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Screening for psychosocial problems in 4-5-year-olds during routine EPSDT examinations: validity and reliability in a
M Pagano1, J M Murphy, M Pedersen
1Child Psychiatry Service, Massachusetts General Hospital, Boston 02114, USA.
Insights
The Pediatric Symptom Checklist (PSC) effectively screens young Hispanic children for psychosocial issues during well-child visits. This tool helps meet federal screening requirements for early detection and intervention.
Area of Science:
- Child Psychology
- Pediatric Healthcare
- Public Health Screening
Background:
- Federal Medicaid/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mandates require psychosocial screening for children.
- Preschool-aged children, particularly those from low-income backgrounds, may benefit from early identification of psychosocial challenges.
Purpose of the Study:
- To evaluate the Pediatric Symptom Checklist (PSC) as a tool for psychosocial screening in low-income, preschool-aged Hispanic children.
- To determine if the PSC meets federal EPSDT screening requirements for this population.
Main Methods:
- A study involving 117 low-income Hispanic children aged 4-5 years old was conducted during well-child examinations.
- The Pediatric Symptom Checklist (PSC) was administered and results were correlated with parental ratings and clinician referral decisions.
Main Results:
- The PSC identified 7% of preschool children as at risk for psychosocial problems.
- PSC scores showed significant associations with parental assessments of functioning and clinician referral decisions.
- High reliability (Cronbach's alpha = .87) was observed across different formats (English, Spanish, oral, written).
Conclusions:
- The Pediatric Symptom Checklist (PSC) is an effective screening measure for psychosocial problems in preschool-aged Hispanic children.
- The PSC can assist healthcare providers in meeting EPSDT requirements during routine well-child visits.
- While identifying a slightly lower rate than in older children, the PSC demonstrates utility for early psychosocial screening.
Abstract:
The effectiveness of the Pediatric Symptom Checklist (PSC) as a psychosocial screening measure to meet Federal Medicaid/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) requirements was examined in 117 low-income preschool (aged 4-5 years old) Hispanic children during well-child examinations in three clinics over an 8-month period. The PSC identified 7% of the sample as at risk for psychosocial problems. The PSC was significantly associated with parental ratings of the children's problems in functioning, with pediatric clinicians' decisions to make mental health referrals, with degrees of associations similar to those found between PSC scores, and with the same measures with school-aged children in the same clinics. Cronbach's alpha was high (r = .87) and virtually identical in English, Spanish, oral, and written formats. Although it identified a slightly lower rate of psychosocial problems in 4-5-year-olds than it had in school-aged children, the PSC appeared to provide an effective method of screening for psychosocial problems during EPSDT examinations.