of the mother-completed Missouri Children's Behavior Checklist (MCBC) with pediatrician identification for behavioral problems.
- To examine factors influencing case identification, including child gender, age, and maternal education.
Main Methods:
- Compared MCBC case identification indexes with pediatrician identification in 41 children undergoing well-child examinations.
- Used DSM-III diagnoses, determined via Child Assessment Schedule interviews, as the diagnostic criterion.
- Analyzed the influence of child gender, age, and maternal education on identification rates.
Main Results:
- The MCBC demonstrated superior case identification indexes compared to pediatrician identification.
- MCBC showed improvements in both overidentification and underidentification rates.
- Pediatrician identification was positively correlated with maternal education, while MCBC identification was inversely correlated with child age.
Conclusions:
- The mother-completed MCBC is a more effective tool for identifying behavioral and emotional problems in pediatric primary care.
- Integrating child self-report with maternal report in screening procedures is essential for comprehensive and accurate assessment.
- Findings underscore the need for multi-informant approaches in pediatric behavioral screening.
Abstract:
Case identification indexes based on the mother-completed Missouri Children's Behavior Checklist (MCBC) were compared with pediatrician identification of behavioral and emotional problems in 41 children seen for well-child examinations. Case identification indexes also were examined as a function of child gender and age and maternal education. The criterion was presence of DSM-III diagnoses determined through Child Assessment Schedule interviews of child or mother. The MCBC yielded better case identification indexes and improvements in both overidentification and underidentification rates. Pediatrician identification indexes were directly related to maternal education and MCBC identification indexes were inversely related to child age. The findings indicate the necessity for including child report, as well as mother report, in screening procedures that are incorporated into primary care pediatric practice.