Workforce Development to Enhance the Cognitive, Affective, and Behavioral Health of Children and Youth: Opportunities and Barriers in Child Health Care Training

Abstract

Responsibility for cognitive, affective, and behavioral (CAB) health of children and adolescents (hereafter "youth") has traditionally been shared among families, education systems, communities, and the health care delivery system. Within routine child health care, increasing but spotty attention is paid to early cognitive, emotional, and behavioral development. Those most intensively trained in emotional development and the clinical behavioral sciences (e.g., child and adolescent psychiatrists and psychologists, behavioral and developmental pediatricians, and social workers) have historically been segmented from routine child health care. Roles of behavioral clinicians have focused largely on treating those who have troublesome or disabling CAB disorders. Relatively less attention has been paid by any segment of the health care field to CAB health promotion and disorder prevention, starting early in life, or even to early detection and intervention for behavioral problems of youth who do not meet diagnostic criteria (NRC and IOM, 2009b). Much of the innovation in this area has been carried out by prevention scientists who have created evidence-based interventions, primarily targeting activities in community settings, and has not focused on opportunities within primary or subspecialty child health care settings. Preventive interventions adapted for child health care settings and training programs are nascent and will require a revision of training goals and curricula as well as a reorganization of practice for successful implementation.

Resilience in Children: Developmental Perspectives

“…The American Board of Pediatrics’ (ABP) annual report for 2017 highlighted the need to improve child health professionals’ skills with behavioral and mental health screening, prevention, and management, and the ABP continues to mobilize training efforts in this area [ 98 ]. In collaboration with the AAP and ABP, the National Academy of Medicine (NAM) developed ten training themes for the future child health workforce to advance children’s cognitive, affective, and behavioral development, including “recognize and mitigate risks for children’s healthy development” and “build on family strengths to promote wellness, resilience, and child care capacity”, [ 99 ]. Ongoing work in this area includes a 2018 NAM-ABP roundtable in which pediatric department chairs and residency program directors met to discuss how to best evolve training along these lines.…”

Promoting emotional wellness in children with cystic fibrosis, Part I: Child and family resilience

“…Having integrated mental health coordinators on CF teams has been a much‐needed first step toward improving whole person and whole‐family care. However, all team members must embrace the goals of greater patient and family behavioral health and capacities to build a supportive infrastructure 100 . Understanding that family wellness will be the foundation for the child's healthy behavioral development, medical care routines, and self‐management skills should provide a convincing rationale for all team members.…”

An examination of the factor structure of TeamSTEPPS measures in school mental health teams

“…types of healthcare providers. Since counsellors and other school mental health team members typically have not received training in teamwork (Boat et al, 2016;National Academies of Sciences, Engineering, and Medicine, 2017) and do not work within medical settings, these distinct dimensions may be less relevant. Second, the use of a total score for these measures may be more appropriate for all groups than dimensions scores as the measure developers recommend.…”