Title
Identification and management of psychosocial problems among toddlers in Dutch preventive child health care
Author
Reijneveld, S.A.
Brugman, E.
Verhulst, F.C.
Verloove-Vanhorick, S.P.
Publication year
2004
Abstract
Objectives: To assess the degree to which preventive child health professionals (CHPs) identify and manage psychosocial problems among preschool children in the general population and to determine the association with parent-reported behavioral and emotional problems, sociodemographic factors, and mental health history of children. Design: The CHPs examined the child and interviewed the parents and child during their routine health assessments. The Child Behavior Checklist (CBCL) was completed by the parents. Setting: Sixteen child health care services across the Netherlands that routinely provided well-child care to nearly all preschool children. Patients: Of 2354 children aged 21 months to 4 years who were eligible for a routine health assessment, 2229 (94.7%) participated. Main Outcome Measures: Identification and management of psychosocial problems by CHPs. Results: In 9.4% of all children, CHPs identified psychosocial problems. Two in 5 of the CHP-identified children were referred for additional diagnosis and treatment. Identification of psychosocial problems and subsequent referral were much more likely in children with a clinical CBCL total problems score than in others (identification: 29% vs 7%; odds ratio [95% confidence interval], 5.40 [3.45-8.47]; referral: 15% vs 3%; odds ratio [95% confidence interval], 6.50 [3.69-11.46]). Conclusions: The CHPs frequently identify psychosocial problems in preschool children, although less than among school-aged children, but they miss many cases of parent-reported problems as measured by a clinical CBCL score. This general population study shows substantial room for improvement in the early identification of psychosocial problems.
Subject
Health
Behavior disorder
Child behavior
Child psychiatry
Demography
Emotional disorder
Parent
Patient referral
Preschool child
Psychosocial disorder
Affective Symptoms
Age Distribution
Child Behavior Disorders
Child Health Services
Child, Preschool
Educational Status
Family Characteristics
Female
Health Care Surveys
Humans
Infant
Logistic Models
Male
Netherlands
Odds Ratio
Population Surveillance
Preventive Health Services
Referral and Consultation
Risk Factors
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DOI
https://doi.org/10.1001/archpedi.158.8.811
TNO identifier
237930
ISSN
1072-4710
Source
Archives of Pediatrics and Adolescent Medicine, 158 (8), 811-817
Document type
article