Promoting Optimal Development: Screening for Behavioral and Emotional Problems


By current estimates, at any given time, approximately 11% to 20% of children in the United States have a behavioral or emotional disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Between 37% and 39% of children will have a behavioral or emotional disorder diagnosed by 16 years of age, regardless of geographic location in the United States. Behavioral and emotional problems and concerns in children and adolescents are not being reliably identified or treated in the US health system. This clinical report focuses on the need to increase behavioral screening and offers potential changes in practice and the health system, as well as the research needed to accomplish this. This report also (1) reviews the prevalence of behavioral and emotional disorders, (2) describes factors affecting the emergence of behavioral and emotional problems, (3) articulates the current state of detection of these problems in pediatric primary care, (4) describes barriers to screening and means to overcome those barriers, and (5) discusses potential changes at a practice and systems level that are needed to facilitate successful behavioral and emotional screening. Highlighted and discussed are the many factors at the level of the pediatric practice, health system, and society contributing to these behavioral and emotional problems.

Source: Pediatrics, American Academy of Pediatrics

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Developmental and Behavioral Screening Initiative


Maximizing the health and developmental potential of children and families in the United States is an urgent priority—developmental and behavioral challenges are associated with lower scores on developmental assessments as well as later behavior issues and lower academic achievement.[1] Recent statistics indicate that 1 in 6 children have a developmental disability in the United States. Young children who live in families with incomes below the Federal Poverty Level are even more likely to have a developmental delay.[2]

Effective promotion of healthy child development and wellness is best achieved early in a child’s life with well-coordinated, multi-sector coordination of services and communication with families. Public awareness of typical child development and risks for delay, developmental and behavioral screening, early identification of delays as well as linkages to referral and follow up services can be delivered anywhere young children and families spend time–in the home and in communities through a range of programs and services.

The Departments of Health and Human Services and Education have partnered to launch a public awareness campaign—targeted at numerous sectors (e.g. early care and education, medical, primary health care, child welfare, mental health) —highlighting the importance of universal developmental and behavioral screening and support within the context of normative child development. The package of materials that will be launched as part of the public awareness campaign will include the following:

1.      A compendium of first line screening instruments for children, birth to 5 years, will list pertinent information, including cost, administration time, quality level, training required, and age range covered, on a host of high quality screening instruments.

2.      Multiple “User’s Guides” for developmental and behavioral screening and support, each tailored to early care and education programs, pediatricians, home visitors, social workers, mental health professionals, and various other relevant partners, will describe the importance of screening, how to talk to parents, where to go for help, and how to select the most appropriate tool for the population served as well as the provider implementing the screen.

3.      An electronic package of resources for follow-up and support to help children, parents and providers through the process. This collection of federal resources includes materials, information, and contact information from each partner agency and relevant grantees, that will serve to bring awareness to parents and providers about general early child development, how and where to get help if a concern exists, tips and techniques to help children with disabilities or delays, and free online training modules on a range of topics.

Source: Administration for Children and Families

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