Background: Preschool-aged children with social-emotional (SE) problems (e.g., behavior problems, delayed social competencies) are at high risk for later psychopathology. To develop protocols for addressing SE development in primary care, a better understanding is needed of the scope of the problem and parental attitudes toward potential interventions.
Objectives: To estimate prevalence of SE problems among preschool-aged children in a low-income clinical population, to explore correlates of SE problems, and to assess families’ receptivity to referrals to services that promote health SE development.
Methods: 254 parents of 3- and 4-year-old children at two primary care clinics completed a standardized screen for SE problems (Ages and Stages Questionnaire: Social-Emotional (ASQ:SE)). Additional questions addressed childcare arrangements, parental depressive symptoms, and attitudes toward preschool and behavioral health referrals. Descriptive and chi-squared statistics and logistic regression were used to analyze the data.
Results: The sample was 91% Medicaid. 24% (95% CI 16.5-31.5%) of children screened positive for SE problems. 27% of parents screened positive for depression. 99% of parents reported they “would welcome” or “would not mind” a referral to preschool. Among parents of children who screened positive for SE problems, 79% reported they would welcome or would not mind a referral to a counselor or psychologist; only 16% had been referred previously.
Conclusions: One in four low-income preschool-aged children screens positive for SE problems, and most parents are amenable to referrals to preschool or early childhood mental health. This represents an opportunity for improvement in primary prevention and early intervention.