Social-emotional problems in preschool-aged children: opportunities for prevention and early intervention

Arch Pediatr Adolesc Med. 2012 Oct;166(10):926-32. doi: 10.1001/archpediatrics.2012.793.


Objectives: To estimate the prevalence of positive screens for social-emotional problems among preschool-aged children in a low-income clinical population and to explore the family context and receptivity to referrals to help guide development of interventions.

Design: Observational, cross-sectional study.

Setting: Two urban primary care clinics.

Participants: A total of 254 parents of 3- and 4-year-old children at 2 urban primary care clinics.

Main outcome measures: Score on a standardized screen for social-emotional problems (Ages and Stages Questionnaire: Social-Emotional) and answers to additional survey questions about child care arrangements, parental depressive symptoms, and attitudes toward preschool and behavioral health referrals.

Results: Twenty-four percent (95% CI, 16.5%-31.5%) of children screened positive for social-emotional problems. Among those screening positive, 45% had a parent with depressive symptoms, and 27% had no nonparental child care. Among parents of children who screened positive for social-emotional problems, 79% reported they would welcome or would not mind a referral to a counselor or psychologist; only 16% reported a prior referral.

Conclusions: In a clinical sample, 1 in 4 low-income preschool-aged children screened positive for social-emotional problems, and most parents were amenable to referrals to preschool or early childhood mental health. This represents an opportunity for improvement in primary prevention and early intervention for social-emotional problems.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child Behavior Disorders / diagnosis*
  • Child Behavior Disorders / epidemiology
  • Child Behavior Disorders / therapy
  • Child Care / methods
  • Child Care / statistics & numerical data
  • Child, Preschool
  • Counseling
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Early Medical Intervention
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Ohio / epidemiology
  • Parents / psychology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Poverty*
  • Prevalence
  • Primary Health Care*
  • Psychological Tests
  • Referral and Consultation* / statistics & numerical data
  • Social Behavior Disorders / diagnosis*
  • Social Behavior Disorders / epidemiology
  • Social Behavior Disorders / therapy
  • Surveys and Questionnaires
  • Urban Health / statistics & numerical data
  • Urban Health Services
  • Young Adult