SummaryBackground: Emotional and behavioural problems emerging in very young children can represent a challenge to the child and family and warrant early identification and appropriate support or intervention. Diagnostic systems are being developed that allow for specific difficulties to be identified and this review summarises them. The review describes the psychometric properties and potential for use in clinical practice of a range of instruments and methods that are available to identify infant mental health difficulties, and which may be suitable for use in primary care settings, including observations, questionnaires and checklists.Conclusions: While debate continues about whether infant mental health problems can or should be identified, the use of standardised tools may help clinicians to compare observations of infants so that those emerging as atypical can receive additional attention, reflecting a more targeted approach to primary care services (DH 2009;DH 2010).Keywords: infancy, measurement, mental health, assessment.
Key practitioner messages:2 Infant mental health is a complex developmental area and attempts to create classification or diagnostic systems are still ongoing and subject to debate. However, they can provide a useful framework for clinicians. There have been challenges to the identification of early-onset mental health problems related to stigma and the possibility that problems may be transient. Infant emotional and behavioural difficulties are strongly related to the environment and in particular to parental behaviour and the dynamics intrinsic to infant-parent relationships. A range of assessment methods is available including structured and semistructured interviews, questionnaires, checklists, and methods that look at the nature of parent-infant relationships. Many of the most robust methods, such as observational strategies, require extensive training to administer and code and are more applicable for research than routine practice. Structured checklists such as the ASQ-SE and the BITSEA are among those with good potential for use in primary care practice.