Activities » Identifying Children and Families at Risk

Early identification is essential for three reasons. First, in terms of brain development, quality early relationships and experiences can positively affect gene function, neural connections, and the organization of the mind, having lifelong positive effects.1 Second, once established, social and emotional problems are highly resistant to change.2 It is not surprising that a strong relationship exists between childhood social and emotional problems, delinquency, and later criminality.3 Third, the costs associated with antisocial and criminal behavior are staggering. Targeted interventions may improve outcomes and save subsequent social costs, such as those incurred in juvenile justice programs.4

To improve the accuracy and efficiency of developmental surveillance, it is important to use formal screening measures in addition to observation and interview. Screening tests also need to be repeated over time to improve the effectiveness of the screening process. Having parents complete a simple questionnaire may improve the accuracy of the screening process while empowering them and conserving valuable professional resources. Parents may provide information that they would not otherwise share and may provide more complete information with a small investment of professional time.

This section will include resources that summarize current guidelines and recommendations and that offer suggestions for improving developmental and behavioral health services for young children.  It will include suggestions for identifying and selecting screening tools.  It will also provide information on engaging and working with primary care practices to implement developmental screening, including establishing learning collaboratives of practice-based teams, developing training modules for individual pilots and practices, identifying “physician experts” to serve as mentors to primary care providers, and partnering with provider organizations that provide direct support to practices. 

Sources:
1. Shonkoff J, Phillips D (eds): From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, D.C., National Academy Press, 2000

2. Walker HM, Sprague JR: The path to school failure, delinquency, and violence: Causal factors and some potential solutions. Intervention in School and Clinic 2000;35(2):67

3. Dishion T, French D, Patterson G: The development and ecology of antisocial behavior, in Cicchetti D, Cohen D (eds): Developmental Psychopathology, Vol. 2: Risk, Disorder, and Adaptation. New York, John Wiley and Sons, 1995, pp 388–394

4. Wildman B, Kizilbush A, Smucker W: Physicians' attention to parents' concerns about the psychosocial functioning of their children. Arch Fam Med 1999;8(5):440

• State-specific Resources produced by ABCD Consortia States for Identifying Children and Families at Risk
• Peer-reviewed literature for Identifying Children and Families at Risk
• Technical assistance Resources produced by NASHP and The Commonwealth Fund for Identifying Children and Families at Risk
• Other Resources for Identifying Children and Families at Risk