The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care

COLEMAN, WILLIAM L.; Dobbins, Mary I.; Garner, Andrew S.; Siegel, Benjamin S.; Wood, David L.; Earls, Marian F.; Brown, Ronald T.; Kupst, Mary Jo; Martini, Daniela; Sheppard, Mary N.; Cohen, George J.; Smith, Karen; Foy, Jane Meschan; Duncan, Paula M.; Frankowski, Barbara L.; Kelleher, Kelly J.; Knapp, Penelope; Laraque, Danielle; Peck, Gary Q.; Regalado, Michael; Swanson, Jack; Wolraich, Mark L.; Dolan, Melissa; Joffe, Alain; O’Malley, Patricia J.; Perrin, James M.; McInerny, Thomas K.; Wegner, Lynn M.; Carmichael, Terry; Gruttadaro, Darcy; Sigman, Garry; Sullivan, Myrtis; Sulik, L. Read; Paul, Linda B.

doi:10.1542/peds.2009-1061

Cited by 303 publications

(79 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We suggest that clinicians use such reflective phrases as “I wonder what (s)he was thinking” or “how did that make you feel,” as the basis for intervening and providing an example of sensitive, responsive caregiving by the pediatric HCP to the family. This approach is consistent with the call by the AAP for more narrative interview assessments in pediatric primary care visits (Hagan et al, 2001) and incorporation of mental health expertise (Committee on Psychosocial Aspects of Child Family Health & Task Force on Mental Health, 2009). …”

Section: Reflective Stancesupporting

confidence: 68%

Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care

Ordway¹,

Webb²,

Sadler³

et al. 2015

Journal of Pediatric Health Care

View full text Add to dashboard Cite

The current state of science suggests that safe, responsive, and nurturing parent-child relationships early in children’s lives promotes healthy brain and child development and protection against lifelong disease by reducing toxic stress and promoting foundational social-emotional health. Pediatric healthcare providers (HCP) have a unique opportunity to foster these relationships. However, such a role requires a shift in pediatric healthcare from a focus only on children to one that includes families and communities as well as the inclusion of children’s social and emotional health with their physical health. To foster healthy parent-child relationships, HCPs must develop the expertise to integrate approaches that support family’s socioemotional health into pediatric primary care. This article suggests ways in which pediatric HCPs can integrate a focus on parental reflective functioning into their clinical work, helping parents to understand some of the thoughts and feelings that underlie their children’s behavior.

show abstract

Section: Reflective Stancesupporting

confidence: 68%

Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care

Ordway¹,

Webb²,

Sadler³

et al. 2015

Journal of Pediatric Health Care

View full text Add to dashboard Cite

show abstract

“…In terms of clinical practice, pediatricians are well positioned to provide consultation to parents of children with cognitive delay on methods to deal with their children’s behavior problems, as well as conduct parental mental health screenings. Although not a part of routine pediatric care, there is support for integrating maternal mental health screenings into pediatric practice 42, 43 and addressing barriers to such screenings (e.g., lack of time, training and reimbursement) 44, 45 may help ensure that mothers are adequately screened and referred to services. Such efforts are important for women’s health in its own right, but are also likely to mitigate the deleterious consequences of maternal depression 46, 47 to children’s well-being and positively impact children’s developmental progress.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Children's Cognitive Delay and Behavior Problems on Maternal Depression

Palta

Poehlmann

Witt

2015

The Journal of Pediatrics

View full text Add to dashboard Cite

Objective To determine the impact of children’s cognitive delay and behavior on maternal depressive symptoms using a large, national cohort of US families. Study design Data were from two waves of the nationally-representative Early Childhood Longitudinal Study, Birth Cohort (n=7,550). Cognitive delay was defined at 24 months by the lowest 10th percentile of the Bayley Short Form-Research Edition. At age 4 years, child behavior was assessed by the Preschool and Kindergarten Behavior Scales, administered to mothers and primary non-parental child care providers, and maternal depressive symptoms with the Center for Epidemiologic Studies Depression Scale. Weighted generalized estimating equation models examined whether children’s behavior mediated the relation between their cognitive delay status at 24 months and four-year maternal depressive outcomes. Results At age 4 years, 26.9% of mothers children with cognitive delay reported high depressive symptoms compared with 17.4% of mothers of typically developing children (p<.0001). When children’s behavior was accounted for, the effect of cognitive delay on maternal depressive symptoms decreased by 36% (p<.0001). Findings remained significant when children’s behaviors were assessed by their primary non-parental care providers. Conclusions Caring for a child with a cognitive delay influences maternal depressive symptoms in part through children’s behavior problems. Preventive interventions to ameliorate adverse outcomes for children with cognitive delay and their families should consider the impact of children’s behavior.

show abstract

“…Recommendations and guidelines have been published to encourage pediatric PCPs to increase screening for MH problems. 4,5 …”

mentioning

confidence: 99%

Parent Reports of Mental Health Concerns and Functional Impairment on Routine Screening With the Strengths and Difficulties Questionnaire

Biel

Kahn

Srivastava

et al. 2015

Academic Pediatrics

View full text Add to dashboard Cite

Objective This study used the Strengths and Difficulties Questionnaire (SDQ) to describe the prevalence of parent-reported mental health (MH) concerns in youth presenting for primary care appointments and to examine relationships between children’s MH issues and functional impairment. We hypothesized that increased MH symptomology would be associated with increased impairment and family burden. Methods Parents of 4–17 years old children were approached at routine visits in 13 primary care sites. Chi-square tests, independent samples t-tests, and a one-way analysis of variance (ANOVA) were used to make comparisons between demographic groups. Age-, sex-, and race-adjusted ordered logistic regression models and ANOVAs examined relationships between impact and SDQ scales. Results Boys had higher total Hyperactivity and Peer Problems. Adolescents showed higher Emotional Symptoms, while younger children showed more Hyperactivity. Latinos reported more Conduct Problems, Hyperactivity, and Peer Problems. Latinos also indicated less distress on the child, impairment at home and school, and family burden. Regression analyses indicated increased odds of impairment with higher scale scores. MH symptoms identified with the SDQ in pediatric primary care settings were associated with parent-reported impairment affecting youth and their families. Conclusions The presence of significant impairment suggests that parents’ concerns identified by screening are likely to be clinically important and worthy of practice strategies designed to promote assessment, treatment, and referral for these common problems. Identifying and exploring parents’ concerns with strategic use of screening tools may allow PCPs to directly engage families around the MH issues that affect them most.

show abstract

The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care

Cited by 303 publications

References 61 publications

Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care

Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care

The Influence of Children's Cognitive Delay and Behavior Problems on Maternal Depression

Parent Reports of Mental Health Concerns and Functional Impairment on Routine Screening With the Strengths and Difficulties Questionnaire

Contact Info

Product

Resources

About