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Arch Pediatr Adolesc Med. 2004 Aug;158(8):811-7.

Identification and management of psychosocial problems among toddlers in Dutch preventive child health care.

Author information

1
TNO (Netherlands Organisation of Applied Scientific Research) Prevention and Health, Leiden, the Netherlands. S.A.Reijneveld@med.rug.nl

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.

PMID:
15289256
DOI:
10.1001/archpedi.158.8.811
[Indexed for MEDLINE]

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