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The family APGAR and psychosocial problems in children: a report from ASPN and PROS
J M Murphy1, K Kelleher, M E Pagano
1Child Psychiatry Service, Massachusetts General Hospital, Boston 02114, USA.
Insights
Lack of family social support is linked to child psychosocial problems. The Family APGAR tool, however, is not sensitive enough to detect these issues, highlighting the need for comprehensive assessments.
Area of Science:
- Pediatric Health
- Family Medicine
- Psychosocial Research
Background:
- Investigated the relationship between family social support and the identification of child psychosocial issues.
- Examined sociodemographic and symptom characteristics associated with psychosocial problems in children.
Purpose of the Study:
- To determine if low social support, measured by the Family APGAR, correlates with parent and physician identification of child psychosocial problems.
- To assess the utility of the Family APGAR in identifying children with psychosocial dysfunction.
Main Methods:
- National study involving 9626 children (ages 4-15) during outpatient medical visits.
- Parents completed the Family APGAR and Pediatric Symptom Checklist (PSC).
- Physicians assessed for new or recurrent psychosocial problems.
Main Results:
- Children from low social support families were 4.3x more likely to have impaired PSC scores and 2.2x more likely to be identified by physicians.
- Low social support was associated with lower parental education, single-parent status, and child mental health service history.
- 50% of children with identified psychosocial problems came from low social support families, but only 21% of those identified had poor Family APGAR scores.
Conclusions:
- A lack of family social support is significantly associated with child psychosocial dysfunction.
- The Family APGAR is a supplementary tool but not a sensitive standalone measure for child psychosocial problems.
- Comprehensive psychosocial assessments are crucial for accurate identification and intervention.
Background:
Our study examined whether the lack of social support as measured by the Family APGAR was related to parents' and physicians' identification of child psychosocial problems and sociodemographic and symptom characteristics of the children screened.
Methods:
The parents of 9626 children, ages 4 to 15 years, seen for outpatient medical visits participated in this national study. Parents completed the Family APGAR and the Pediatric Symptom Checklist (PSC), a measure of psychosocial dysfunction. Physicians rated the presence of a new or recurrent psychosocial problem in the child.
Results:
Children from families with a lack of social support were 4.3 times as likely to receive scores indicating impairment on the PSC and 2.2 times as likely to be identified as having psychosocial problems by physician report. Families with low social support were significantly more likely to report low parental educational achievement, single parent status, and a history of mental health services for the child. Fifty percent of children from families with low social support were identified as having a psychosocial problem by either the PSC or physician rating, or both; however, only 21% of the children identified with psychosocial impairment by these two measures had scores indicating poor family functioning on the Family APGAR.
Conclusions:
A lack of family social support is associated with child psychosocial dysfunction as assessed by two different measures. However, the Family APGAR was not a sensitive measure of child psychosocial problems, and thus it supplements, but does not replace, information concerning the child's overall psychosocial functioning.