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AAP urges regular behavioral and emotional problem screenings

The American Academy of Pediatrics declared a need for more behavioral screenings to reliably diagnose and treat behavioral and emotional problems in children and adolescents, described barriers to behavioral screenings and issued guidance for implementation, according to a recent clinical report published in the journal, Pediatrics.

“Developmental and behavioral health disorders are now the top five chronic pediatric conditions causing functional impairment,” Carol Weitzman, MD, FAAP, and Lynn Wegner, MD FAAP of the AAP’s Section on Developmental and Behavioral Pediatrics, Committee on Psychosocial Aspects of Child and Family Health, Council on Early Childhood and Society for Developmental and Behavioral Pediatrics, wrote.

Costello and colleagues estimated that approximately 11% to 20% of children in the U.S. have a behavioral or emotional disorder at any given time. Often times, these common problems go undetected and are frequently not treated properly. In a study of over 200 practices by Gardner and colleagues, 50.2% of clinicians report never using any formal measure to assess mental health. Lack of confidence in training and ability to manage children’s mental health problems, along with a lack of time, long wait times and lack of referable mental health providers all contribute to the absence of standardized screenings, according to several papers.

Due to these issues, the AAP recommends these guidelines successful implementation of behavioral and emotional screenings:

• prepare and train staff for adoption of screening practices;
• identify available resources for when a child or parent has a positive screening result;
• establish routines to ensure that children are screened at regular intervals;
• track referrals to learn if services were obtained, were effective and reduced or eliminated symptoms;
• implement ways to seek payment for additional time needed to screen patients; and
• take advantage of collaborations for further assistance such as colocations and integrated and consultative models, especially when a subthreshold problem does not meet the severity level for referring the child to a psychiatrist (eg, Massachusetts Child Psychiatry Access Project, Washington Partnership Access Line).

“The lessons learned through developmental screening implementation have been used to make behavioral and emotional screening a more routine component of pediatric health supervision. Investments described in this report, financial and otherwise, are critical to ensure a future of thriving and strong infants, children and adolescents who will mature into healthy adults,” the researchers wrote.

References:

Costello EJ, et al. Arch Gen Psychiatry. 2003;60:837-844.

Gardner W, et al. Ambul Pediatr. 2003;3:191-195.

Horwitz SM, et al. Pediatrics. 2007;119:e208-e218.

Olson AL, et al. Ambul Pediatr. 2001;1:91-98.

Stancin T, et al. J Dev Behav Pediatr. 1997;18:183-194.

Disclosures: Healio.com/Internal Medicine could not confirm relevant financial disclosures at the time of publication.